Constipation, or difficulty passing stool, is a common problem during pregnancy: up to 40% of pregnant women become constipated at some point.

Why am I constipated during pregnancy?

One of the reasons you can get constipated when you’re pregnant is that your body produces more of the hormone progesterone, which relaxes muscles throughout your body – including your digestive tract. This means that food moves more slowly through your intestines.

There are also changes in your blood vessels and overall body fluid when you are pregnant. Your blood vessels dilate so they can hold about 50% more fluid by the time you give birth.

As your pregnancy progresses, your “hydration goal line,” if you will, is constantly changing as your body retains more and more fluid. This can lead to symptoms of dehydration, including constipation and headaches.

Other factors that contribute to constipation can include a low-fiber diet (which many women switch to because of nausea or bloating) and reduced physical activity due to fatigue and pregnancy discomfort. Iron supplements, especially in high doses, can make constipation worse.

Will the constipation spread after the first trimester?

Constipation can last beyond the first trimester, yes. This is because some of the main factors for constipation – such as increased progesterone and decreased physical activity – can continue after the first trimester. Also, your intestines will absorb less water, which causes the stool to become drier.

Later in pregnancy, these problems are exacerbated by your growing uterus, which can put pressure on your colon and rectum, slowing the movement of stool through your system.

For many people, healthy eating habits with plenty of dietary fiber plus hydration and consistent physical activity are enough to keep things moving. Prevention is key when it comes to constipation!

– Kristin Cohen, DNP, Board Certified Nurse Midwife and Board Certified Nurse Practitioner for Women

Is constipation normal during pregnancy?

Unfortunately, constipation is pretty common during pregnancy because of all the hormone, body, and lifestyle changes that happen.

Occasionally, however, constipation during pregnancy can be a symptom of another problem. For example, medical conditions that can cause constipation include:

• Endocrine problems such as hypothyroidism or diabetes
• Irritable bowel syndrome
• Intestinal obstruction
• Neurological disorders such as multiple sclerosis
• Colorectal cancer

If you have severe constipation accompanied by abdominal pain, which alternates with diarrhea, or if you have mucus or blood, call your doctor immediately.

Constipation can cause other problems as well. One of the most common are hemorrhoids, which are swollen veins in the rectum and anus. This is common in pregnancy due to the natural pressure on your stomach. Hemorrhoids are aggravated by straining during bowel movements or hard stools.

Hemorrhoids can be extremely uncomfortable, although they rarely cause serious problems. In most cases, they disappear fairly quickly after the baby is born. However, if the pain is severe, or if you have rectal bleeding, call your doctor.

Straining to have a bowel movement can also affect the pelvic floor muscles, which help control the bladder. This can lead to a condition called stress urinary incontinence, where you leak urine during activity – including laughing, sneezing or coughing.

This condition is already often associated with pregnancy and childbirth due to the extra pressure on your body from carrying the pregnancy and the vaginal birth process, but the risk of developing it can increase due to constipation.

Ways to get rid of constipation in pregnancy

“The best way to get rid of constipation is to prevent it from happening in the first place,” advises Kristin Cohen, DNP, a certified nurse-midwife, nurse practitioner for women, and member of BabyCenter’s medical advisory board. “For many people, healthy eating habits with lots of dietary fiber plus hydration and consistent physical activity are enough to get things moving. For people who need more than this, I find that using a fiber supplement like Metamucil every morning is usually very helpful. Again: Prevention is key when it comes to constipation!”

Here are some more tips to prevent and relieve constipation when you’re pregnant:

Drink lots of water. Try to drink 10 to 12 cups of water or other beverages a day. (Or drink throughout the day until your urine is clear or pale yellow—a sign of adequate hydration.) Drinking a glass of fruit juice—especially prune juice—daily can also help. Some people find that drinking a warm liquid right after waking up helps get things moving. Keep in mind that humid weather, sweating, and exercise can increase the amount of fluid you need.

Eat foods rich in fiberincluding whole grain cereals and breads, brown rice, beans and fresh fruits and vegetables and dried fruits such as apricots and raisins every day. Adding a few tablespoons of unprocessed wheat bran (available at health food stores) to your cereal in the morning can help, although it may take a few days before you notice a difference. Options like these help add bulk to your stools so they pass through your system more easily.

Exercise regularly. Walking, swimming, cycling and yoga can relieve constipation and make you feel fitter and healthier.

Listen to your body. Your bowels are most likely to be active after a meal, so take time to use the bathroom after eating if necessary. Do not delay going to the toilet when you feel the need.

Try another vitamin. If your prenatal multivitamin is high in iron (and you’re not anemic), ask your doctor about switching to a supplement with less iron. You can also take your iron supplements in smaller doses throughout the day (such as in liquid or gummy form), which can reduce their effect on the gut. If you think an iron supplement is to blame for your constipation, talk to your doctor about how often you take it. It may be best to take it less frequently, depending on how constipated you are.

Try a stool softenersuch as Colace (docusate sodium). It’s not a laxative and won’t “make you go” but it will ease your bowels.

Ask your provider about it taking magnesium. They may recommend that you take 200 to 400 milligrams once or twice a day to keep things normal.

If the measures above don’t help (or are difficult for you to follow), talk to your service provider taking over-the-counter fiber supplements like Metamucil. Just make sure you increase your water intake as well to compensate for the excess fiber.

These supplements are usually suitable for most women, but they can sometimes cause uterine contractions, so it’s important to follow your doctor’s instructions. Also, if you take too much, you can actually experience diarrhea.

“I would definitely recommend talking to your doctor about how to prevent constipation from getting really bad,” he says BabyCenter Community Member EllieB86. “There’s only so much fiber, tons of water, and regular exercise (along with all the prunes and all the natural remedies people suggest) can do in some cases.”

In general, constipation and other bathroom issues can extend into the postpartum period, but be sure to get back on track.

You will often have a bowel movement within three or four days after giving birth, although it may take a few months to get to a regular schedule. If you still have problems until then, talk to your doctor.