constipation-in-pregnancy
Gut Science

How to manage constipation in pregnancy

Although constipation in pregnancy can be uncomfortable, it won’t harm the baby. Learn more about lifestyle changes and medications that can help.
10 minutes
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Written By

Marie Ellis

Marie has been a health and science journalist and writer for over 15 years. She has a master's degree in critical theory from the University of Sussex and a bachelor's degree in English from the University of California-Irvine. In her spare time, she likes to write fiction, participate in park runs with her family and perform in theatre where she lives in Bristol.

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Reviewed By

Dr Sammie Gill

Specialist Gastroenterology Dietitian

Dr Sammie Gill is a specialist gastroenterology dietitian and senior clinical research and science communications manager here at Symprove. Sammie has a Ph.D. in nutritional immunology and has previously worked for the British Dietetic Association (BDA), King’s College London and in the NHS. When she’s not buried in gut science or planning clinical trials, she’s most likely found pottering in her kitchen, digging into a gut-loving breakfast (her favourite meal of the day), writing content, responding to media requests, or running 1-2-1 dietetic sessions with Symprove customers.

Constipation is very common during pregnancy, and shifts in hormone levels are mostly to blame. 

It’s not typically anything to worry about, and it won’t affect your baby.

But constipation can be uncomfortable, so rest easy knowing that there are things you can do to help. For example, strategies like eating more fibre and staying hydrated can provide relief, and so can certain medications.

In this article, we’ll explore why constipation happens during pregnancy and what you can do at home to start feeling better.

Why does constipation happen in pregnancy?

If you’re pregnant and constipated, know that you’re in good company. Up to 40% of pregnant women experience constipation.

Although pregnancy can be a magical experience at times, it also comes with its worries. The good news is that constipation doesn’t pose risks to your baby. And it usually goes away after you’ve given birth.

Constipation in pregnancy can happen for several reasons, including:

  • Hormone levels: The fluctuations in hormones during pregnancy – especially rising progesterone levels – can lead to a longer gut transit time. This is the average time it takes for food to move through your gut.
  • Your uterus: As your uterus grows in the third trimester, it can put pressure on your bowels, making it harder for poo to move through.
  • Iron supplements: Most doctors and midwives recommend taking a prenatal vitamin, and most of these contain iron, which is important for both you and your baby. A common side effect, however, is constipation.
  • Too little fibre: If you’ve changed your eating habits due to nausea or cravings, you might not be getting enough fibre, which is in fruits, vegetables, nuts, seeds, beans and whole grains.

    What are the symptoms of constipation?

    If you’ve had fewer than three poos in the last week or if you’re pooing less often than usual, you’re probably experiencing constipation. 

    Your poo may also be unusually large or small, and it may be hard or lumpy.

    You may also feel like you haven’t fully emptied your bowels after a poo, and you may feel bloated or sick.

    Another uncomfortable issue that can accompany constipation is called piles, also known as haemorrhoids. Symptoms of piles include:

    • itchiness, soreness or swelling around your bum hole
    • pain during a poo
    • a lump directly outside your bum
    • bright red blood after a poo, which may indicate that you have an anal fissure

    Getting relief from piles often means addressing the causes of constipation, which we’ll detail in the next section. 

    In the meantime, here are strategies for easing the symptoms: 

    • avoiding standing or sitting for too long
    • soaking a cloth in iced water, wringing it out and holding it gently against the area
    • avoiding straining while having a poo
    • using moist toilet paper after a poo and patting rather than rubbing your bum hole

    What helps ease constipation in pregnancy?

    Many ways to relieve constipation are safe during pregnancy. Below, we’ll offer five effective tips. 

    1. Eat fibre-rich foods

    Fibre is a carbohydrate in plants – including fruits, veg and whole grains. Your body can’t digest fibre, so it travels through your gut, keeping things moving through your small and large intestines. 

    Fibre can make your poo bulkier, but it can also make it softer and easier to pass, helping to relieve the discomfort of constipation.

    We should consume around 30 grams of fibre a day, but most of us in the United Kingdom get much less.

    In general, eating more plant-based foods is a great way to increase your fibre intake. If you’re looking for foods that can relieve constipation quickly, here are some top contenders:

  • Prunes are rich in fibre. They also have a laxative effect because they contain a carbohydrate called sorbitol. Research suggests that eating around 100 g of prunes every day for 4 weeks can improve symptoms of constipation.
  • Kiwi fruit is rich in both fibre and an enzyme called actinidin, which may help with symptoms of constipation. Research shows that eating two kiwis a day for 4 weeks could help you poo more often.
  • Whole grains, such as oats, brown rice, whole grain pasta and rye bread, contain insoluble fibre. This doesn’t absorb water and adds bulk to your poo, which can help relieve constipation.

    When it comes to your diet, it’s a good idea to make changes gradually, so your body can get used to the added fibre.

    For high-fibre inspiration to ease constipation, see our meal suggestions here.

    2. Get plenty of liquids

    Staying hydrated is important for many reasons, and it’s key in keeping your poos soft and easy to pass. 

    Drinking lots of water is, of course, one way to make sure you’re getting enough liquids, but there are other ways to stay hydrated.

    Try some of these strategies:

    • having clear soup or plain broth
    • drinking herbal or fruit tea
    • drinking milk
    • having yoghurt or cottage cheese
    • adding raspberries, cucumber or mint to water, to make it more appealing
    • eating watery fruit and veg, such as watermelon, strawberries, tomatoes and cucumbers

    3. Move your body

    To help ease constipation, the NHS suggests getting more physical activity, but this doesn’t have to be intense.

    Going for a daily walk or even doing some housework or gardening can help keep things moving through your body and help you poo more regularly.

    Staying active throughout pregnancy also has other benefits. Researchers have found that on average, pregnant participants who are physically active have a shorter labour time and a lower risk of complications during labour.

    Here are some tips for exercising during pregnancy:

    • Don’t exhaust yourself. Listen to your body, particularly as your pregnancy progresses. You might have more energy on some days than others.
    • Don’t exercise too strenuously. If you become breathless and can’t hold a conversation while exercising, slow down.
    • Don’t suddenly take up a strenuous exercise that you didn’t do before pregnancy. 
    • Do be extra careful if your activity carries a risk of falling, such as horse riding or cycling.
    • Do warm up before exercising, and cool down afterwards.
    • Do aim to be active every day.
    • Do stay hydrated.
    • Do pick an activity that you enjoy and are comfortable doing. 
    • Do let your exercise class teacher know you’re pregnant.
    • Do try swimming. The water will support your increasing weight.

    4. Try probiotics

    Probiotics are live bacteria that provide health benefits when you consume them. 

    Research has shown that probiotics can help relieve constipation, among other gut issues, so you may want to see if they work for you. 

    It can take a few weeks to notice the effects of a new probiotic. If the one you’re taking isn’t helping your symptoms, you could give a product containing different microbes a try. 

    Probiotics are generally considered safe for the mother and baby during pregnancy. But if you have any questions or concerns, be sure to ask your midwife or doctor. 

    To learn more about probiotics, read our article on live, friendly bacteria.

    5. Try a new prenatal supplement

    If you’ve tried the approaches above and still have constipation, you may want to ask your doctor about a prenatal supplement that contains less iron.

    A midwife may have recommended taking an iron supplement during pregnancy for your baby’s health. But it’s very common to become constipated or get piles while you’re taking high levels of iron.

    If you’re experiencing this and it’s uncomfortable, speak with your doctor or midwife about your options.

    Are medications safe for constipation in pregnancy?

    If the lifestyle changes above haven’t helped, you might want to ask your doctor or midwife about medications. 

    Here are some of the more common medications for easing constipation in pregnancy:

  • Laxatives: These make pooing easier and more comfortable, and they’re generally safe during pregnancy. A common option is lactulose.
  • Suppositories: These mild laxatives are for rectal use only. During pregnancy, you’ll need to use them under a doctor’s instruction.
  • Fibre supplements: Though it’s best to get your fibre from food, fibre supplements are available, and they’re safe when you’re pregnant. A common fibre supplement is a laxative called Fybogel.

    When to see your doctor

    Before you start taking any new medication during pregnancy – including laxatives – consult your doctor or midwife. 

    If constipation lasts longer than a few weeks, let your doctor or midwife know. It’s also important to consult them if you’re experiencing any additional symptoms, including:

    • stomach pain
    • vomiting
    • blood in your poo
    • sudden changes in how you poo

    Summary

    Constipation is a common and typically harmless experience during pregnancy. 

    It’s often caused by hormonal changes, extra iron from supplements or pressure from your growing uterus. While it can be uncomfortable, it doesn’t harm your baby, and it usually goes away after you give birth.

    Making lifestyle changes, like eating more fibre, staying hydrated and keeping active, can help ease your constipation. Adding probiotics or switching to a prenatal vitamin with less iron may also help.

    If these strategies don’t work, ask your doctor or midwife about medications, such as laxatives.

    While constipation can be unpleasant, the good news is that it’s temporary and manageable. If symptoms persist or you experience other issues, let your doctor or midwife know.

    To learn more about other gut health topics, visit Symprove’s Gut Hub. 

    Sources

    Anal fissure. (2021). Link.

    Are probiotics and prebiotics safe for use during pregnancy and lactation? A systematic review and meta-analysis. Nutrients. (2021). Link.

    British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. BMJ. (2021). Link.

    Constipation. (2023). Link.

    Constipation: Treatment during pregnancy. (2022). Link.

    Consumption of 2 green kiwifruits daily improves constipation and abdominal comfort—results of an international multicenter randomized controlled trial. American Journal of Gastroenterology. (2021). Link.

    Effectiveness and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: A systematic review and meta-analysis of 10 randomized controlled trials. Nutrients. (2022). Link.

    Eight ways to get constipation relief. (2023). Link.

    Exercise in pregnancy. (2023). Link.

    Fybogel (ispaghula husk). (n.d.). Link.

    How to get more fibre into your diet. (2022). Link.

    Irritable bowel syndrome in adults: Diagnosis and management. (2017). Link.

    Lactulose. (n.d.). Link.

    Piles in pregnancy. (2024). Link.

    Pregnancy and exercise. StatPearls. (2023). Link.

    Pregnancy, breastfeeding and fertility while taking ferrous sulfate. (2023). Link.

    Pregnancy, breastfeeding and fertility while taking senna. (2022). Link.

    Pregnancy constipation. (2021). Link.

    The effect of prunes on stool output, gut transit time and gastrointestinal microbiota: A randomised controlled trial. Clinical Nutrition. (2019). Link.

    The impact of physical activity during pregnancy on labor and delivery. American Journal of Obstetrics and Gynecology. (2023). Link. 

    The use of glycerol suppositories. (2023). Link.

    Treating constipation during pregnancy. Canadian Family Physician. (2012). Link.