Constipation During Pregnancy: Causes, Relief, and Prevention Tips

In short: Constipation is common in pregnancy because progesterone relaxes the muscles of the bowel and slows it down, and later the uterus presses on the bowel. More fruit, vegetables, whole foods and fluids, and gentle exercise help. Glycerine suppositories or some laxatives can be used under medical supervision. See the doctor if constipation is severe or comes with pain or bleeding.

Constipation means having difficulty passing stool, usually because of irregular bowel movements that lead to small amounts of hard, compact stool. This can vary a lot from person to person, and even between members of the same family.

In simple terms, constipation can be described as:

• An irregular and infrequent evacuation.
• Difficulty in evacuation.
• Feeling of incomplete evacuation.

Causes of constipation during pregnancy

Constipation is a very common pregnancy complaint, affecting around 40% of pregnant women. It’s often related to:

• Increased level of progesterone hormone, which relaxes the smooth muscles of the intestine.
• Abdominal distention due to the growing pregnant uterus, which increases pressure on the intestine and can slow bowel movements.

Iron tablets, which are often prescribed during pregnancy, can also make stools harder. If this happens, do not stop them on your own – ask your doctor about a different preparation or dose.

Other causes of constipation

• Unknown causes.
• Social reasons such as:
• Not eating enough vegetables and fruits.
• Lifestyle habits.
• Being overweight or excessively thin.
• Discomfort or inconvenience of the toilet/bathroom area.
• Some medications, such as:
• Anti-depressants.
• Drugs used to treat psychological disorders and epilepsy.
• Diuretics.
• Colon cancer.
• Diabetes.
• Hypercalcemia.
• Intestinal inflammation and irritable bowel syndrome.

Tips to help avoid constipation

• Increase your intake of:
• Foods that are naturally rich in fiber.
• Vegetables and fruits.
• Whole grains.
• Stay well hydrated with natural juices and plenty of water.
• Keep up gentle exercise and safe physical activity during pregnancy, as advised by your doctor.
• If diet changes are not enough, laxatives that are safe in pregnancy can be used under your doctor’s or pharmacist’s guidance – usually fibre-based products (such as ispaghula) first, and then softening laxatives such as lactulose or macrogol.

Preventing constipation

• Adopt a healthier daily lifestyle.
• Maintain regular, pregnancy-safe exercise.
• Try not to ignore the urge to have a bowel movement — respond to it when it arises rather than delaying it.

Possible consequences of constipation

First: Hemorrhoids, which can lead to:

• Anal itching.
• Swelling and pain of the anal area.
• Rectal (anal) bleeding.

Second: A build-up of dried feces in the rectum, which can lead to:

• Swelling of the rectum.
• Reduced sensitivity in the rectal area.
• Difficulty controlling bowel movements.
• Rectal prolapse (part of the rectum slipping out through the anus) – this is rare.

If constipation during pregnancy is persistent, painful, or accompanied by bleeding, it’s best to discuss it with your obstetrician rather than self-treating. Dr. Najeeb Layyous and his clinical team are available to guide you through safe, pregnancy-appropriate care for digestive discomforts like this one.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist