Constipation during pregnancy: What causes it and how to keep things moving

Along with the glowing skin and lush locks that pregnancy brings, there are also the not-so-beautiful experiences like constipation.

Some mums even experience severe pain from constipation during pregnancy.

What causes this? And are there solutions to this unpleasant problem?

This article will tackle these issues and give mums-to-be suggestions to ease severe pain from constipation during pregnancy.

Constipation during pregnancy: What causes it?

First, you should know that constipation in pregnancy is quite common.

There are several factors that can contribute to constipation, including changes in hormones, diet and physical activity. 

Physiological changes

During pregnancy, there are several physiological changes that occur in a woman's body that can contribute to constipation. These changes include decreased maternal activity and increased progesterone levels.

As with many other pregnancy issues, constipation is mainly caused by pregnancy hormones. Specifically, progesterone.

Progesterone is a hormone that helps relax the muscles in the uterus to accommodate the growing foetus, but it can also relax the muscles in the intestines.

While this gives extra time for nutrients to absorb into your system, at the same time, it may cause a "poop traffic jam".

Constipation in pregnancy can start very early, almost as soon as your progesterone levels start rising.

Increased iron intake

Iron supplements are commonly prescribed to pregnant women to prevent or treat iron deficiency anaemia.

However, iron supplements can also cause constipation as they slow down the process of digestion.

It's essential to consult with a healthcare provider before taking iron supplements to ensure the dosage is appropriate for individual needs.

Diet

A low-fibre diet is a common culprit for causing constipation during pregnancy.

When you don't get enough fibre in your diet, your digestive system slows down, and your stools can become hard and difficult to pass.

Lack of physical activity

When you're not active, your bowel movements may slow down, and waste can build up in your digestive system, leading to constipation.

Exercise helps stimulate the muscles in your digestive system, which can promote regular bowel movements.

Some pregnant women feel sluggish during the day, which leads to a lack of physical activity.

Your pelvic floor muscles and your growing baby

The pelvic floor muscles play an important role in maintaining bowel regularity.

During pregnancy, these muscles can become weakened due to the weight of the growing uterus, leading to constipation.

Constipation symptoms

As mentioned earlier, constipation can begin in the first trimester, and the condition continues throughout your pregnancy. Here are some of the common symptoms of constipation among pregnant women:

• Irregular bowel movement – you can only poop a few times a week.
• Straining when you poop, and your belly feels swollen and gassy.
• Lumpy, hard and dark stools. They're so dry that passing them is painful.

Severe pain from constipation during pregnancy

Even when not pregnant, we've all dealt with constipation at some point. But for some women, constipation during pregnancy can result in excruciating pain.

Here are three reasons for severe pain from constipation during pregnancy:

Gas: This is caused by the slowing down of your digestion process. This gas can cause severe pain, either in your belly or through your chest and back.

Anal fissures: When you push and strain to pass large, hard stools, the lining of your anus can rip and tear. This wound is known as an anal fissure and can cause extreme pain.

Nerve injury: If your bowels are distended because of constipation, this can put pressure on your sciatic nerve (this nerve runs from the lower back down the back of each leg). The result? Severe pain.

All the pressure that builds up in your belly because of constipation may make you anxious about your baby's situation.

Can constipation hurt the baby during pregnancy?

In a word: No.

Unless you are becoming severely dehydrated or unwell, constipation is an extremely common problem during pregnancy, especially in the first trimester when your digestive system adjusts to new hormone changes.

It's not uncommon to feel bloated, gassy and even nauseous, but those symptoms aren't likely to hurt your baby.

Possible complications of constipation during pregnancy

While generally not a serious issue, constipation while pregnant can lead to some uncomfortable complications such as haemorrhoids and anal fissures.

Haemorrhoids are swollen veins in the rectal area that can cause pain, itching and bleeding, while anal fissures are small tears in the lining of the anus that can cause pain during bowel movements.

In severe cases, constipation during pregnancy can also lead to faecal impaction, a condition where hardened stool becomes stuck in the rectum and can't be expelled.

This can cause severe pain and discomfort and requires medical attention to resolve.

It's important for pregnant women to talk to their healthcare provider if they're experiencing constipation to discuss the best course of treatment and prevent complications.

When should I be worried about constipation during pregnancy?

The first trimester is a time of exciting change and discovery. But that doesn't mean it's easy, especially if you're experiencing constipation during pregnancy.

So what should you do about your constipation? How can you tell if it's something to worry about?

The good news is, most of the time, constipation in pregnancy is completely normal and nothing to worry about.

If you've experienced constipation before or since becoming pregnant, it's probably just part of being pregnant.

But if it happens suddenly or gets worse over time, that's when you should start to worry. So how do you know if your constipation is serious? Here are some signs:

• You have a hard time passing stool.
• When trying to pass stool, you feel cramps in your lower abdomen or pelvic area.
• You experience bleeding from the rectum (either during bowel movements or afterwards).

How to ease constipation during pregnancy

The best way to relieve the pain brought about by constipation is to make changes in your lifestyle. This includes adopting a high-fibre diet, becoming physically active and drinking lots of water.

However, if constipation persists even after a lifestyle change, your doctor may prescribe some laxatives to soften your stools or a fibre supplement to aid digestion.

Avoid taking any medication without your doctor's advice. Home remedies for constipation, like castor oil or mineral oil, should not be taken during pregnancy unless your doctor recommends you take them.

Is it ok to push hard to poop while pregnant?

It's okay to push hard to poop while pregnant.

As your body expands, it can make it more difficult to go. And if you're constipated, you may be tempted to push harder and harder… but don't!

Pushing too hard can cause haemorrhoids or even tear the anal muscles. So instead of pushing, try relaxing your pelvic muscles and pushing gently. This will help move things along without causing damage.

If you're still having trouble after trying this method for a few days, consult with your doctor or midwife about other options that can help relieve symptoms of constipation during pregnancy.

Can I take stool softeners while pregnant?

According to the American Pregnancy Association, some stool softeners, such as Colace (docusate sodium), may be safe to use during pregnancy under the guidance of a healthcare provider.

How to avoid constipation in pregnancy

Mums-to-be, there's no need to suffer through nine months of severe pain from constipation due to pregnancy. Here's what you can do to prevent it:

1. Eat more fibre

Foods rich in fibre help you get rid of waste better, preventing constipation. You should try to eat 25 to 35 grammes of fibre a day. Here's an example of the amounts of vegetables that will provide around 25 grammes of fibre:

• 1 cup of carrot slices, cooked = 5 grammes of fibre
• 1 cup of cooked broccoli = 4.5 grammes of fibre
• 1 cup of raw carrots = 4 grammes of fibre
• 1 sweet potato = 4 grammes of fibre
• 1 cup of cauliflower, cooked = 3 grammes of fibre
• 2 cups of raw spinach leaves = 1.4 grammes of fibre

You can boost this by switching to whole-grain bread and cereals and eating plenty of fruits (tip: kiwi and prunes are great for easing constipation). Add some psyllium husk to your meals for a further boost of fibre.

Avoid refined foods (eg white bread, white rice, pasta and cereals), which can worsen things.

Remember, before making any radical changes to your diet, you should always check with your doctor first.

2. Drink more fluids

If you are increasing your fibre intake, it's even more important to increase the number of fluids you drink.

Ideally, this fluid should be water, and you should drink around 10 to 12 cups daily. Avoid fizzy drinks like soda, bottled juices (too much sugar) and excessive caffeine.

3. Exercise

Regular exercise during pregnancy – even a 10-minute walk – can encourage bowel movements.

4. Smaller, frequent portions

We know pregnancy can make you very hungry. But resist downing three large meals, which can cause stress on your digestive system.

Instead, try eating six small meals. You'll find that with this, you also experience less gas and bloating.

5. Watch your supplements

We're not telling you to stop taking your prenatal vitamins. But sometimes, the extra iron and calcium that are found in some prenatal supplements can make constipation worse.

According to BabyCenter, pregnant women need more iron than non-pregnant women to support the growth and development of their baby. The recommended daily intake of iron for pregnant women is 27 milligrams (mg) per day, which is almost double the amount needed by non-pregnant women (18 mg per day).

However, it's important to talk to your healthcare provider before taking any iron supplements as taking too much iron can be harmful.

Speak to your doctor about an alternative (like slow-release iron supplements), as well as taking a magnesium supplement, which could help.

6. Be wary of laxatives

It might be tempting to take an over-the-counter laxative to ease constipation, but don't do this. Please speak to your doctor first, and go with their advice.

Can prune juice help with constipation?

Prune juice can help with constipation, but it's not a miracle cure.

To understand why prune juice is helpful for constipation, you need to know what causes constipation in the first place.

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The most common cause of constipation is dehydration, which can happen when you don't drink enough water or eat too much salt.

When your body becomes dehydrated, it doesn't have enough fluids to move waste out of your intestines. This waste builds up and causes constipation.

While drinking prune juice (or eating dried plums) won't solve dehydration issues, it can help flush out some of that excess waste and make you more comfortable while you wait for your body to rehydrate itself naturally.

In conclusion, constipation during pregnancy is a common issue that many women face, but it doesn't have to be a source of discomfort and pain.

By making simple lifestyle changes such as incorporating more fibre, staying hydrated and engaging in regular physical activity, pregnant women can prevent and manage constipation.

Additionally, it's important to talk to your healthcare provider if you're experiencing constipation during pregnancy, as they can offer personalised advice and guidance on the best course of treatment.

With a healthy lifestyle and the support of a trusted healthcare provider, women can keep things moving smoothly throughout their pregnancy.

This article was first published in theAsianparent.