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.

Could it be a sign of something more serious?

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.