How to Deal with Constipation During Pregnancy

When you become pregnant, rising levels of the hormone progesterone slow your digestive system to a snail’s pace, and for good reason: your body is absorbing the extra nutrients and fluids it needs to grow a healthy baby. The result, though, is harder stools that are more difficult to pass. This happens so early that it is the first sign of pregnancy for some women, says Suzanne Wong, an OB/GYN at Toronto’s St. Joseph’s Health Centre.

In your second and third trimesters, pressure from your growing uterus on your bowels can exacerbate the problem in your digestive tract. Plus, the extra iron and calcium in your prenatal vitamins are binding, so they’re not doing your situation any favors, either. And if you suffered from constipation prior to pregnancy, there’s a good chance you’ll suffer in pregnancy. “The risk of becoming constipated is enhanced if you have a predisposition to it,” says Wong.

While it can make you feel all sorts of awful, it’s rare constipation will lead to anything dangerous. The most severe cases might result in hemorrhoids and anal fissures and other bottom troubles, caused by pressure on the veins around the rectum. These cause pain and discomfort but don’t put you or your baby in any danger. And there are plenty of natural ways to curb constipation and pass stool before it gets to that point—prevention, says Wong, is key.

The best line of defense, according to Calgary registered midwife Nicola Strydom, is threefold: a high-fiber diet, plenty of fluids and moderate physical activity. There are other constipation solutions to try, too.

Eat a high-fiber diet

“We recommend whole grains and at least five portions of fruits and vegetables a day,” says Strydom. For some, that’s easier said than done: “I couldn’t stand greens while pregnant,” says Hedrick. “The absence of them likely contributed to my constipation.”

But there are enough high-fiber foods that if you develop an aversion to one, you can surely pick up the pace with another. Consider dried fruit, hummus, oatmeal, lentils and bran. If you don't get enough fiber in your diet, you can add a supplement like this unflavored fiber powder to smoothies, soups and other foods.

Drink plenty of fluids

It’s recommended that women drink 10 cups of fluids daily during pregnancy, but if you think that much water is too much to down, don’t worry—other liquids count too. Often something warm first thing in the morning, like herbal tea or hot lemon water, is enough to get things going. Drinking enough water is the best way to fight chronic constipation.

Try moderate physical activity

You needn't embark on a complicated or time-consuming exercise routine to solve your constipation woes. Experts say adding a 20- to 30-minute walk each day can be enough to stimulate digestion. This free, easy solution is one of the best ways to get bowels to move through your intestines regularly.

Change or add supplements

If you’re eating well and exercising, and you’re still constipated, Strydom suggests changing vitamins until you find a brand that’s less constipating. A fiber supplement like Metamucil can also get you out of your bind and is considered safe in pregnancy. Never take a laxative or stool softener to treat constipation, though, without first speaking with your health care provider, says Wong.

While Hedrick found temporary relief in water and All-Bran (“I sprinkled it on everything,” she says), long-term relief didn’t come until after delivery when she was able to return to her pre-pregnancy diet, which included “a lot of dark, leafy greens” as opposed to “fully loaded cheeseburgers.” Despite her experience, though, Hedrick says she’d do it all over again: “There are no pregnancy discomforts that could have held me back from having children,” she says.

Don’t resist the urge to go

If you suddenly get the urge to go, it’s important not to ignore it. According to  Johns Hopkins University, suppressing the urge will only exacerbate constipation, so it's essential to respond to your body's natural signals and go to the bathroom when the need arises.

But you also won’t want to push when you are trying to go. This can make hemorrhoids worse. Instead, consider adopting a squatting position or utilizing a toilet stool to help you go. These methods can facilitate a more comfortable and natural bowel movement.

Add probiotics to your diet 

Probiotic-rich foods like sauerkraut and yogurt naturally contain beneficial gut bacteria. However, you can also supplement your diet with probiotic capsules or powders. These probiotic supplements help maintain an optimal level of healthy gut microbes, promoting regular bowel movements.

A 2022 study published in the Molecules journal found that probiotics can increase the frequency of weekly bowel movements and reduce the time it takes for food to travel through the digestive system, leading to more consistent bowel regularity.

Use laxatives carefully 

Using laxatives might seem like an easy solution for constipation, but it's important to be cautious.

According to a 2012 study in the Canadian Family Physician journal, pregnant women who overuse laxatives could face serious health issues, such as dehydration and electrolyte imbalances.

It's also important to note that not all laxatives are created equal. The Cleveland Clinic advises that certain laxatives, including those containing castor oil and mineral oil, should not be used during pregnancy unless a healthcare provider specifically recommends them.

Delivery doesn’t necessarily mean an end to your constipation woes. (And be warned: the first bowel movement post-delivery can require some courage. If you delivered vaginally, your perineal area is still healing, and you'll want to be careful not to disturb any stitches.)

The combination of extra iron supplements (to make up for any blood loss), narcotics (in the case of a C-section), limited mobility (because, well, you just had a baby) and a fear of pain while straining to go can all contribute to postpartum constipation.

If this is the case, says Wong, the same rules of pregnancy constipation apply: stick to high-fiber foods (aim for 25 grams a day), hydrate and move around as much as you can. And finally, if you're offered a stool softener like Colace right after delivery, accept it. Trust us on this one.

Steer clear of stimulant laxatives and anything that may cross your placenta or breastmilk barriers. You'll be well on your way to regular bowel movements before you know it.

This article was originally published in August 2017 and has since been updated.