Constipation during pregnancy is extremely common, and the most effective relief comes from a combination of dietary changes, adequate fluids, and daily movement. If those three strategies aren’t enough, several over-the-counter options are considered safe during pregnancy. Here’s what actually works, why pregnancy makes you constipated in the first place, and how to layer these approaches for the best results.
Why Pregnancy Causes Constipation
Progesterone is the main culprit. This hormone rises steadily throughout pregnancy, and it directly relaxes the smooth muscle in your intestinal walls. That relaxation slows the rhythmic contractions that push food through your digestive tract, giving your body more time to absorb water from stool. The result: harder, drier stool that’s difficult to pass.
Your growing uterus adds physical pressure on your intestines, which can slow things down further in the second and third trimesters. And if you’re taking a prenatal vitamin with iron, that’s a well-known contributor to constipation on its own. Many pregnant women are dealing with all three factors at once.
Start With Fiber, Water, and Movement
These three changes are the recommended first line of treatment before trying any medication. They work together, and skipping one can undermine the others.
Fiber
Aim for 28 grams of fiber per day during pregnancy. Most people fall well short of this. Good sources include lentils, black beans, raspberries, pears, oats, and whole wheat bread. Prunes, apricots, and peaches are particularly helpful because they’re high in both fiber and sorbitol, a natural sugar alcohol that draws water into the gut and softens stool. Even a small glass of prune juice daily can make a noticeable difference.
Increase fiber gradually over a week or two rather than all at once. A sudden jump can cause bloating and gas, which you’re already more prone to during pregnancy.
Water
Current guidelines recommend pregnant women drink between 1.9 and 3 liters of water per day (roughly 64 to 100 ounces). Fiber absorbs water as it moves through your digestive system. Without enough fluid, adding fiber can actually make constipation worse. If you’re increasing your fiber intake, increase your water at the same time.
Movement
Thirty minutes of walking each day is enough to stimulate your intestines and keep things moving. Swimming is another good option because the water supports your extra weight, making it more comfortable in later pregnancy. Even if you can’t manage a full 30 minutes, shorter bouts of activity still help. The goal is consistency rather than intensity.
Sorbitol-Rich Fruits as Natural Laxatives
Certain fruits act as gentle, natural laxatives because of their sorbitol content. Sorbitol isn’t digested or absorbed in the small intestine. Instead, it holds water in its molecules as it passes through, increasing the water content in your gut and softening stool.
The best sources are prunes (dried plums), apricots, peaches, and plums, along with their juices. UK health guidelines specifically recommend these fruits for constipation relief. Eating two or three servings a day, or drinking a glass of prune or apricot juice, gives you a mild osmotic effect without any medication. These fruits also contribute to your daily fiber goal, so they’re doing double duty.
Probiotics May Help
Probiotics, whether from fermented foods like yogurt, kefir, and sauerkraut or from supplements, can alter the bacterial environment in your colon in ways that improve bowel function. The evidence is modest, but probiotics are safe during pregnancy and worth trying as part of your overall approach, especially if diet and movement alone aren’t getting you all the way there.
Safe Over-the-Counter Options
When lifestyle changes aren’t enough, several types of laxatives are considered safe during pregnancy. They’re typically recommended in a specific order, starting with the gentlest options.
Bulk-Forming Laxatives
Products containing psyllium husk are the first medication to try. They work the same way dietary fiber does: absorbing water and adding bulk to stool. They aren’t absorbed into your bloodstream and have not been associated with increased risk of birth defects, making them safe for long-term use throughout pregnancy. The typical dose is one to two rounded teaspoons mixed into a full 8-ounce glass of water, taken one to three times a day. Drinking enough water with these products is essential. Taking them without adequate fluid can cause intestinal blockage.
Stool Softeners
Docusate sodium is widely considered safe during pregnancy. Multiple studies have found no adverse effects on mother or baby. It works by drawing water into the stool, making it softer and easier to pass. It’s only minimally absorbed by your body. This is one of the most commonly recommended options for pregnant women who need something beyond fiber and fluids.
Osmotic Laxatives
Lactulose and polyethylene glycol (the active ingredient in products like MiraLAX) are poorly absorbed into your system and have not been linked to adverse effects in pregnancy. They work by pulling water into the colon. These are best used occasionally or short-term rather than daily for extended periods, because prolonged use could potentially lead to dehydration or electrolyte imbalances.
Stimulant Laxatives
Senna-based products are not associated with increased malformation risk and are not readily absorbed into the bloodstream. However, they can cause abdominal cramping, and like osmotic laxatives, they’re best reserved for occasional use. Think of stimulant laxatives as the option you turn to when gentler approaches haven’t worked, not as a daily solution.
Managing Iron-Related Constipation
If your prenatal vitamin’s iron content seems to be making things worse, you have a few options. Taking your iron supplement with food (though this slightly reduces absorption) or splitting the dose into smaller amounts throughout the day can sometimes ease the digestive impact. Some women find that switching to a different form of iron, such as iron bisglycinate, causes less constipation. Talk to your provider about alternatives if constipation is severe, because in some cases a lower iron dose or a different formulation may be appropriate based on your blood levels.
Pairing your iron supplement with a stool softener or bulk-forming laxative can also offset the constipating effect without interfering with absorption.
Signs That Need Medical Attention
Most pregnancy constipation is uncomfortable but manageable. However, certain symptoms warrant a call to your provider:
- Rectal bleeding or bloody stools
- Abdominal pain or cramping beyond mild discomfort
- Inability to have a bowel movement for more than a week despite trying the strategies above
- Dizziness or lightheadedness
- Dark urine or very little urine output, which may signal dehydration
These can indicate complications that go beyond routine constipation and may need specific treatment.