Bowel Movements During Pregnancy
and How to Prevent Constipation

By Dr. Ritu Krishnatreye, BHMS
Bowel movements during pregnancy

A woman’s body goes through several changes during pregnancy. Her appetite, sleep, bowels and even energy levels are affected and she may notice mild to severe changes in normal body functions.

During pregnancy, changes in bowel movements are common. This is because the entire digestive system is affected by hormonal changes. 

Most women experience difficulty in passing stools during pregnancy. Constipation during pregnancy is a common problem that affects more than half of pregnant women at some point during pregnancy.

The good new is, bowel changes during pregnancy can be fairly well managed with some simple and easy measures.

Bowel movements during early pregnancy

Bowel movements are not usually affected much during the first trimester. However, there are two factors that can contribute to constipation during this time.

1. Progesterone, a hormone that helps to maintain the pregnancy, can result in constipation. It helps to relax the smooth muscles of the uterus and to relax blood vessels, but it also relaxes colon muscles, taking away some of their ability to move fecal matter through the colon.
   
   As stool transit time is slowed down, more moisture is extracted from fecal matter, increasing the chance of constipation. 
   
   
2. Morning sickness is another contributing factor to constipation during early pregnancy. Some women may experience nausea and vomiting, which in turn may cause some dehydration, as well as affect their dietary habits.
   
   Not getting enough fiber in one’s diet and not eating as much can both result in slower stool transit times, which can lead to dry, hard stools that are difficult to pass.
   

Bowel movements during the second trimester

The second trimester can be characterized by sluggish bowel movements and constipation. 

1. Iron and calcium supplements are prescribed during pregnancy to cope up with the increasing demand. These two nutrients are vital during pregnancy, but they have tendency to cause constipation.
    
2. As a woman’s tummy expands, she may become less active, which can contribute to constipation. In fact, there are medical reasons that may necessitate bed rest even as early as the first trimester.
   
   
3. Pregnancy may cause some extra stress, and stress has been proven to contribute to constipation.  

Bowel movements during the third trimester

1. As the pregnancy progresses, the uterus continues to grow, which puts an extra pressure on the colon, including the rectum. This pressure can cause restrictions in the colon, increasing stool transit times, resulting in constipation. 
   
   
2. With the advancement of pregnancy, a woman can become even less active, contributing to more of a constipation problem. 

Bowel movements after delivery

After delivery, things may be a little strange the first time a woman needs to empty her bowels, especially for those that delivered vaginally.

It may take few days to a couple of weeks before bowel movements return back to normal. 

• Vaginal delivery may cause a stretching of the perineal and pelvic floor muscles.
  
  
• At times it is also associated with tears, bruising, swelling and may require an episiotomy (stitching vaginal tears), which may make passing stools painful.
  
  
• Shortly after delivery a woman may experience painful gas while passing stool. 
  
  
• Pain relievers used during the delivery may have an adverse affect on the colon’s ability to contract.
  
  
• Hemorrhoids may have worsened during labor, making bowel movements uncomfortable.

Steps to Maintain Normal Bowel Movements During Pregnancy

Helpful changes to one’s diet

The first step to alleviate the symptoms of constipation during pregnancy and keep one’s bowel movements normal is to eat plenty of fiber containing foods and water.

Fiber adds bulk to the fecal matter; bulk is what stimulates the wavelike contractions of the colon, called peristalsis.

To do this, add fresh vegetables, fruits, whole grains and bran cereals into your diet. Drink at least eight to ten glasses of water to help avoid dehydration, a major cause of constipation. 

Overcoming iron supplement problems

If your iron supplements are contributing to constipation, talk to your gynecologist about changing it to one that is better absorbed. Your gynecologist may also prescribe an iron supplement that contain small amount of laxatives.

Exercise can help

Unless you have been confined to bed rest, try to stay physically active.

Walking, swimming and other light activities are generally advised during pregnancy. They not only help to keep bowels functioning normally, but exercise can also help to reduce stress. 

Magnesium can help keep things moving

Take a daily magnesium supplement.

Not only is magnesium a nutrient needed by both mother and baby, magnesium also works as a natural osmotic laxative, drawing additional water into the colon.

This extra moisture helps to keep stools moist and soft, improving bowel transit time. 

Take time to talk with a friend

If you are experiencing any anxiety that may be caused by the pregnancy, work or family, talk it over with a friend. There are numerous changes ahead, and discussing these can help to reduce stress, thereby reducing constipation. 

After the delivery

Straining should be avoided right after delivery. Take plenty of fluids and get a fiber rich diet. Prune juice and bran are natural laxatives and can help with constipation.

If constipation still persists, your doctor may want to prescribe a laxative to keep stools soft and easy to pass until the bowel normalizes a bit.

Conclusion, bowel movements during pregnancy

Constipation during pregnancy is a common problem.

However, there are numerous things that a pregnant woman can do to avoid it. Give it a little extra attention, and hopefully you will be constipation free throughout pregnancy.

(Return from Bowel Movements During Pregnancy to Pregnancy and Constipation)