Constipation often comes as an uncomfortable and unexpected pregnancy symptom. Pregnancy constipation often accompanies bloating and is caused by a slowdown in your digestion. Hormones changes during pregnancy are the main reason your digestion slows down.
Unfortunately, constipation may occur in all three trimesters, and often appears throughout entire pregnancies. However, the good news is constipation is reasonably easy to fix so relief is possible.
Constipation is defined as having fewer than three bowel movements per week. It may also present as excessive straining to complete bowel movements. You may also experience hard, lumpy stool or feel as though you cannot completely empty your rectum when using the bathroom. If you are experiencing these symptoms, speak with your doctor at your next appointment.
Pregnancy Constipation has multiple causes. Generally, constipation is caused by too little fiber, too little water, eating foods your body doesn’t tolerate well, or inactivity. These causes are consistent during pregnancy. Another common factor with constipation during pregnancy is the high concentration of iron in prenatal vitamins. Iron is essential for a healthy baby, but can make it harder for the bacteria in your bowel to break down food, which can cause or exacerbate constipation. However, the main cause of constipation during pregnancy is a shift in your hormones.
Progesterone is the most common hormone to cause pregnancy constipation. Progesterone is secreted in your ovaries and is released throughout pregnancy. This hormone relaxes your smooth muscles, which is critical while growing and carrying a baby. However, progesterone also relaxes the muscles in your stomach, small intestine, and large intestine, which slows your digestion significantly. This slowdown in digestion also causes a slowdown in elimination.
As your pregnancy progresses and your uterus and baby grow, your growing baby begins to crowd your internal organs. Your gastrointestinal tract gets compressed, displaced, and even blocked at times. Your baby may also place pressure on your rectum, making it harder to empty its contents. These physical changes may worsen constipation later in your pregnancy.
Fortunately, constipation can be treated with modifications to your diet, lifestyle, and medication routine.
Increase Fiber Intake
Fiber is key to smooth digestion. Eating enough fiber throughout the day helps alleviate constipation, as well as the associated bloating you may experience during pregnancy. Aim for 25 to 30 grams of fiber daily to maintain optimal bowel function. Fruits, vegetables, whole grains, and beans are all dense sources of fiber.
Please note, extreme amounts of fiber may produce excess gas and leave you feeling uncomfortable. If you are interested in increasing the fiber in your diet, do so slowly until you achieve the recommended daily intake to help your digestive system adapt.
Water is the second key to smooth digestion. Without enough water, the fiber you eat will not be able to pass smoothly through and out of your body. Drinking water throughout the day helps alleviate constipation and bloating. While it may sound like a lot to drink, aim for 96 ounces of water per day to optimize digestion and elimination.
Many women also find that sipping warm beverages helps alleviate digestive symptoms that occur during pregnancy. Hot tea, warm water with lemon, or a warm ginger beverage may be soothing and effective to stimulate your digestive tract. Please note, limit caffeine during pregnancy; decaffeinated tea is your best choice.
Shift to Small, Frequent Meals
Adjusting your daily intake into smaller, more frequent meals may help relieve constipation. By spreading your food out throughout the day, your body can digest your food more completely, which allows for smoother transfer to your intestines, colon, and out of your body. Large meals (even meals that were appropriately sized before pregnancy) may be too much for your digestive system to handle at one time during pregnancy.
Eating smaller, more frequent meals also allows your body more time to digest and extract the nutrients from your food. This eating pattern will help your baby get all the nutrients he or she needs without overloading your system.
Physical activity stimulates your bowels, which can alleviate constipation. The type of activity isn’t as important as just getting your body moving. Find an activity that feels good for your changing body and make it a priority to stick with it. Aim for 20 to 30 minutes of exercise at least three days a week to stay active throughout pregnancy. As always, make sure to discuss your exercise routine with your doctor to ensure it is safe for both you and your baby.
Taking a walk after each meal is also beneficial to stimulate digestion. Even if you only have ten minutes, try using it to move!
Soften Your Stool
If adjusting your diet and lifestyle does not prove effective for treating constipation, your doctor may recommend a stool softener to use on a short-term basis during pregnancy. Stool softeners increase moisture in your bowel to make it easier to pass stool. They also help to soften hard stool, which may be challenging to pass.
Colace, and other stool softeners, are available over the counter, but they are medications, and should be discussed with your doctor before use.
Remember, each pregnancy is different. Your pregnancy symptoms may be different from those your friends or family members experience, or even different than symptoms you experienced during previous pregnancies.
One of the best things you can do is to learn your own triggers. Pay close attention to which foods and activities make you feel good, and which foods and activities make you uncomfortable or contribute to symptoms like constipation. It may also help to keep a journal of what foods you eat and what symptoms you experience.
If you are struggling to find an eating pattern that makes you feel good during your pregnancy, our team is here to help.
Liz has been reading nutrition labels since she learned how to read. Growing up with severe peanut and tree nut allergies she learned that it’s important to know what you are putting into your body. She made her first big lifestyle change as a freshman in high school, when she decided to become a vegetarian. However, it wasn’t until she took a food class in Italy as part of a study abroad program in college that it clicked in her mind that she wanted to make food and nutrition her career. Liz graduated from Penn State University in 2015 with a bachelor's degree in Nutrition, as well as a bachelor's degree in Marketing. She completed her dietetic internship with Aramark in Philadelphia, and her master's degree at Northeastern University shortly after.