Constipation occurs in up to 38% of pregnant women. For some women constipation develops for the first time during pregnancy while others may have experienced chronic constipation throughout their life, which may worsen as a result of pregnancy.

How does it happen?
Constipation experienced early in pregnancy is most likely caused by rising progesterone levels resulting in reduced motility of the large intestine. As your pregnancy progresses and the uterus grows, the increased pressure on your bowels and rectum can also contribute to constipation. If you have an underactive thyroid this may further increase your susceptibility.

A number of dietary and lifestyle factors can also worsen constipation or a slow moving bowel such as inadequate fibre intake, not drinking enough water, poor dietary choices, stress, and lack of exercise.

Haemorrhoids
Chronic constipation and straining as a result can lead to haemorrhoids which are swollen veins at or near the anus. The increased pressure in the abdomen which occurs in pregnancy may result in haemorrhoids. Symptoms include intermittent bleeding from the anus, itching and occasional pain.

Haemorrhoids are common in pregnancy with a higher incidence of symptoms in pregnant than non-pregnant women. It seems that the risk of experiencing haemorrhoids increases with age and the number of pregnancies you have carried. For many women, symptoms resolve after birth, but it is important that you address any underlying constipation if this is an ongoing issue for you.

Let’s talk about the loo
If your stools are like hard pellets, then you are not properly eliminating your waste. This can result in headaches and digestive symptoms such as bloating and abdominal discomfort.

These tips may help:

• Ensure you are eating foods high in fibre every day such as fresh fruits, vegetables and whole grains such as brown rice and rolled oats.
• Avoid starchy and refined carbohydrates.
• Avoid excessive amounts of dairy, including cheese.
• Drink 2 L of purified water each day. Try warm water too. Start the day with warm water with a squeeze of lemon juice to help get the bowels moving.
• Start the day with a walk to stimulate bowel movement. Engage in gentle exercise and stretching every day.
• Probiotics such as Acidophilus and Bifidobacterium species may help to keep the bowels healthy.
• Slippery elm may help to soften the stool, making it easier to pass.
• Try a glass of prune juice each day. You might like to dilute the juice with water and sip throughout the day.
• Avoid tea and coffee. Drink peppermint tea or chamomile tea which have a soothing effect on the digestive system.
• Avoid harsh laxatives without first discussing it with your health care professional. Some herbal and pharmaceutical laxatives are not safe in pregnancy and may reduce absorption of much needed nutrients by increasing your digestive transit time.
• Vitamin C and calcium fluoride may help to support connective tissue strength and healing if you are experiencing haemorrhoids.

A note about iron supplementation...
Ferrous sulphate is a form of iron known to cause constipation, and high doses of iron supplementation may cause a problem in some women. If you suffer from chronic constipation or have started experiencing it in your pregnancy check your pregnancy supplement. Try a lower dose of iron or choose a formulation that can be taken in individual doses throughout the day.

References available upon request 

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