Constipation during pregnancy

Constipation is when you have difficulty passing stools (poo) or have fewer bowel movements than normal. 'Normal' varies between people — for adults, it can range from 3 bowel movements a day to 1 every 3 days. If you don't have a bowel movement every day, that doesn't necessarily mean you're constipated.

Constipation is very common during pregnancy. Up to 2 in 5 people have constipation during pregnancy.

Symptoms of constipation during pregnancy include:

• having trouble passing bowel movements
• having bowel movements less often than usual
• passing hard, lumpy stools
• straining (pushing hard) during bowel movements
• passing only small amounts of stool at a time
• feeling like you haven't completely emptied your bowels
• pain or discomfort in your stomach

If you had constipation before pregnancy, your symptoms may worsen during pregnancy.

Constipation during pregnancy can be caused by:

• hormonal changes
• medicines or supplements
• diet
• lack of exercise
• stress or a change in your daily routine

Hormonal changes

The pregnancy hormone, progesterone, relaxes your muscles and slows the movement of food in your gut. This increases your chance of constipation.

Medicines or supplements

Some medicines used during pregnancy can cause constipation. These include:

• medicines for nausea and vomiting
• medicines for heartburn
• strong pain medicines

Sometimes supplements can also cause constipation. These include:

• iron
• calcium
• some multivitamins

If you have constipation and are taking these medicines, speak with your doctor. Sometimes a change in dose or brand can help.

Diet

Not eating enough fibre, or eating a lot of high-fat foods, can lead to constipation during pregnancy.

Exercise

Not getting enough exercise can also lead to constipation during pregnancy.

To make a diagnosis, your doctor will ask you about:

• your symptoms
• any medical conditions you have
• any medicines or supplements you are taking
• your lifestyle

Your doctor may also examine you — for example, by feeling your abdomen (tummy).

Most people don't need any tests for constipation during pregnancy. If your doctor does recommend a test, they will choose one that is safe for you and your baby — for example, avoiding x-rays, which use radiation.

Constipation is very common in pregnancy. But sometimes it can be a sign of another condition.

See your doctor if you:

• have severe constipation. This might mean 3 or more days between bowel movements, tummy pain, straining for a long period or feeling that there is a 'ball', blocking your rectum.
• have constipation that is not getting better with simple lifestyle changes
• are worried about your symptoms

When to seek urgent care

Get urgent care if you have constipation as well as:

• unexplained weight loss
• bleeding from your rectum (bottom) or blood in your stool
• severe abdominal (tummy) pain, cramping or bloating
• vomiting

Self-care at home

The first steps are to increase:

• fluids — drink at least 7 to 8 glasses a day and even more in hot or humid weather
• fibre in your diet — eat wholegrain foods, fruit and vegetables

Good toilet habits also help.

• Go to the toilet as soon as you get the urge — don't wait.
• Try sitting on the toilet about 20 minutes after meals, especially breakfast.
• Sit on the toilet, lean forward with your feet apart and your back straight.
• Relax your abdominal (tummy) muscles — think about making them 'bulge' out. This helps you to avoid straining.
• Use a footstool when on the toilet.

Medicines for constipation during pregnancy

If your symptoms continue, your doctor may recommend fibre supplements or laxatives. Taking laxatives can sometimes cause side effects such as abdominal pain and diarrhoea.

Not all laxatives are recommended during pregnancy, and doses may need to be different — always check with your doctor or pharmacist before starting one.

New parents are often more busy than usual. But it's important to take care of your health.

If you have a caesarean birth, you may experience constipation for a few days.

If you have stitches after a vaginal birth, you may feel worried about opening your bowels. This can lead to constipation.

Strong pain medicines you take after having your baby can also cause constipation.

Be sure to have a fibre-rich diet and increase your fluid intake while breastfeeding to keep your bowels healthy.

Untreated constipation can cause complications such as:

• haemorrhoids — swollen or inflamed veins in your anus and rectum
• anal fissure — small splits in your anus that cause pain and bleeding
• faecal impaction — when stool becomes stuck in your colon
• faecal incontinence — leaking of stool between bowel movements
• rectocele — a bulge in your rectal wall caused by excessive pushing over long periods

These complications are rare, as constipation rarely becomes serious.

You may feel uncomfortable from constipation, but it's not harmful to your baby.

If you are pregnant or planning a pregnancy maintain regular bowel motions by:

• eating a healthy diet, including foods high in fibre such as wholegrain bread, cereals, fruit, vegetables and nuts
• drinking plenty of fluids
• taking regular exercise
• going to the toilet as soon as you feel the urge, rather than waiting
• talking to your pharmacist about a fibre supplement if you're not getting enough fibre from food

It's better to prevent constipation rather than wait to treat it later.

The Royal Hospital for Women has developed a leaflet on Constipation in Pregnancy and Breastfeeding, with suggestions on lifestyle changes as well as medicines to treat constipation.

Ask your midwife, doctor or pharmacist for help with constipation during pregnancy.

Languages other than English

Health Translations Victoria offers a fact sheet on constipation in languages other than English.

Information for Aboriginal and/or Torres Strait Islander peoples.

Continence Health Australia offers a brochure on constipation explaining what constipation is, why it happens, and how to prevent it.