Constipation during pregnancy

'Normal' bowel movements vary between people. Constipation is when your stools (poo) become hard, dry and difficult or painful to pass.

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

Being constipated can make you feel uncomfortable. You may need to push or strain when passing a stool.

Some people with constipation feel they have not fully emptied their bowels. After passing stools, you may feel the need to pass more.

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

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 can lead to constipation during pregnancy.

Exercise

Not getting enough exercise.

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. Most people don't need any tests for constipation.

See your doctor if you notice any changes in your bowel habits during pregnancy, or if you see blood in your stools.

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

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.

Most laxatives can be taken during pregnancy and breastfeeding.

Always check with your pharmacist before taking any medicine while pregnant.

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:

• anal fissure
• haemorrhoids
• faecal impaction
• rectal prolapse

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
• drinking plenty of fluids
• taking regular exercise

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.