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Constipation in Pregnancy

by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.
Practically speaking, constipation can mean hard or infrequent bowel movements. While not a topic many people feel comfortable discussing, constipation is common in women in general and particularly a problem for pregnant women.

Three main reasons why pregnant women get constipated:
  • The pregnancy hormone progesterone slows down intestinal function, and the longer the stool sits in the large intestine, the harder and drier it gets.

  • While they have many benefits, prenatal vitamins, particularly those containing iron, are very constipating. Calcium-based antacids (like TUMS®) and calcium supplements also can lead to constipation.

  • As the uterus grows, it can press on the bowel and slow the passage of stool.

Two other factors that can potentially cause constipation after having the baby:
  • If there is pain from an episiotomy or laceration, women often feel afraid to have a bowel movement and consciously or unconsciously hold back

  • Narcotic pain medications (such as codeine) are constipating.

Non-medical treatments:

You can choose activities and diet to avoid constipation
  • Exercise regularly

  • Drink plenty of liquids

  • Increase your fiber intake. Eat fiber-rich foods such as fruits, vegetables, and high-fiber cereals. Use fiber supplements like Metamucil® or Citrucel®. Even with a healthy, balanced diet, the fiber content may not be adequate. Although you may think of Metamucil and Citrucel as laxatives, they are simply a concentrated source of fiber, and therefore safely serve a useful purpose. The powder forms work better than tablets for most people. Be sure to drink a lot of liquids! Fiber supplements are safe even if taken on a daily basis.
  • Pick a time of day to routinely try to move your bowels. Many people find that trying to have a BM after breakfast or after a cup of coffee is better than waiting until they feel the urge. Rushing around all day ignoring the mild signals you get from your body is not conducive to normal bowel function!

Medications:

Stool softeners (like Colace®) and mild laxatives like Milk of Magnesia (we call it M.O.M. in the hospital!) are safe to use during pregnancy. M.O.M. can also be used for heartburn. It is always best to avoid stimulant laxatives (like Dulcolax®, Ex-lax® and Correctol®) unless directed by your practitioner. If you are not sure about a laxative's safety, be sure to ask your practitioner.

How long will it last?

Constipation is often a problem throughout pregnancy and the postpartum period, and for many women is a lifelong struggle. Taking control of the problem early in pregnancy can save you a lot of trouble later on, and help you to enjoy your pregnancy.
 RELATED INFORMATION
*  Hemorrhoids During and After Pregnancy
*  Pregnancy & Urinary Stress Incontinence
*  Principles of Healthy Eating During Pregnancy
*  GI Symptoms in Pregnancy


Created August 11, 2000
Reviewed April 07, 2003
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