Constipation is a common concern for many expectant mothers, affecting an estimated 16% to 39% of women during pregnancy. This discomfort arises from physiological changes as the body adapts. Understanding the reasons for constipation and safe management options, including laxative choices, can help navigate this common experience.
Understanding Constipation During Pregnancy
The increased production of the hormone progesterone is a primary factor. Progesterone relaxes muscles throughout the body, including those in the intestines, which slows down the movement of food and waste. This slower transit allows more water to be absorbed from the stool, making it harder to pass.
As pregnancy progresses, the growing uterus can also exert pressure on the intestines, impeding waste movement. Additionally, iron supplements, often prescribed to prevent or treat anemia, can contribute to constipation.
First-Line Relief Strategies
Before considering medications, lifestyle adjustments can alleviate constipation during pregnancy. Increasing dietary fiber intake is a highly effective initial step. Consuming fiber-rich foods like fruits, vegetables, whole grains, and legumes adds bulk to stool, helping it retain water and making it softer and easier to pass. Adults should aim for approximately 25 to 31 grams of fiber daily.
Adequate hydration is equally important, as water helps soften stool and supports proper bowel function. Drinking 8 to 10 glasses of water per day is recommended. Engaging in regular, gentle physical activity, such as walking, swimming, or prenatal yoga, also promotes bowel regularity by stimulating intestinal movement.
Safe Laxative Choices
When lifestyle modifications are insufficient, certain laxatives are suitable for use during pregnancy. Bulk-forming laxatives are often a first choice. They work by absorbing water in the intestines, which increases the bulk and weight of the stool, stimulating bowel activity and making it softer and easier to pass. Examples include psyllium (Metamucil) and methylcellulose (Citrucel). These agents are minimally absorbed into the bloodstream, making them generally safe for both the mother and the developing baby.
Stool softeners, such as docusate sodium (Colace), are another option. They work by allowing water and fat to mix into the stool, softening it without stimulating bowel contractions. Docusate sodium is poorly absorbed, posing a low risk to pregnancy when used as directed.
Osmotic laxatives, including polyethylene glycol (MiraLAX) and lactulose, draw water into the intestines. This increased water content softens stool and promotes bowel movements. Polyethylene glycol is a first-choice osmotic laxative during pregnancy due to minimal systemic absorption. Lactulose is also commonly used.
Laxatives to Avoid
Some laxative types are not recommended during pregnancy due to potential risks. Stimulant laxatives, such as senna and bisacodyl, directly stimulate gut muscles to contract and move stool along. These can cause uterine contractions or electrolyte imbalances. While some studies suggest limited risks with occasional use, they should be used with caution and only under medical guidance if other options fail.
Mineral oil is another laxative to avoid. This lubricant can interfere with the absorption of fat-soluble vitamins (A, D, E, K), important for maternal and fetal health. It can also be absorbed into the bloodstream in greater amounts than other laxatives.
When to Seek Professional Advice
It is always advisable to consult a healthcare provider before taking any medication, including over-the-counter laxatives, during pregnancy. Seek medical attention if constipation persists despite lifestyle changes and safe laxatives. Other concerning symptoms warranting immediate medical evaluation include severe abdominal pain, cramping, or blood in the stool. Any uncertainty about the appropriate type or dosage should prompt discussion with a doctor or midwife.