Constipation during pregnancy

Why am I so constipated while I'm pregnant?

Constipation is a common problem during pregnancy: Up to half of pregnant women get

constipated at some point.

One reason for constipation during pregnancy is an increase in the hormone progesterone, which
relaxes smooth muscles throughout the body, including the digestive tract. This means that food
passes through the intestines more slowly.

And the problem may be compounded later in pregnancy by the pressure of your growing uterus
on your rectum. Iron supplements, especially in high doses, can make constipation worse.

What can I do to relieve constipation during pregnancy?

Here are some tips for preventing and easing constipation when you're pregnant:

 Eat high-fiber foods, including whole grain cereals and breads, brown rice, beans, and
fresh fruits and vegetables every day. It can help to add a couple of tablespoons of
unprocessed wheat bran (available at health food stores) to your cereal in the morning,
though it may take a few days before you notice a difference.

 Drink plenty of water. Try to have 10 8-ounce cups of water or other beverages daily.
(Or sip throughout the day until your urine is clear or pale yellow in color – a sign of
adequate hydration.) Drinking a glass of fruit juice every day, especially prune juice, can
also be helpful. Some people find that drinking a warm liquid right after waking up helps
get things moving.

Pregnancy constipation
Constipation is common during pregnancy. What causes constipation, and how can you prevent
it?
 Exercise regularly. Walking, swimming, riding a stationary bike, and yoga can all ease
constipation and leave you feeling more fit and healthy.
  Listen to your body. Your bowels are most likely to be active after meals, so make time
to use the bathroom after you eat if you need to. Don't put off going to the bathroom
when you feel the urge.

 Try another prenatal vitamin. If your prenatal multivitamin contains a large dose of
iron (and you're not anemic), ask your healthcare provider about switching to a
supplement with less iron.

If the measures above don't help (or it's hard for you to follow them), talk to your provider about
taking an over-the-counter fiber supplement or a laxative or stool softener.

Is constipation during pregnancy ever serious?

Not usually, but occasionally constipation during pregnancy can be a symptom of another
problem. If you have severe constipation that's accompanied by abdominal pain, alternates with
diarrhea, or you pass mucus or blood, call your doctor or midwife immediately.

Also, straining during a bowel movement or passing a hard stool can lead to or
worsen hemorrhoids, which are swollen veins in the rectal area. Hemorrhoids can be extremely
uncomfortable, though they rarely cause serious problems. In most cases, they go away fairly
soon after your baby is born. However, if the pain is severe, or if you have rectal bleeding, call
your provider.
 Constipation during pregnancy
Your body produces more female hormones than usual while you’re pregnant. These
hormones have the important job of ensuring that your pregnancy develops as it
should, but their presence does cause some unwelcome side effects. One of them is
increased constipation.

Constipation during pregnancy occurs for four main reasons 

 Slow digestion
 Pressure on the intestines 
 Influence of hormones
 Lack of moisture

The high levels of progesterone relax the smooth muscle walls of the bowel, slowing
down the entire digestive tract.

As if this wasn’t enough, the increasing pressure of the growing uterus on the

intestines causes them to be pushed into an even smaller space. This means that it
becomes even more difficult for the waste to move through the mass of pulsing
muscular tubing.

The longer waste stays in the bowel, the more moisture is absorbed, so the waste gets
harder and even more difficult to expel. Nature slows down your digestive tract for a
very good reason.

Food stays in the stomach longer so that the placenta has more time to absorb the
necessary nutrients to pass to your baby.

This means that it takes longer for your body to expel its waste. Other causes include
irregular eating habits, stress, some medications, including iron remedies, lack of fibre
and exercise, or too little intake of fluids.

What are the signs of constipation? 

 More than four days between bowel movements.

 Dry, hard stools that are painful and difficult to pass.
 If you're left with a feeling that not everything has passed when you do have a
bowel movement.
 If there’s bleeding from the rectal area when hard stools have been passed.
 Lack of appetite and not being able to face food.
 Bloating of the lower abdomen, cramp, spasm and pain.
 Having a headache and general unease are signs of constipation and
dehydration.

You're at increased risk to suffer with constipation in pregnancy if... 

 You’re already prone to bouts of constipation.

 You have nausea and vomiting and aren’t managing to eat as much as you
should be.
 You have irritable bowel syndrome (IBS). 
 Pregnancy-induced anaemia may make constipation worse, as well as some of
the medications used to treat anaemia.
 You don’t exercise. Lack of exercise makes your whole system sluggish.

As your pregnancy progresses, increased pressure on your pelvic area makes

constipation more likely. While you have no influence over your hormones or the
decreasing space in your abdomen, there’s a lot you can do to prevent constipation
from happening, and ways to manage it if it’s a problem.

Constipation isn’t life threatening, but it can become uncomfortable and can
make haemorrhoids/piles much worse. Tackle constipation before it becomes a
problem.

Prevention is better than cure 

Stay active! Brisk walking several times a week will wake up your system. Other
forms of exercise, like swimming and yoga, are also a good idea. Drink at least eight
cups of water a day. Sip it throughout the day, and you’ll not find yourself in the loo
as much as if you drink a glass quickly every hour or so. 

Limit your intake of tea and other caffeinated products such as coffee and colas.
These can irritate your bladder and make you want to urinate more often. 

You need roughage to assist with digestion. Add high fibre foods to your diet. Eat raw
or cooked fruits and vegetables and whole grain products, like wholewheat bread,
brown rice and oatmeal. Sprinkle your salads, fruit, vegetables and breakfast cereals
with crushed linseeds and prunes. Chew your food well.

Try to take your iron supplements with orange juice or prune juice. Follow good
bowel habits. Respond immediately to your body’s cues.

When to worry

When you’re experiencing repeated rectal bleeding or abdominal pain, and nothing
seems to help, notify your doctor immediately as there may be something more
serious going on, such as intestinal inflammation or parasites. 

Top 10 tummy tips 

Eating a small handful of raisins before going to bed will stimulate normal elimination
in the morning

1. Drinking either hot or very cold liquid on an empty stomach may help stimulate
your bowels. On waking, have a large glass of very warm water with a squeeze of
lemon to get you moving and to balance your pH.

2. Keep a small footstool in the bathroom. Placing your feet on the stool will
provide better leverage and prevent unnecessary straining, which could lead to piles. 

3. Psyllium (ispagula husks), the seeds from plantain, may be effective for
constipation, especially if you have IBS. Eating prunes can be just as effective and
tastes better. If you’re taking medication for a heart condition, please check with your
caregiver before using psyllium. Linseeds (flaxseeds) are rich in fibre and essential
fatty acids, and can be used as an alternative to psyllium. Be sure to drink at least one
large glass of water for each tablespoon of linseeds you consume.

4. Take probiotics. This will ensure healthy intestinal flora and improve overall
digestive function.

5. Try a tablespoon of molasses and raw honey every day. Importantly, always talk
to your doctor about any remedy you may try.

6. Midwife Jacky De-Boer recommends abdominal massage in an anti-clockwise

direction, around the outer borders of your uterus. She says, “Although your faeces
move in a clockwise direction, the peristaltic movement of your intestine is in fact
anti-clockwise. If you do this, you will stimulate the intestines instead of just moving
the faeces along.” Add a few drops of lavender or dill and mandarin oil mixed in a
carrier oil when you do this.
7. Dandelion tea may ease constipation. Steep the leaves in boiling water and drink it
daily.

8. Reflexology can make a difference to constipation, as it regulates bowel movement.

You can do this by massaging the arches of your feet. The arches correspond to the
digestive system. Massage in a circular, clockwise motion, for about five minutes on
each foot. Use the same blend of oils as for the abdominal massage.

9. Take 10 Segiro drops, orally, three times daily to stimulate peristaltic activity.

10. One tablet of Nat Mur tissue salt taken three times daily will assist with the
passing of dry hard stools.
 NAME : DIAJENG FENTI SETIAWAN

NIM : P17321183017

1. What is constipation ?

Answer : Depending on your diet, age, and daily activity, regularity can
mean anything from three bowel movements a day to three each week.
If fecal material sits in the colon, the harder the stool becomes and the more
difficult it is to pass. This condition is known as constipation. A normal
stool should not be either unusually hard or soft, and you shouldn't have to
strain unreasonably to pass it.

2. Why it happen in pregnant woman ?

Answer : The cause of constipation during pregnancy depends on the stage at which
it occurs. Possible causes include:

 Hormones: Changing hormone levels in early pregnancy cause the intestines to

slow down the movement of stool through the bowel. This delay increases the
amount of water that the colon absorbs from the stool, which makes it more solid and
difficult to pass.

 Prenatal vitamins: Prenatal vitamins are chock-full of iron, a crucial mineral

that can sometimes be deficient during pregnancy. Iron can cause constipation and
hard, black stools.

 Pressure from the uterus: In later pregnancy, the growing uterus can put
pressure on the bowel, making it harder to move stool through the intestines.
In addition to infrequent bowel movements, constipation can cause bloating, stomach
discomfort, and hard, dry stools that are painful to pass. It can also result in a feeling
that not all the stool has passed.

3. When does constipation generally start during pregnancy ?

 Answer : Constipation tends to start as early as progesterone levels rise, around the
second to third month of pregnancy. It may get worse as pregnancy progresses and your
uterus grows.

4. How to prevent and treat constipation during pregnancy ?

Answer : During pregnancy, women can often relieve constipation using gentle, safe
home remedies:

 Fiber: Taking fiber supplements or eating more fibrous foods, such as fruits,

vegetables, and whole grains, can increase the number of stools and facilitate their
passage through the intestines. Adults should eat between 28 and 34 grams of fiber
each day.

 Fluid: Drinking enough water is important to keep stool soft and easy to pass.
If a person feels that water is not helping, they can try adding clear soups, teas, and
naturally sweetened fruit or vegetable juices to their diet.

 Activity: Being active helps stool move through the intestines. Getting regular
exercise, with a doctor's approval, can help relieve constipation. If exercising is not a
priority or possibility, try to fit in a gentle walk each day.

 Probiotics: Millions of healthy bacteria live in the gut and help it function

correctly. Probiotics may help repopulate the gut bacteria with healthy strains that
encourage normal and regular bowel movements. Foods high in probiotics include
yogurt, sauerkraut, and kimchi.

Other treatments

If the home remedies above do not work, it may be time to discuss other options with
a doctor.

For women taking prenatal vitamins that are high in iron, doctors may recommend
trying a vitamin that contains less iron.
The primary medical treatment for constipation in pregnancy is a medication called a
laxative, which makes it easier and more comfortable to go to the bathroom.

It is generally safe to use gentle laxatives, but it is best to avoid stimulant laxatives
because they can induce uterine contractions.

Although many laxatives are available over the counter, it is important to check with a
doctor which one is safe to use. Limited information is available about using some of
these medications during pregnancy.

Women can usually safely use the following types of laxative during pregnancy:

Bulk-forming agents

Bulk-forming agents mimic fiber by adding material to the stool and helping it absorb
more water. By doing this, they make the stool larger, softer, and easier to pass.

These types of laxative can cause some cramping or discomfort, so people should start
with the lowest dosage and ensure that they drink lots of water.

Examples of bulk-forming agents include psyllium, methylcellulose, and

polycarbophil.

Stool softeners

Stool softeners add water to the stool to help make it softer and more comfortable to
pass.

The stool softener that doctors most commonly recommend to pregnant women is
docusate (Colace).
Lubricant laxatives

Lubricant laxatives add a slippery coating to either the stool or the inside of the
intestinal tract to aid the passage of stool out of the body.

Glycerin suppositories are one type of lubricant laxative. It is essential to always

speak to a healthcare professional before using suppositories, especially when
pregnant.

Osmotic laxatives

By drawing more water into the intestines, these laxatives help soften the stool. They
also allow the bowel to contract more to move the stool along. These types of laxative
can also cause cramping and bloating in the abdomen.

Examples of osmotic laxatives include polyethylene glycol

and magnesium hydroxide.
 Constipation and pregnancy: What to know

Constipation is a very common symptom that many women experience during

pregnancy.

Some women have constipation at an early stage of their pregnancy, while it does not
affect other women until much later on.

In this article, we explain why constipation is common in pregnancy and discuss safe
treatments and home remedies that women can use to relieve the discomfort.

Causes

The cause of constipation during pregnancy depends on the stage at which it occurs.
Possible causes include:

 Hormones: Changing hormone levels in early pregnancy cause the intestines to

slow down the movement of stool through the bowel. This delay increases the
amount of water that the colon absorbs from the stool, which makes it more solid and
difficult to pass.

 Prenatal vitamins: Prenatal vitamins are chock-full of iron, a crucial mineral

that can sometimes be deficient during pregnancy. Iron can cause constipation and
hard, black stools.

 Pressure from the uterus: In later pregnancy, the growing uterus can put
pressure on the bowel, making it harder to move stool through the intestines.
In addition to infrequent bowel movements, constipation can cause bloating, stomach
discomfort, and hard, dry stools that are painful to pass. It can also result in a feeling
that not all the stool has passed.

Constipation can be particularly uncomfortable during pregnancy.

 Home remedies

During pregnancy, women can often relieve constipation using gentle, safe home
remedies:

 Fiber: Taking fiber supplements or eating more fibrous foods, such as fruits,

vegetables, and whole grains, can increase the number of stools and facilitate their
passage through the intestines. Adults should eat between 28 and 34 grams of fiber
each day.

 Fluid: Drinking enough water is important to keep stool soft and easy to pass.
If a person feels that water is not helping, they can try adding clear soups, teas, and
naturally sweetened fruit or vegetable juices to their diet.

 Activity: Being active helps stool move through the intestines. Getting regular
exercise, with a doctor's approval, can help relieve constipation. If exercising is not a
priority or possibility, try to fit in a gentle walk each day.

 Probiotics: Millions of healthy bacteria live in the gut and help it function

correctly. Probiotics may help repopulate the gut bacteria with healthy strains that
encourage normal and regular bowel movements. Foods high in probiotics include
yogurt, sauerkraut, and kimchi.

Other treatments

If the home remedies above do not work, it may be time to discuss other options with
a doctor.

For women taking prenatal vitamins that are high in iron, doctors may recommend
trying a vitamin that contains less iron.

The primary medical treatment for constipation in pregnancy is a medication called a

laxative, which makes it easier and more comfortable to go to the bathroom.
It is generally safe to use gentle laxatives, but it is best to avoid stimulant laxatives
because they can induce uterine contractions.

Although many laxatives are available over the counter, it is important to check with a
doctor which one is safe to use. Limited information is available about using some of
these medications during pregnancy.

Women can usually safely use the following types of laxative during pregnancy:

Bulk-forming agents

Bulk-forming agents mimic fiber by adding material to the stool and helping it absorb
more water. By doing this, they make the stool larger, softer, and easier to pass.

These types of laxative can cause some cramping or discomfort, so people should start
with the lowest dosage and ensure that they drink lots of water.

Examples of bulk-forming agents include psyllium, methylcellulose, and

polycarbophil.

Stool softeners

Stool softeners add water to the stool to help make it softer and more comfortable to
pass.

The stool softener that doctors most commonly recommend to pregnant women is
docusate (Colace).

Lubricant laxatives

Lubricant laxatives add a slippery coating to either the stool or the inside of the
intestinal tract to aid the passage of stool out of the body.
Glycerin suppositories are one type of lubricant laxative. It is essential to always
speak to a healthcare professional before using suppositories, especially when
pregnant.

Osmotic laxatives

By drawing more water into the intestines, these laxatives help soften the stool. They
also allow the bowel to contract more to move the stool along. These types of laxative
can also cause cramping and bloating in the abdomen.

Examples of osmotic laxatives include polyethylene glycol

and magnesium hydroxide.

Complications

In most cases, constipation in pregnancy is short-lived and resolves with no or

minimal treatment. In rare cases, however, prolonged constipation can cause fecal
impaction, which may need removal by a doctor.

Continued use of certain types of laxative can cause the bowel to "forget" how to push
stool through the intestines.

These drugs can also cause electrolyte or fluid imbalances in some people. Such
issues usually affect people who have other health problems, such as diabetes or
kidney disease.

It is best to speak to a doctor about the types of laxative to take and how often to take
them.

When to see a doctor

It is vital that pregnant women speak with their doctor before taking any medication,
including laxatives or other constipation remedies.
 Seeing a doctor is also advisable if any additional symptoms occur, including:

 nausea

 stomach pain

 vomiting

 constipation that lasts for longer than 1–2 weeks

 bleeding from the rectum

 no relief after using a laxative

As always, mention any other symptoms or concerns to the doctor for more specific
information and advice.
 Constipation During Pregnancy
What is constipation?
Depending on your diet, age, and daily activity, regularity can mean anything from three bowel
movements a day to three each week.
If fecal material sits in the colon, the harder the stool becomes and the more difficult it is to pass. This
condition is known as constipation. A normal stool should not be either unusually hard or soft, and you
shouldn't have to strain unreasonably to pass it.

Irregular bowel movements causing a bloated, gassy, clogged-up feeling are a very regular
pregnancy complaint. Here's what you can do if you're feeling stopped up.

When Does Constipation Generally Start During Pregnancy?

Constipation tends to start as early as progesterone levels rise, around the second to third

month of pregnancy. It may get worse as pregnancy progresses and your uterus grows.

What Causes Constipation During Pregnancy?

As with many other pregnancy symptoms, pregnancy hormones are the culprit behind

constipation. Progesterone causes the muscles in your bowels to relax, allowing food to
hang around longer in the digestive tract. The upside is there's added time for nutrients to
be absorbed into your bloodstream and reach your baby. The downside is you end up with
a waste-product traffic jam. Your expanding uterus also takes up valuable space normally
occupied by your bowel, cramping its usual activity.

What Can I Do About Constipation When I'm Pregnant?

You don't have to resign yourself to nine months of misery. There are plenty of tactics to
combat colon congestion (all the while heading off hemorrhoids, a common side effect of
constipation):

 Fight back with fiber. Fiber-rich foods help you eliminate waste; aim for 25 to 35
grams each day. Check the food labels if you want, but there's no need to do the
math. Instead, focus on simply eating plenty of whole-grain cereals and breads,
legumes (peas and beans), fresh fruits and veggies (raw or lightly cooked —
 preferably with skin left on) and dried fruits. Going for the green can also help you
go, in both the form of leafy green vegetables and kiwi fruit, which packs a potent
laxative effect. Sample from this fiber-rich and tasty menu to get started. Really
plugged up? Try adding some bran or psyllium to your diet, starting with a sprinkle
and increasing as needed. Be sure to check with your doctor first before you do
this, though, and don't go overboard, since these fiber powerhouses can carry away
important nutrients before they can be absorbed. (Also be prepared for some
flatulence, another common complaint of pregnancy as well as a temporary side
effect of upping the fiber in your diet.)
 Resist refined. Shun refined grains (white bread, white rice, refined cereals and
pasta), which tend to back things up. 
 Drink up. Downing 12 to 13 full glasses of fluids (water, vegetable or fruit juice
and broth) every day keeps solids moving through your digestive tract and makes
your stool soft and easier to pass. You can also turn to warm liquids, including that
health spa staple, hot water and lemon, to help stimulate peristalsis (the intestinal
contractions that help you go). Prune juice is a good pick for truly tough cases,
since it's a mild laxative.
 Don't max out at mealtime. Big meals can overtax your digestive tract, leading to
things getting backed up. Try eating six mini-meals a day rather than three large
ones and you'll also experience less gas and bloating.
 Go when you gotta go. Regularly holding it in can weaken the muscles that
control your bowels and lead to constipation, so try to go whenever you have to.
 Consider your supplements and medications. Ironically, many of the
supplements and medications that do a pregnant body good (prenatal
vitamins, calcium and iron supplements, and antacids) can exacerbate constipation.
So check with your practitioner about alternatives (such as slow-release iron
supplements) or adjustments in dosages until the situation improves. Also ask your
practitioner about taking a magnesiumsupplement to help fight constipation.
Taking it at night may relax achy muscles and help you sleep better, too.
 Get your fill of probiotics. The probiotic acidophilus, found in yogurts that
contain active cultures, stimulate the intestinal bacteria to break down food better to
keep things moving. You can also ask your practitioner to recommend a good
 probiotic supplement in capsules, chewables or powder form that can be added to
smoothies.
 Get a move on. Regular exercise during pregnancy encourages regular bowel
movements. Even just a 10-minute walk can get things moving, so make sure
you're getting the recommended amount of practitioner-approved exercise.
 Do your Kegels. Pelvic floor exercises can help keep you regular when practiced
regularly.
 Stay away from stimulant laxatives. Not all laxatives and stool softeners
(especially herbal or homemade ones) are safe for use during pregnancy. Talk to
your practitioner before taking any constipation medication or remedy.
RESUME

Constipation is if fecal material sits in the colon, the harder the stool becomes and the more difficult it
is to pass. This condition is known as constipation.

Constipation generally start during pregnancy when constipation tends to start as

early as progesterone levels rise, around the second to third month of pregnancy.

Causes Constipation During Pregnancy is pregnancy hormones are the culprit behind constipation.
Progesterone causes the muscles in your bowels to relax, allowing food to hang around longer in the
digestive tract. The upside is there's added time for nutrients to be absorbed into your bloodstream and
reach your baby. The downside is you end up with a waste-product traffic jam. Your expanding uterus
also takes up valuable space normally occupied by your bowel, cramping its usual activity.

How to treat constipation during pregnancy

1. Fight back with fiber. 

2. Resist refined. 

3. Drink up. 

4. Don't max out at mealtime. 

5. Go when you gotta go. 

6. Consider your supplements and medications. 

7. Get your fill of probiotics. 

8. Get a move on. 

9. Do your Kegels. 

10. Stay away from stimulant laxatives.