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What causes constipation in pregnancy?Constipation is common in pregnancy because the pregnancy hormone progesterone relaxes and slows down the movement of food through your intestines.
You are likely to suffer from constipation if you:
- are generally prone to constipation
- have pregnancy sickness and are struggling to eat as much as usual
- have irritable bowel syndrome (IBS)
If you don't exercise much, your whole system will be sluggish. As your pregnancy progresses, and your baby gets bigger, increased downward pressure on your pelvic area makes constipation more likely.
If you have severe constipation and strain to poo, it increases your risk of developing piles (haemorrhoids).
How can I prevent constipation?Constipation doesn't cause any particular medical complications, but it is uncomfortable and can make haemorrhoids worse. So it's best to tackle constipation before it becomes a problem.
Eat a high-fibre diet which contains lots of wholegrain cereals, wholemeal bread and fruit and vegetables. This will provide you with roughage to aid your digestion. But you should also make sure you drink at least 1.5 litres (2.6 pints) of water every day.
Try to avoid drinks which make you wee more often, such as tea, coffee, cola and alcohol. These diuretics may dehydrate you and make your constipation worse.
Don't rely on taking bran to avoid constipation, unless you also significantly increase your fluid intake. Without extra water, bran will bulk up your poo, making it hard and less able to pass along your intestines. Large amounts of bran may also interfere with your body's ability to absorb certain nutrients from your food.
Staying active and exercising will help to prevent constipation. Walking, swimming or aquanatal classes, gentle cycling on an exercise bike, or pregnancy exercise classes can all help. Some yoga positions can be practised to keep constipation at bay, and pilates is particularly effective.
Tai chi or qi gong may help you to maintain physical and emotional health and wellbeing through a gentle sequence of structured movements. They also aid balance and mobility, and may help to prevent or treat your constipation.
What tips can I try to ease constipation?Drink at least 1.5 litres (2.6 pints) of water daily and start your day with a cup of warm water with a slice of lemon before you have anything else to eat or drink. Start each meal with salad or raw vegetables or fruit, and eat high-fibre foods (roughage).
Include plenty of these in your diet:
- Fresh fruit, such as oranges, grapefruits, tangerines and blackcurrants.
- Dried fruit, such prunes and apricots.
- Vegetables, such as celery, watercress, cabbage, spinach and artichokes.
- Wholegrain cereals and wholemeal bread, as well as beans, lentils and pulses.
Psyllium can be bought in health food stores and contains mucilage, which bulks up your poo. You must also drink at least eight glasses of water daily to keep the poo moving along your gut. You may, however prefer to eat prunes, as they may be more effective and taste nicer (Attaluri et al 2011). Don't use psyllium if you are taking medication for a heart complaint.
Linseeds (flaxseeds) are rich in fibre and essential fatty acids, and are an alternative to psyllium. But drink at least one large glass of water for each dessertspoonful of linseeds you have. Try sprinkling the seeds on your breakfast cereal, salads, or yoghurt. But be aware that too many linseeds may cause diarrhoea and, very rarely, can trigger allergic reactions (Leon et al 2003).
You could drink dandelion or mallow tea, made from the leaves of the plants. Steep the leaves in boiling water and drink it daily to ease constipation.
Senna is a traditional remedy for constipation and is safe in small doses and for short periods in pregnancy under the supervision of your doctor or midwife (PRODIGY 2008). Some experts believe it should be avoided in the third trimester, as it may stimulate your uterus (womb) and cause Braxton Hicks contractions.
Add three to four drops of essential oils such as sweet orange, lemon, lime, grapefruit or bergamot to a teaspoonful of carrier oil (preferably grapeseed) to your bath. Relax in the warm water for a while, perhaps massaging your tummy gently with soap lather in a clockwise direction.
Don't massage too firmly, especially if you have any risk of premature labour, or if your placenta is lying low in your uterus (placenta praevia).
You can try a simple reflexology treatment at home. Ask your partner or a friend to massage the arches of your feet. The arches correspond to the digestive system. Your partner should massage in a circular, clockwise motion, as this is the same direction as the movement of the intestines. Ask your partner to spend about five minutes on each foot.
If you would like to massage yourself, try using the hand reflexology zones. Massage the dip in the palms of both hands in a clockwise movement. Or put two bottles under the arches of your feet while you're sitting, and gently roll them backwards and forwards on the floor.
Acupressure or acupuncture
An acupressure or acupuncture point related to your digestion is located in the middle of your tummy. About three finger-widths below your navel (point CV6), gently press intermittently, about 20 to 30 times, and repeat several times a day.
There's no evidence that homeopathy is effective. However, if you want to try it, make sure that you see a qualified, registered homeopath. Homeopathic remedies should be prescribed according to your precise symptoms.
If you need an iron supplement because you are prone to anaemia, try a multivitamin preparation or a liquid iron supplement, but check with your midwife first.
Try to eat some red meat or pulses, and include dark green vegetables in your meals. Ask your doctor to change you to a different brand of iron tablet if the one you are taking causes constipation. If constipation becomes a more serious problem, your doctor or midwife may prescribe a laxative which is safe to use in pregnancy.
Pelvic floor relaxation
When you feel the need to go to the toilet, make sure you have privacy and time. Sit on the toilet, breathe deeply, then exhale so your pelvic floor muscles relax, but try not to strain. Standing up just before trying to pass the stool can sometimes help. While sitting, go on to your tiptoes to bring up your knees. Or, use a small stool to raise up your feet. This will put you into a squatting position, which is the ideal position to do a poo (Sikirov 2003).
Which complementary therapies could I try?If your constipation persists, you could consult a qualified practitioner of acupuncture or shiatsu to help to rebalance your internal energies. Osteopathy or chiropractic may correct any misalignments in your skeleton. This may be from a previous injury putting stress and tension on soft parts of your body, including your stomach and intestines.
If you'd like to try Chinese medicine, acupuncture, or ayurvedic medicine, consult a practitioner who is registered, insured, and has experience of treating pregnant women.
Colonic irrigation is not recommended in pregnancy as it can affect the normal pH and bacterial balance of your lower colon. There is a possible risk of mild complications such as vaginal infections, or more serious problems.
Last reviewed: March 2012
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Leon F, Rodriguez M, Cuevas M. 2003. Anaphylaxis to Linum. Allergol Immunopathol (Madr). 31: 47-9
Melamed N, Ben-Haroush A, Kaplan B, et al. 2007. Iron supplementation in pregnancy - does the preparation matter? Arch Gynecol Obstet. 276(6): 601–604
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PRODIGY. 2008. Constipation: clinical topic. prodigy.clarity.co.uk [Accessed March 2012]
Sikirov D. 2003. Comparison of straining during defaecation in three positions: results and implications for human health, Dig Dis Sci 48(7): 1201-5
Tiran D. 2001. Clinical Aromatherapy for Pregnancy and Childbirth. 2nd ed. Edinburgh: Churchill Livingstone
Tiran D. 2003. Self help for constipation and haemorrhoids in pregnancy. British Journal of Midwifery. 11(9): 579-581