Constipation During Pregnancy: Causes, remedies, and safe solutions

Constipation in pregnancy is a common issue and is especially prevalent in women experiencing morning sickness or Hyperemesis Gravidarum (HG), and those taking medications such as Ondansetron (Zofran). Understanding why constipation occurs and how to manage it safely can help make your pregnancy journey more comfortable.

Before we delve into the details, it's essential to note that this article is for informational purposes only and should not be considered medical advice. If you are pregnant and experiencing constipation or any other health concerns, it is crucial to seek guidance from a healthcare professional.

Why Does Constipation Happen in Pregnancy?

Constipation during pregnancy can occur for several reasons:

1. Hormonal Changes: Pregnancy hormones, particularly progesterone, relax the muscles in your digestive tract. This relaxation can slow down the movement of food and waste, leading to constipation.

2. Pressure from the Growing Uterus: As your baby grows, the expanding uterus can press on your intestines, making it harder for stool to pass.

3. Iron Supplements: Many pregnant women take iron supplements to prevent anemia. However, iron can be constipating, especially in higher doses.

4. Medications like Ondansetron: For those struggling with severe morning sickness or HG, medications like Ondansetron may be necessary. While Ondansetron is effective in reducing nausea and vomiting, it can also contribute to constipation. This is because Ondansetron affects the gut's motility, making it harder for the intestines to move waste along.

Managing Constipation: Safe and Effective Approaches

There are several ways to manage constipation during pregnancy. It's always best to start with the gentlest options and seek professional advice before trying any new treatments.

1. Dietary Fibre: Increasing your intake of dietary fibre is often the first step in managing constipation. Foods rich in fibre, such as whole grains, fruits, vegetables, and legumes, can help add bulk to your stool and promote regular bowel movements. Psyllium fibre, like that found in No2, is a natural bulk-forming laxative that can be particularly helpful. Psyllium is also a prebiotic, meaning it nourishes the beneficial bacteria in your gut, supporting overall digestive health.

2. Hydration: Drinking plenty of water is crucial when increasing your fibre intake. Water helps soften the stool, making it easier to pass. Aim to drink at least 8-10 glasses of water a day.

3. Exercise: Regular physical activity can stimulate your intestines and help keep things moving. Even gentle exercises like walking or prenatal yoga can be beneficial.

4. Laxatives: In some cases, dietary changes alone may not be enough, and laxatives may be needed. According to the NSW Royal Hospital for Women, the following types of laxatives are generally safe for use during pregnancy:

   • Bulk-forming laxatives (e.g., psyllium, ispaghula, sterculia): These increase bulk and moisture in the stool, stimulating bowel activity. They are usually effective within 24 hours but may take 2-3 days of regular use.

   • Osmotic laxatives (e.g., macrogol, lactulose, sorbitol): These draw water into the bowel to soften the stool and expand it, making it easier to pass. They can be effective within 2-48 hours when taken on an empty stomach.

   • Stimulant laxatives (e.g., senna, bisacodyl): These stimulate the gut directly and are typically effective within 6-12 hours. They should be used occasionally and are best taken at bedtime.

   • Stool softeners (e.g., docusate): Often used in combination with other laxatives, they help soften the stool but may be less effective on their own.
     
     For more information on these treatments, you can refer to the document from the NSW Royal Hospital for Women.

5. Avoiding Triggers: If you find that certain foods or medications are making your constipation worse, discuss these concerns with your healthcare provider. They may be able to suggest alternatives that are gentler on your digestive system.

When to Seek Help
While constipation is common during pregnancy, it should not be ignored, especially if it becomes severe or is accompanied by other symptoms like abdominal pain or rectal bleeding. Always consult your healthcare provider if you have concerns about your bowel movements or if you need advice on managing constipation safely during pregnancy.