Women often experience mild to severe constipation at any stage of pregnancy, but more commonly in early pregnancy (1).
Is Constipation an Early Sign of Pregnancy?
Constipation is considered one of the earliest signs of pregnancy, especially when it occurs along with nausea, dizziness, mood swings and food cravings (4).
Symptoms of Constipation in Pregnancy
Symptoms of constipation (3):
- Less than three bowel movements in one week
- Hard feces making it difficult to pass, feeling like some feces has remained in the rectum
- Occasional rectal bleeding due to hard feces
- Decreased appetite
- Lower abdominal bloating, pain or cramps.
When you are experiencing repeated rectal bleeding or abdominal pain, visit your doctor, because these may be symptoms of a serious health condition, such as intestinal inflammation or parasites.
Constipation Causes in Early Pregnancy?
- Increased production of the hormone progesterone, which relaxes the muscles of the intestinal wall, which makes it less capable of moving waste materials (1).
- Oral iron supplements (5)
- Dehydration (1)
- Lack of exercise (1)
Constipation Causes in the Late Pregnancy
- The same causes as in early pregnancy
- The enlarged uterus pressing upon the intestine and rectum during later stages of pregnancy (2).
- Tailbone pain or pelvic pain during pregnancy
Women prone to constipation in general are more likely to be constipated during pregnancy.
Natural Remedies to Relieve Constipation During Pregnancy
- Squeeze half a lemon into a glass of lukewarm water and drink the mixture every morning to have a smoother bowel movement (4).
- Eating plenty of dry fruits, such as prunes (or prune juice), dates and raisins (4).
- Drinking other fruit juices can also help with the symptoms.
How to Maintain Regular Bowel
Try to have bowel movements regularly, a good time is every morning after breakfast.
Try to maintain regular sleeping and eating schedule.
Exercise regularly. Swimming (7) or walking for around 20-30 minutes at least 2 to 3 times every week stimulates bowel motility. Yoga may help to reduce stress.
Drink enough water (or coconut water) to keep you well hydrated (6). However, there is no need to exaggerate with water. More than 300 mL of translucent or yellow urine in the morning and tense skin on the back of your hand which becomes flat immediately when you pinch and release it are few signs of good hydration.
Include some foods high in fiber in your diet: whole-grain breads or cereals, brown rice, beans and peas, fresh vegetables and fruits. Fruits and vegetables most useful for this purpose include prunes, kiwi, peas and beans. NOTE: Large amounts of foods, high in soluble fiber, such as barley or oat bran, can cause unpleasant bloating.
Avoid or limit these foods:
- Foods low in fiber, such as fried potatoes, white bread, toasted or popped cereals, large amounts of meat, cheese, chocolate or sweets
- Foods very high in calcium, such as cheese, certain mineral waters, calcium-fortified cereals and juices.
- Foods, which have particles or fiber that may stick in your bowel: sunflower, pumpkin, watermelon seeds or other seeds with shells, oranges with large amount of white fibrous threads.
Supplements that may be associated with constipation:
- Oral iron supplements (which are also part of prenatal vitamins) may cause constipation in some women (1,4). Try to increase the intervals between your iron supplement dosages or spread out the dosage throughout the day. You can cut the tablet in halves, taking one half in the morning and the other in the evening. You can also ask your doctor to prescribe a vitamin supplement with lower iron levels or ask for iron injections.
- Unless your doctor specifically recommends you, avoid excessive amounts of calcium supplements and calcium or aluminum antacids (1,11,12).
Laxatives Safe for Treatment of Constipation During Pregnancy
Bulk Forming Laxatives
- Docusate sodium or calcium (14)
- Magnesium hydroxide (milk of magnesia) (10)
- Magnesium sulfate (16)
- Lactulose (pregnancy B category — no adverse effects in animals, but not tested in humans) (13). Lactulose may cause excessive gas (flatulence) (8).
- Sorbitol (15)
Stimulant laxatives may cause abdominal cramps and should be used only when other laxatives are not effective (8).
NOTE: None of the above treatment options and home remedies should be used unless they are approved by your doctor. Seek immediate medical attention if you are experiencing serious complications such as rectal bleeding and hemorrhoids.
Laxatives to Avoid During Pregnancy
- Polyethylene glycol (category C — may harm the baby) (9)
- Magnesium citrate is category C pregnancy drug (17)