Understanding and Managing Constipation During Pregnancy

Constipation is a condition that results in decreased frequency of bowel movements. When the frequency of passing the stool reduces to an extent where the patient has not had even three bowel movements in a week for over a month, it can be classified as chronic constipation needing medical intervention. As early as the first or second month in pregnancy, the hormonal changes in the body lead to constipation in many women. This infrequency in bowel movements becomes severe in the third trimester of pregnancy.

What exactly causes constipation in pregnancy?

The hormonal changes that the body undergoes during pregnancy can be regarded as the main culprit for constipation. 

• Progesterone: This is a hormone that is produced by ovaries. During pregnancy the ovaries produce excess progesterone to support the uterus which houses the fetus. However the side effect of this hormone becomes evident on other organs like intestines. The bowels that are present in the abdomen become relaxed when progesterone acts on them. In means that the normal mobility of the intestine is disrupted. This relative slowing down of the normal digestive process leads to constipation. 
• Weight of the fetus: As the fetus grows inside the uterus the excess weight that is exerted by it on the bowels makes the mechanical motion of the bowels difficult to carry on normally. 
• Excess iron: Sometimes when you take supplements to improve nourishment during pregnancy, they can act against you. One main element that can increase the risk of constipation is iron supplement. Excess amounts of iron makes it difficult for the body to digest the food.
• Dehydration: One of the most obvious reasons that leads to constipation is not consuming enough liquids. Gut motility is closely linked to water intake hence water intake should be monitored during pregnancy.
• Lifestyle: Skipping on fibre rich foods also increases constipation. It is also essential to ensure to get some form of exercise during pregnancy to help exert wastes from the body. 

How is constipation treated and managed during pregnancy?

The first line to improve constipation is closely linked with lifestyle changes and dietary improvements. It has been proven that getting some form of exercise everyday increases the gut motility. 

Tracking fluid intake along with consuming fibre rich foods should improve the signs of constipation and provide relief.

If prescribed by your OB GYN, using probiotics has also shown marked improvement in some patients. These help to repopulate the gut bacteria and aid healthy motility of the intestine muscles.

However if these measures fail to show any improvement, laxatives can be used to treat constipation. There are some studies conducted that indicate that some laxatives are safe to use during pregnancy.

Bulk-forming agents: These substances do not have any systemic effects and are hence considered safe during pregnancy. The way bulk forming agents work is when they are present in the intestine, they absorb water and become larger or bulk up. This means that there is increased weight in the tubes of the intestine facilitating easy movement of stool.

However these may not be the best option in every case as they can lead to some bloating and cramps.

Stool softeners: This form of laxative has been studied for ages and there no notable side effects. The stool gets hardened in the large intestine because the water gets reabsorbed into the body when it is not expelled out. And stool softeners essentially add water to soften the stool allowing easy passage.

Lubricant, Osmotic, and Stimulant laxatives: These category of laxatives if misused can lead to electrolyte imbalances. They are hence not available over the counter. Your OB GYN will prescribe one of these laxatives when Stool softeners and Bulk-forming agents are not aiding proper digestion and expulsion. 

The way some laxatives work is they act on the muscles of the intestine promoting motility. This can hence lead to diarrhoea when not monitored properly.

These laxatives are rarely absorbed into the body. Hence it is unlikely that they can be harmful to the fetus. 

Conclusion

The best way to avoid constipation during pregnancy is concentrating on lifestyle improvements. Closer attention to consuming natural forms of fibre rich foods like Almonds, green leafy vegetables, Chia seeds and sweet potatoes along with having at least eight glasses of water everyday is the best way to prevent constipation during pregnancy.

Setting some time in the day to get exercise in the form of Walking or yoga even less intense aerobics can help with this condition. 

It is best to consult with your OB GYN before taking over the counter laxatives or stool softeners to ensure that the dosage is appropriate. It is important to not consume any laxatives for a longer period of time to maintain gut health. In most cases constipation that begins during pregnancy improves by itself postpartum in a few months.