Let’s face it, there are some topics that come up during pregnancy that people often hesitate to discuss outside of pregnancy. And constipation is one of them. Pregnancy directly affects the digestive system. In fact, various types of digestive upset — nausea, vomiting, constipation — may be the earliest pregnancy symptoms for many women. In this post, we’ll take a look at what causes constipation during early pregnancy, and what you can do to help combat it.
What is Constipation?
If you feel like you need to have a bowel movement but you’re not able to, or if bowel movements are uncomfortable or painful, you’re likely constipated (1). You may also feel abdominal pain or discomfort. When you do pass stools, they tend to be hard and dry, and may even cause tears in your bowel’s delicate lining, leading to some bright red bleeding. While constipation can happen at any time during pregnancy, it is particularly common during the first trimester.
Why Does Constipation Happen During Early Pregnancy?
As we’ve discussed before, your body undergoes a huge hormone shift in early pregnancy. An increase in progesterone relaxes your muscles, causing your intestines and bowels to slow down. This is paired with a decrease in motilin (2), a hormone that is a key player in keeping things moving in the digestive process. As the stool spends a longer time in your colon, more water is reabsorbed by your body, which makes the stool hard.
In addition to the hormonal slow-down, there are a few other factors that may pile on and add to your chances of experiencing constipation during early pregnancy. Morning sickness might make you drink less than you normally would, and dehydration leads to constipation. Most pregnant women take a prenatal vitamin that includes iron, and some women even take additional iron supplements. Iron is essential in supporting a healthy pregnancy, but it can also cause constipation.
How Can I Help Combat Constipation During Early Pregnancy?
One of your best allies in the battle against constipation is fiber. Foods with a lot of fiber hold onto water longer, and this can help soften your stool (3). Dietary fiber is found in fruits, vegetables, beans/legumes, and whole grains. Some women find that snacking on dried fruits or drinking prune juice are easy ways to get fiber (4). The USDA has a great chart listing high fiber foods here.
There are many reasons why it’s important to stay hydrated, especially during pregnancy. We can add to that list the fact that drinking plenty of fluids can help fight constipation. Healthcare providers often suggest that you aim for eight glasses of water a day. That may sound like a lot. But remember that in this case, “glasses” are eight ounce measurements, and that the drinking glasses you own likely hold two of these servings. In addition to drinking water, you can snack on foods that contain a lot of water, like fruit. Or mix it up by making smoothies or slushies with fruit and juices.
Make sure you stay active. Regular, pregnancy-appropriate exercise can benefit you in so many ways, including decreasing constipation. The shifting of your body position may stimulate your bowels and increase muscle contractions that help move stool through your intestines (3).
How You “Go” Matters
When stools are hard, it may seem natural that you’d need to strain to pass them. However, you should not strain when having a bowel movement, because straining can cause hemorrhoids or fissures. Hemorrhoids are swollen and inflamed veins around your anus or in your lower rectum (5). Anal fissures are small tears in the delicate skin around the anus. Both can be painful. I think we can all agree that during pregnancy we’re not looking to add additional discomforts!
In addition to softening stools with extra fiber and water, you can make passing stools easier by just changing your toilet posture. Most of us are accustomed to using the bathroom in the same position you use to sit on a chair. However, humans are really designed to squat while eliminating. This relaxes and straightens the puborectalis muscle and allows stool to pass most easily. Of course, we’re not actually asking you to give up your toilets and take to the woods! You can simulate the squatting position by putting your feet up on a stool while sitting on the toilet. There are products, like the Squatty Potty, that are stools designed to wrap around the bottom of your toilet when not in use so as not to take up extra space or make a tripping hazard.
Persistent Constipation During Early Pregnancy
If you have tried the above tricks and are still struggling with constipation, talk to your doctor or midwife. There may be laxatives that are safe to take during pregnancy. Just don’t take any medications, supplements, or other remedies without discussing it with your healthcare provider beforehand.
Ultimately, constipation can be annoying and uncomfortable, but fortunately does not pose a risk to you or your little one. Work with your provider to find relief, and get back to enjoying your pregnancy.
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1. Barratt, J., Cross, C., Steel, S., & Biswas, C. (2016). The pregnancy encyclopedia: All your questions answered. London: Dorling Kindersley Limited.
2. Trottier, M., Erebara, A., & Bozzo, P. (2012, August). Treating constipation during pregnancy. Retrieved July 14, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418980/
3. Curtis, G. B., & Schuler, J. (2016). Your pregnancy week by week. Cambridge, MA, MA: Da Capo Life Long.
4. American College of Obstetricians and Gynecologists. (2021). YOUR PREGNANCY AND CHILDBIRTH: Month to month. Place of publication not identified: ACOG.
5. Definition & Facts of Hemorrhoids. (2016, October 01). Retrieved July 14, 2020, from https://www.niddk.nih.gov/health-information/digestive-diseases/hemorrhoids/definition-facts