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Constipation in pregnancy – Don’t get Stuck!

Pregnancy Dr Minke Burke Director
Just when your nausea is settling and you feel a little better, some women have to face their next battle: Constipation. Here’s how to avoid getting stuck...

Constipation is described as infrequent of difficult bowel motions, and it is estimated that between 10 and 40% of women suffer from constipation at some stage in their pregnancy.  Around 40% suffer from this at 15 weeks gestation.

Why do women suffer from constipation in pregnancy?

A few reasons. The first one is progesterone! Your progesterone levels peak in the first trimester of pregnancy. Progesterone is an essential hormone keeping your uterus nice and relaxed, in fact your whole body is more relaxed and so is your bowel. You feel more bloated, this why you feel like you are 20 weeks pregnant when you’re only 12 weeks. With this bowel relaxation, its motility slows down increasing your risk of constipation.

Then there is the reduced physical activity. Most women feel tired and perhaps nauseous within the first trimester of pregnancy. This results in being less active, which further slows down your bowel motility.

Vitamin supplements and in particular iron and calcium can also slow down your bowel motion. To add to the problem, more water gets absorbed through the bowel leading to relative dehydration. Finally, your growing uterus interferes with bowel motility, slowing things down.

What can we do?

  • Increase your fibre intake. There are two types of fibre; soluble and insoluble. The first type attracts water and turns this into gel, which makes your stool softer and easier to pass. The insoluble fibre increases bulk and speeds up passage through your bowel.  Both types of fibre are found in vegetables, fruits and cereals.  Aim for 25-30 mg a day. To give you some perspective:

– 1x banana = 3-4 grams of fibre

– 2x Weetbix = 3.3 grams of fibre

– 100 grams of vegetables = 4.4 gram of fibre

For more information about what to eat during pregnancy you can read our blog Food Safety in Pregnancy.

  • Increase your fluid intake.  It’s a bit difficult to determine exactly how much fluid you should drink.  It depends on how active you are, humidity and temperature.  In general, if your urine is nice and clear you are well hydrated.  If your urine is yellow, increase your water intake.  Remember, don’t drink fruit juices or soft drinks, they contain too much sugar.  Water is best.
  • Increase your exercise.  If you are too tired, perhaps go for an easy walk, anything is better than nothing at all.  For more information about the benefits of exercise in pregnancy you can read our blog.

The aim is to pass an easy motion every day. If you are not passing an easy motion don’t think it’ll just pass and get better after a while. If conservative methods fail and you still feel constipated, talk to your Alana Obstetrician to see what’s best in your individual circumstances.

Here are some aperients (drugs that help relieve constipation) that are considered compatible with pregnancy.

  1. Metamucil, Normacol, Benefiber- these are all “bulk formers” and are best used to prevent constipation, or continued use to maintain an easy bowel motion.  However these are not very effective in acute constipation as they take up to 72 hours to take effect.
  2. Lactulose and Movicol, as osmotic laxatives, they attract more water to the bowel. Women can experience more flatulence when using Lactulose.  Rectal enemas also belong to this group and they may be useful if stool is stuck in the lower rectum.
  3. Coloxyl, a stool softener. Works best if already adequate fibre is taken.   “Senna” (Senekot), a stimulant is best avoided as long-term use may worsen your bowel motility. A side effect may be cramping pain and can be confused with uterine contractions.

If you have severe pain, mucous or blood loss when you open your bowel please let your Alana Obstetrician know or contact us for further information.

For more information about our services, please visit our Gynaecology, Obstetrics and Fertility main pages.