Constipation During Pregnancy
The short answer
Constipation affects up to 40% of pregnant people and is caused by the hormone progesterone slowing digestive transit, iron supplements, a growing uterus pressing on the intestines, and reduced physical activity. It can be managed with increased fiber, fluids, and gentle exercise.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
Constipation may begin early due to rising progesterone levels and prenatal vitamins containing iron. Eating high-fiber foods (fruits, vegetables, whole grains), drinking plenty of water, and staying active can help. If your prenatal vitamin seems to worsen constipation, ask your provider about switching to a different formula.
Constipation often continues or worsens as the uterus grows. Aim for 25-30 grams of fiber daily and at least 8-10 glasses of water. Prune juice and psyllium-based fiber supplements are generally safe. Stool softeners like docusate sodium may be recommended by your provider if diet changes are not enough.
The growing uterus puts additional pressure on the intestines, potentially worsening constipation. Continuing fiber-rich foods, staying hydrated, and gentle daily exercise like walking can help. Avoid straining during bowel movements, as this can worsen hemorrhoids. Talk to your provider before using any laxative.
Constipation is common after delivery, especially after a cesarean section or if you took pain medications. Stool softeners are commonly recommended postpartum. Resume fiber and fluid intake as soon as you can. Your first postpartum bowel movement may be uncomfortable but is important - do not delay it.
What Should You Do?
When to take action
- Having fewer bowel movements than usual but no significant pain
- Stools are harder than normal but you can still pass them
- Constipation improves with increased fiber, fluids, and activity
- Symptoms began with pregnancy or with starting iron supplements
- You have not had a bowel movement in more than 3-4 days despite trying home remedies
- You have significant abdominal bloating or cramping from constipation
- You are developing hemorrhoids or anal fissures from straining
- You have severe abdominal pain, vomiting, or inability to pass gas, which could suggest a bowel obstruction
- You notice blood in your stool that is more than a small amount from hemorrhoids
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Maternal Concerns
Hemorrhoids During Pregnancy
Hemorrhoids are swollen blood vessels in the rectal area that affect up to 35% of pregnant people. They are caused by increased blood volume, pressure from the growing uterus, constipation, and straining. While uncomfortable, they are very common and usually treatable with conservative measures.
Severe Heartburn and GERD in Pregnancy
Heartburn (gastroesophageal reflux) is extremely common in pregnancy, affecting up to 80% of pregnant people. It is caused by the hormone progesterone relaxing the valve between the stomach and esophagus, and by the growing uterus pushing up against the stomach. While very uncomfortable, it is not harmful to you or your baby.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.
20-Week Anatomy Scan Unexpected Findings
The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.