When does constipation stop in pregnancy
Constipation during pregnancy | Pregnancy Birth and Baby
Constipation during pregnancy | Pregnancy Birth and Baby beginning of content5-minute read
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What is constipation?
'Normal' bowel function differs from person to person, although some people find it difficult to pass soft stools (poo) regularly. Constipation means having fewer than 3 bowel motions per week and with stools that are hard to pass. If you suffer from constipation, it may be difficult or painful to pass stools, and you may find you need to push or strain. Some people with constipation feel they have not fully emptied their bowels and that even after passing stools, they feel the need to pass more.
Up to 1 in 4 women experience constipation during pregnancy. However, constipation will often resolve itself as pregnancy progresses.
What causes constipation during pregnancy?
Low levels of dietary fibre in your diet can contribute to constipation during pregnancy – as they can at any other time. There are, however, reasons why constipation is more common during pregnancy.
An increase in the pregnancy hormone progesterone can cause your gut to work less efficiently and your food to move more slowly through your intestines. This is known as reduced gastric motility.
Another cause of constipation is the medicines and supplements that some women take during pregnancy. Medicines prescribed for nausea and vomiting, antacids for heartburn, and some strong pain medicines can induce constipation in some women. Supplements like iron and calcium, as well as some multivitamins can also trigger constipation.
If you take any of these during your pregnancy and are troubled by constipation, speak with your doctor about whether a change in the formulation of your medicine or supplement can help. Sometimes a simple change of brands or dose can reduce constipation.
However, everyone is different and a formulation that causes constipation for one person might work well for another.
Am I more likely to experience constipation if I had it before pregnancy?
Women who have had constipation before pregnancy are, unfortunately, likely to experience worsening of symptoms during pregnancy.
If you have constipation and are planning a pregnancy, try to get into good habits before you become pregnant. Keeping to a healthy diet, drinking plenty of fluids, and doing regular exercise may help you maintain regular bowel motions.
It is better to prevent constipation early on rather than wait to treat it later.
How is constipation treated during pregnancy?
The first step in treating constipation is to increase the fluids and fibre in your diet. Eating wholegrain foods, fruit and vegetables can often resolve constipation. If symptoms continue, then fibre supplements or laxatives may be a short-term solution – however, it is always better to stimulate the bowel with a healthy diet rather than take medications.
Taking laxatives can sometimes result in side effects such as abdominal pain and diarrhoea.
While most cases of constipation are not a sign of illness, sometimes there are complications such as haemorrhoids, faecal impaction or rectal prolapse. In rare cases, constipation can be caused by more serious conditions such as tumours.
Speak with your doctor if you are concerned, and especially if you notice blood in your stools.
Will it affect my baby?
If you’re pregnant, you don’t need to worry that constipation will affect your baby since the discomfort occurs in the mother’s gut and bowels and isn’t passed on to the baby. Most laxatives are not well absorbed into the bloodstream and can be taken during pregnancy and breastfeeding, but always check with your pharmacist before taking a medicine while pregnant.
Will it continue after I’ve had the baby?
There are several reasons why constipation may continue after birth. Women who have had a caesarean often experience constipation for a few days until their regular bowel movements return.
Women who have stiches after a vaginal birth may hesitate on the toilet, which can cause a build-up in their bowels.
If you’ve taken strong pain medication after having your baby this may also cause constipation.
New mothers are often busier than usual in the first few weeks and months of motherhood. It may seem like taking care of yourself has become less of a priority, but your health is no less important now than it was during your pregnancy. Be sure to have plenty of fibre-rich fruit, vegetables, and wholegrains as well as increase your fluid intake while breastfeeding to encourage healthy bowel movements, even when you are busy.
Where to get help?
Constipation can vary in severity and if changes to your diet do not help relieve your symptoms, ask your midwife, doctor or pharmacist for guidance on choosing and using a laxative.
Sources:
Australian Government Department of Health (Common conditions during pregnancy: constipation), Better Health Channel (Constipation), The Royal Hospital for Women (Constipation in pregnancy and breastfeeding)Learn more here about the development and quality assurance of healthdirect content.
Last reviewed: January 2021
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Constipation in Pregnancy: Causes and Remedies
Struggling to go to the bathroom is never particularly pleasant, but constipation in pregnancy comes with its own special set of challenges—especially if you’re not feeling your best to begin with.
Constipation, which is defined as having less than three bowel movements a week and/or having trouble passing stool when you do go, is fairly common in pregnancy, says Michael Cackovic, MD, a maternal-fetal medicine specialist at the Ohio State University Wexner Medical Center. And while constipation in pregnancy won’t hurt baby, it can make you feel pretty uncomfortable.
If you’re having trouble going “number two” while pregnant, know this: You’re not the only one. Here’s how to cope when you have constipation during pregnancy—and why you’re dealing with it in the first place.
In this article:
Is constipation a sign of pregnancy?
What causes constipation in pregnancy?
When does constipation in pregnancy start?
How to find pregnancy constipation relief
Is Constipation a Sign of Pregnancy?
Constipation in early pregnancy is common, so experiencing it regularly could offer a clue that you’re expecting.
But for the majority of women, it’s probably not the first or most obvious sign of pregnancy, says Julie Lamppa, CNM RN, a nurse-midwife at the Mayo Clinic. But if you’ve been trying to conceive and suddenly notice that you’re having poop problems around the time your period is due, it might be a tip-off.
What Causes Constipation in Pregnancy?
Wondering why you’re suddenly not going quite as much? A lot of it comes down to those pesky (but necessary) pregnancy hormones. “The increase in progesterone levels plays a big part in causing constipation in the first trimester,” says Lamppa. As progesterone increases during your pregnancy, it “leads to slower-moving intestines,” explains Jessica Shepherd, MD, an ob-gyn and the founder of Sanctum Med + Wellness in Dallas, Texas. “This means slower digestion, which can lead to constipation.”
Other factors, like the presence of iron in most prenatal vitamins (a mineral that has been linked to constipation) and not drinking enough water to meet your growing needs, can perpetuate the problem, says Christine Greves, MD, a board-certified ob-gyn at the Winnie Palmer Hospital for Women & Babies in Orlando, Florida.
What’s more, if you’re experiencing morning sickness, and coping with a limited diet of binding foods (crackers, toast, cereal, etc.), it can further block you up.
When Does Constipation in Pregnancy Start?
Constipation in pregnancy can begin early and continue for months. “It can start in the first trimester and even continue for days or weeks after the birth,” Lamppa says. But don’t worry, having early constipation in pregnancy doesn’t necessarily mean you’ll be plugged up for months on end. “Often, women will find that it can wax and wane—or they get good control with their diet, activity, supplements or medications,” Lamppa says.
How to Find Pregnancy Constipation Relief
Got that sluggish feeling in your gut? If you’re tired of sitting on the toilet with little reward, there are a few things you can do to get relief and hopefully kick things into gear again. Below, a few options to try.
What can pregnant women take for constipation?
Pregnancy constipation pain can be uncomfortable.
If you’re wondering what over-the-counter options you can take, the good news is that stool softeners are generally considered a safe and effective option, Greves says. These medications help add moisture to your stool and make it easier to pass. Still, talk to your doctor before using any medication or supplement in pregnancy. One treatment option you should avoid altogether is laxatives; Greves notes that these can cause dehydration.
Home remedies for constipation during pregnancy
If you’d rather not take a stool softener or your doctor has hesitations, rest assured there are a few ways to try to relieve constipation during pregnancy at home without medication. These include:
-
Upping your fiber intake. Fiber helps increase the weight and size of your poop while also softening it, making it easier to pass, according to the Mayo Clinic. “One delicious way to do this is to blend your favorite fruits and vegetables—frozen or fresh—into a smoothie,” Lamppa says.
“Give it a bigger boost by adding some chia seeds.” -
Drinking more water. It’s important to make sure you’re adequately hydrated while pregnant. This can help regulate many bodily functions, including your ability to poop. What’s more, water can soften stools, making them easier to pass, Greves says.
-
Getting more exercise. Being active can help move things along in your intestines as well. “Increasing physical activity such as walking and low-impact exercise can be beneficial,” Cackovic says.
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Switching up your prenatal vitamin. “You may want to take a break from the typical prenatal vitamin that contains iron, which can cause constipation to worsen,” Lamppa says. “Using a prenatal gummy that’s iron-free for a while may help.” But she adds this caveat: “You don’t want to do this for the entire pregnancy because supplemental iron is important.”
Ways to Prevent Constipation in Pregnancy
The best way to prevent constipation in pregnancy is to be proactive in your approach to living healthier.
“Incorporate fiber into your diet, drink lots of water each day and exercise,” Lamppa says. Greves also recommends trying to eat more frequent, smaller meals instead of larger ones. Bigger meals, she explains, “can be harder to process and could increase your risk of constipation.”
When to Call the Doctor
If you’ve tried everything and you’re still struggling or it’s been a few days since you’ve actually been able to poop, Greves says it’s probably time to check in with your doctor or midwife. It’s not taboo to talk about poop (or a lack thereof). And, trust us, once baby comes, it’ll become a regular part of your vernacular. Consider this practice.
Constipation in pregnancy is par for the course—it’s one of the many not-so-enjoyable consequences of those surging hormones. So if you’re having a hard time, remember that this too shall pass (quite literally). Unfortunately, there’s no guaranteed way to get immediate constipation relief during pregnancy, but incorporating some healthy habits into your routine can help get things going again.
Of course, don’t hesitate to reach out to your OB or midwife if you think there’s a problem.
About the experts:
Michael Cackovic, MD, is an ob-gyn and maternal-fetal medicine specialist at the Ohio State University Wexner Medical Center. He received his medical degree from MCP Hahnemann University College of Medicine, Philadelphia, Pennsylvania.
Christine Greves, MD, is a board-certified ob-gyn at the Winnie Palmer Hospital for Women & Babies in Orlando, Florida. She received her medical degree from the University of South Florida College of Medicine where she also completed her residency.
Julie Lamppa, CNM, RN is a certified nurse-midwife at the Mayo Clinic.
Jessica Shepherd, MD, is the founder of Sanctum Med + Wellness in Dallas, Texas. She is also the founder of Her Viewpoint, an online women’s health forum focused on addressing taboo topics in a casual and approachable setting.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
How to Ease Uncomfortable Pregnancy Gas
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How Your Vaginal Discharge Can Change During Pregnancy
Constipation during pregnancy: causes, recommendations
In addition, constipation in pregnant women may be caused by changes in the nature of food, the use of smooth muscle-relaxing drugs (lowering uterine activity, progesterone) 3 or mineral supplements containing iron and calcium4. Sometimes a woman has to lie down all the time, and at least minimal physical activity is necessary to maintain a normal bowel movement 3 .
Another reason for the formation of constipation in pregnant women can be a decrease in fluid intake, starting from the earliest dates 4 .
In addition, constipation in pregnant women may be caused by changes in the nature of food, the use of smooth muscle-relaxing drugs (lowering uterine activity, progesterone) 3 or mineral supplements containing iron and calcium4. Sometimes a woman has to lie down all the time, and at least minimal physical activity is necessary to maintain a normal bowel movement 3 . Another reason for the formation of constipation in pregnant women can be a decrease in fluid intake, starting from the earliest dates 4 .
Thus, low bowel tone during pregnancy is generally initially protective, but may result in constipation 1 .
Possible complications of constipation in pregnancy
Gestational constipation can not only drastically reduce the quality of life, but also pose a certain threat to the well-being of the pregnant woman and the fetus.
Prolonged stagnation of feces can lead to a series of disorders, among other things, to the activation of opportunistic microorganisms. The penetration of microbes and their metabolic products through the intestinal wall can be at least a predisposing factor, and sometimes a direct cause of complicated pregnancy, problems in childbirth and the postpartum period 1 .
Disruption of the normal balance of the colonic microbiota during constipation may later cause a change in the composition of the microflora of the cervical canal.
This condition can cause intrauterine ascending infection and the occurrence of various complications of the gestation period. The course of pregnancy against the background of stagnation in the large intestine can lead to the threat of interruption, untimely discharge of amniotic fluid, inflammation of the uterine mucosa 1 .
The pathological increase in intestinal permeability caused by constipation impairs its barrier function, and even after childbirth it may not fully recover.
That is why constipation is a situation that cannot be ignored and must be treated 1 .
Disruption of the normal balance of the colonic microbiota during constipation may later cause a change in the composition of the microflora of the cervical canal.
This condition can cause intrauterine ascending infection and the occurrence of various complications of the gestation period. The course of pregnancy against the background of stagnation in the large intestine can lead to the threat of termination, untimely discharge of amniotic fluid, inflammation of the uterine mucosa 1 .
The pathological increase in intestinal permeability caused by constipation impairs its barrier function, and even after childbirth it may not fully recover. That's why constipation is a situation that cannot be ignored and must be treated 1 .
Treatment of gestational constipation
The main rules for the prevention and treatment of constipation in pregnant women are primarily diet and recommendations for increasing physical activity 4 . Treatment of constipation, especially in pregnant women, begins with dietary measures 4 .
For a laxative purpose, foods rich in indigestible plant fibers (fiber) are introduced into the menu. There are many such substances in raw fruits and vegetables, wholemeal bread 4 .
In terms of nutritional properties, wheat bran is considered the most acceptable for human consumption, which can be added 2-3 teaspoons to prepared meals 3 .
Prunes, kefir, dried apricots are considered products that help relieve constipation. The menu is recommended to include beets, zucchini, cabbage, lettuce, cucumbers and tomatoes.
It is recommended to limit the consumption of strong tea and coffee, sweets and cocoa, flour dishes in the diet 3 .
It may also be necessary to correct the mode of motor activity, the amount of which is discussed with the doctor 3 . Gymnastics, walking or swimming in the pool may be recommended for a pregnant woman, if this is not contraindicated for health reasons 4 .
In some cases, despite following all recommendations, it may be necessary to use laxatives 4 . The choice of a possible drug cannot be made independently, because self-medication with laxatives during pregnancy is especially undesirable 1 .
The use of any medicine during pregnancy carries certain risks that only a doctor can weigh.
Therefore, only with medical permission, laxatives may be recommended. One of the laxatives that can be prescribed by a doctor to pregnant women starting from the 2nd trimester is Guttalax®: in the 1st trimester of pregnancy, the drug is contraindicated, in the 2nd and 3rd trimesters of pregnancy it is used with caution.
Guttalax® is available in drops and tablets5,6. In view of the lack of studies, the use of Guttalax® tablets during pregnancy is recommended only in cases where the potential benefit to the mother outweighs the possible risk to the fetus. During pregnancy, the drug can be used only after consultation with a specialist.
More about the drug
To increase the efficiency of preparation for the study, the individual functional state of the large intestine is also taken into account. If you have chronic constipation, you need to pay special attention to diet. In preparation for research, Guttalax® Express can be used in suppositories 8 .
The active substance - bisacodyl - becomes active and acts only in the lumen of the large intestine, therefore it does not affect the digestion and absorption of nutrients in the small intestine 8 .
The drug Guttalax® Express enhances peristalsis, stimulates the natural process of bowel movement, and softens the stool. The development time of the laxative effect of the drug is 20 minutes (from 10 minutes to 30 minutes, in some cases - 45 minutes) 8 .
THERE ARE CONTRAINDICATIONS. IT IS NECESSARY TO CONSULT WITH A SPECIALIST.
Manifestations of constipation in pregnant women - signs and symptoms
Co-author, editor and medical expert - Klimovich Elina Valerievna.
Number of Views: 54,600
Last Updated: 12/27/2022
Average Read Time: 4 minutes
Constipation is a common problem during pregnancy. About 75% of women complain of problems with bowel movements during pregnancy. At the same time, these difficulties remain in about a third of women after childbirth.
Contents:
Detailed description of the symptoms
What constipation can cause in a pregnant woman
Our body constantly produces substances that stimulate bowel movements.
During pregnancy, the susceptibility of the intestinal muscles to various kinds of irritants is significantly reduced. The change in the intensity of intestinal reactions is due to the fact that it has a common innervation * with the uterus, because of this, any excessive activation of peristalsis can provoke contractile activity of the uterus. This can be a threat to the child. Unfortunately, this defensive reaction has unpleasant consequences - constipation. Often they occur between 17 and 36 weeks of pregnancy.
Clinically, constipation in pregnant women is manifested by several main symptoms:
- stool retention for more than 3 days and problems with passing gases, flatulence;
- unpleasant feeling of incomplete emptying of the bowels;
- the need to strain during bowel movements;
- painful stools;
- "sheep feces" (hard, dry, fragmented feces).
In the event of constipation, you should always seek medical advice, especially if you notice deterioration and pain.
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Detailed description of symptoms
Constipation is characterized by decreased stool frequency. It happens that a pregnant woman manages to empty her intestines only once a week or less. The consistency of feces changes, discomfort and pain in the abdomen (often in its left half), there is a feeling of dissatisfaction after the stool.
Atonic constipation is characterized by very painful defecation, which occurs with great difficulty. Due to microscopic tears of the mucous membrane of the anus, streaks of blood may appear on the surface of the feces. Spasmodic constipation is characterized by fragmented stools ("sheep feces"). This condition is often accompanied by flatulence, a feeling of pressure, expansion, spasmodic pains in the abdomen. With prolonged constipation, there may be a feeling of lethargy, fatigue, a significant decrease in efficiency.
Pain in a pregnant woman occurs for no apparent reason or may be the result of excitement or physical exertion.
Attacks of acute pain or exacerbation of constant discomfort, as a rule, are associated with negative emotions. The pain can be of varying strength, for example, in some cases it radiates to the lower back, leg, anus, and even the genitals. In some pregnant women, along with abdominal pain, there is a burning sensation in the rectum and itching in the anus. Nausea, bitterness in the mouth are often noted; passing gases is difficult.
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What can cause constipation in a pregnant woman
Feces in the rectum, which a pregnant woman cannot get rid of for a long time, bring her considerable discomfort. However, these are not the only consequences of constipation.
- The large intestine mucosa is characterized by absorptive capacity; in case of constipation, not only water is absorbed into the blood, but also various toxic metabolic products. Intoxication of the woman and the fetus can lead to negative consequences and disrupt the development of the child in the future.
