Constipation, characterized by infrequent or difficult bowel movements, is common during pregnancy. Many expectant mothers find themselves needing to push hard, raising concerns about potential effects on their bodies and the developing baby. Up to half of pregnant individuals may experience constipation at some point.
Why Straining Is a Concern
Prolonged or forceful straining during bowel movements can lead to several uncomfortable physical consequences. One common issue is the development of hemorrhoids, which are swollen veins in the rectum and anus. Increased intra-abdominal pressure from straining, combined with increased blood volume and pressure on pelvic veins during pregnancy, contributes to their formation. Hemorrhoids can cause itching, soreness, and make bowel movements more challenging.
Another potential consequence is anal fissures, small tears in the lining of the anus. Passing hard stools and the strain associated with constipation can cause these painful cracks. Anal fissures often result in sharp pain during bowel movements, followed by a burning sensation, and may also lead to bright red blood on toilet paper or in the toilet bowl. Both can negatively affect quality of life during pregnancy.
Causes of Constipation During Pregnancy
Several physiological changes during pregnancy contribute to constipation. A major factor is the increased production of the hormone progesterone. Progesterone causes smooth muscles throughout the body, including those in the intestines, to relax. This slows the movement of food and waste through the digestive tract. Slower transit allows more water to be absorbed from the stool, making it harder to pass.
As pregnancy progresses, the growing uterus also exerts physical pressure on the intestines. This mechanical compression can further hinder the normal movement of waste, contributing to constipation, especially in later stages. Additionally, iron supplements can slow down bowel movements. Excessive iron intake can impede the breakdown of food by gut bacteria, exacerbating constipation if fluid intake is insufficient.
Strategies to Ease Bowel Movements
To prevent and alleviate constipation, thereby reducing the need to strain, several strategies can be adopted. Increasing dietary fiber intake is recommended, aiming for approximately 25 to 30 grams per day. This can be achieved by incorporating more fruits, vegetables, whole grains, and legumes into meals and snacks, which add bulk to stools and make them easier to pass.
Adequate hydration is equally important, as water helps soften stools. Pregnant individuals should aim to drink around 10 to 12 cups of fluids daily, especially when increasing fiber intake. Regular gentle exercise, such as walking, swimming, or prenatal yoga, can also stimulate bowel activity and promote regular movements.
Adopting a proper toileting posture, such as using a footstool to elevate the knees, can help align the rectum for easier bowel movements. If lifestyle changes are not sufficient, certain over-the-counter options may be considered, but always with a healthcare provider’s consultation. Bulk-forming laxatives like psyllium or methylcellulose, and stool softeners such as docusate sodium, are generally considered safe during pregnancy as they are minimally absorbed by the body.
When to Seek Medical Advice
While constipation is common during pregnancy, certain symptoms warrant a consultation with a healthcare provider. It is advisable to contact a doctor if constipation becomes severe or persists despite consistent lifestyle modifications. Experiencing intense pain during bowel movements, noticing bright red blood in the stool, or on toilet paper, should also prompt medical evaluation.
Signs of fecal impaction, where a hard mass of stool becomes stuck in the rectum, also require professional attention. Any new or concerning symptoms, such as unexplained weight loss, continuous bleeding throughout the day, or changes in stool color or shape that last longer than three weeks, should be discussed with a doctor to rule out other underlying conditions.