Pregnancy and Constipation

By Dr. Jeeno Jayan, MBBS
Pregnancy and constipation

For most women, pregnancy is a wonderful time of life. There is nothing that can describe the feeling of a mother with a baby growing in her tummy. As the baby moves and communicates with her, she gains strength to put up with the annoyances and health issues that may arise, including constipation.

Yes, many pregnant women suffer from constipation. It can be a subject that is embarrassing to talk about. Perhaps that is why some suffer in silence until constipation becomes a major issue.

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According to Dr. Ken Troffater, director of Maternal-Fetal Medicine at the University of South Carolina, more than 50 percent of all pregnant women suffer some degree of constipation.

“It is probably second only to headaches among common
pregnancy complaints. It may be helpful to think of constipation
as ‘nature’s way’ of helping the mother to absorb the most food and
fluid from her diet she possibly can to help maintain the pregnancy.”

The standard definition of constipation is having a bowel movement less than three times per week accompanied by hard, dry stool that requires straining to eliminate.

This discomfort can start as early as the first trimester, but usually becomes more of a problem from 20 weeks on.

5 Reasons Why

Constipation Comes During Pregnancy

1. Constipation due to reduced food and water consumption

Some women are unusually prone to constipation because of dehydration or too little fiber in their diet. This can cause chronic constipation throughout the pregnancy. 

Those suffering from extreme nausea in early pregnancy may find it difficult to eat and drink enough to keep their bowels moving. Vomiting is another cause of dehydration, which can lead to hard stools.

2. Constipation due to hormonal changes

Hormonal changes which happen in a pregnant women’s body can relax certain muscles, including the colon muscles that squeeze food through the digestive tract. This slows down the movement of feces through the bowel. 

A primary cause of pregnancy and constipation is the hormone progesterone. By the end of the first trimester this hormone is produced in large amounts by the placenta. 

One of the major effects of progesterone is to cause relaxation of smooth muscles. Therefore, progesterone decreases the strength and frequency of bowel contractions.  The slower the motility of the bowel, the greater the opportunity for absorption of water. 

Unfortunately, by the time the stool reaches the rectum too much water can be absorbed, making the stool compact, hard, and difficult to pass. This may result in a woman going 4 or 5 days between bowel movements.

3. Constipation due to a modified diet

It’s important to understand that products made from white flour, like most pastas, white bread, cakes and pastries, have very little fiber. 

White rice also fits into this category, as the bran and germ have been stripped away. Without fiber, stool doesn't move very easily through the digestive tract.

Many women have specific cravings during pregnancy, and indulge in ice cream, pastries or sweets. These items can lead to constipation.

Refined foods cause constipation by creating a plaster-like substance in the bowel. This in turn can stretch the bowel, causing diverticulitis.

4. Constipation due to an iron supplement

Iron supplements are also a common cause of pregnancy and constipation. 

Normal iron supplements are not absorbed well, meaning undigested iron is makes it to the intestines. The leftover iron binds with other undigested substances to become sticky and tar like, and does not move well through the bowel. 

Increasing the amount of iron in one's diet and taking less supplemental iron may bring some relief from constipation during pregnancy.

5. Constipation due to anatomical effect

As the pregnancy progresses, the uterus enlarges, the baby’s head presses against the pelvis, and the pelvic floor relaxes.

This causes the lower intestine and rectum to become compressed, making it harder for stool to move through. As stool spends more time in the colon, more water is extracted, resulting in constipation.  (See constipation early pregnancy)

Is Constipation During Pregnancy Serious?

For most pregnant women constipation is more of an inconvenience than a major problem. However, if it persists, let your doctor know. 

Constipation can sometimes lead to hemorrhoids, which can be extremely uncomfortable.

Fortunately, hemorrhoids during pregnancy will normally resolve themselves fairly soon after the baby is born and the constipation disappears.

Be Aware of Seven Constipation Symptoms

Constipation may be a result of certain medical conditions. If a pregnant woman experiences any of the following symptoms, she should discuss and tell it with her doctor.

1. Severe abdominal distention
2. Persistent abdominal pain
3. Blood stains on feces
4. Constipation that is followed with diarrhea
5. Sudden weight loss
6. Dark or tarry stools
7. Long, thin and pencil-like stools

Remedies for Pregnancy and Constipation

Supplemental magnesium

For pregnancy and constipation, a daily magnesium supplement is usually a good option.

Magnesium is a natural mineral found abundantly in sea water. Taking a magnesium supplement during pregnancy may help prevent constipation.

Magnesium pulls water into the colon, keeping stool moist, soft and slippery. At the recommended dose, magnesium is considered safe for pregnancy.

Magnesium may be added to a morning drink or taken at bedtime, where it helps to relax the body for a good night’s sleep. For the 80% of Americans that don’t get enough magnesium in their diet, taking supplemental magnesium may also result in other health benefits.

Diet and lifestyle changes might help ease constipation

• Eat high-fiber foods such as whole grain products, high fiber cereal, fresh fruits and vegetables.
  
  
• Cut down on refined foods. Refined flour is usually used to make white bread, pasta, crackers, pastries and biscuits. If these foods are part of your daily diet, it may be a good idea to switch to healthier whole grain/whole wheat products.
  
  
• Drink plenty of water (at least six to eight glasses a day). A person may also increase fluid intake by drinking fresh fruit juice, coconut water and buttermilk. A glass of warm water with a squeeze of lime early in the morning is believed to stimulate bowel movements.
  
  
• Calorie-filled colas and sodas do not provide much nutrition, nor do they hydrate well. Avoid caffeinated products. They work as diuretics, flushing an excessive amount of water through the kidneys and out the body.
  
  
• For added constipation relief, include dried fruits like dates, prunes and raisins in the diet. Add raisins or sprinkle flaxseed powder on toast.
  
  
• Exercise. Walking, swimming, or cycling on a stationary bike can all help ease constipation. Be careful to follow an exercise routine that isn’t too strenuous.
  
  
• Some natural laxatives, like castor oil, are not suitable during pregnancy. They are purgative in nature, can cause cramping and are best avoided. Castor oil may also interfere with vitamin and mineral absorption in the body.
  
  Also see breast feeding to fight constipation.

Conclusion, pregnancy and constipation

Pregnancy and constipation can usually be managed easily and safely with simple remedies like magnesium supplements and diet modifications. 

By taking a few precautions, you can keep the wonder of pregnancy from being dampened by constipation.

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