Why do we get constipated during pregnancy?
A PERSONAL NOTE
by Gutsy Flora
Despite being obsessed with gut health, I have actually never suffered from any serious gut health issues… until I recently got pregnant. It was then I realised I had to up my own Gutsy Game!
I initially thought the problem was down to the emotional excitement and anxiety at the early weeks of my pregnancy. I am well aware of the gut-brain-axis so that seemed like the most obvious reason and I just did my usual thing when I’m not feeling 100% - I ate some extra fibre, drank a bit more water and went on a walk - but no improvement.
I eventually did get a handle on things, but soon reached out to fellow Gut Health enthusiast Kirstin, who has recently had a baby, and she quickly explained what had been going on, and re-assured me that what I was experiencing was normal.
So this blog is for all you new mums out there wondering what the heck has been going on and what you can do about it.
WHY DO WE GET CONSTIPATION DURING PREGNANCY?
by Kirstin Kade
Constipation is fairly common during pregnancy.
Progesterone is a hormone that is responsible for smooth muscles throughout your body to relax - this effect is important to prevent premature uterine contractions and to maintain pregnancy.
Increased levels of progesterone during pregnancy can cause the muscles in your gastrointestinal tract (GIT) to relax, which slows down gastric motility (the movement of food through your GIT). This means that food remains in your GIT for longer periods of time. On one hand, this is advantageous as it allows your body more time to extract and absorb nutrients from the food that you eat. On the flip side, it also allows your body to extract more water from your food too, which can result in your poo being less soft and not quite as easy as normal to pass.
In addition to this, increased progesterone and relaxin levels cause ligamentous laxity (hypermobility), which can lead to stretching of the pubic symphysis. During pregnancy, this, combined with the increased abdominal pressure and weight of a growing baby, placenta, and amniotic fluid, can result in conformational changes to the pelvic floor that can make it more difficult to pass stool.
TOP TIPS TO HANDLE CONSTIPATION DURING PREGNANCY
Here are some tips to tackle constipation during pregnancy. It’s worthwhile giving each of them a try to figure out what is and isn’t really effective for you:
1. Get yourself a squatty potty or prop your feet up on a low stool when you need to poop. This can help you to not strain when you go to the loo (for the sake of your pelvic floor and to prevent the development of haemorrhoids).
2. Get your fill of fibre from a wide variety of sources. I know that this can be tricky during the first trimester of pregnancy, but be curious and try figure out what fibre sources your body can handle (even if what you manage to stomach is some seeded whole grain toast or wholemeal pasta with chickpeas). If you’re REALLY struggling with getting sufficient fibre in through your diet, chat to your GP about adding a psyllium supplement to your daily routine.
3. Drink enough fluids. Carry around a bottle of water with you throughout the day to make sure that you are drinking regularly.
4. Try eating smaller, more regular meals and snacks. This can ease the work that your Gastro-intestinal Tract has to do and can also help ease morning sickness.
Iron supplements are commonly prescribed during pregnancy…they are a double-edged sword though...
5. Find a loo and GO when nature calls. Don’t put it off until later! We’re often guilty of holding it in because we’re just too busy, but it’s worthwhile honouring your body’s signals.
6. Light physical activity may also be beneficial, as it can promote regular bowel movements during pregnancy.
7. There may also be value in trying out a magnesium supplement, and as a bonus this may also help to improve sleep. Make sure to talk to your healthcare provider about this beforehand.
8. Probiotics may also be beneficial (however there is limited evidence to suggest which specific strain(s) of bacteria will be useful in the case of constipation).
9. Iron supplements are commonly prescribed during pregnancy, which is a time where women are susceptible to anaemia. They are a double-edged sword though - whilst they can prevent anaemia, iron supplements are renowned for contributing to constipation. Chat to your healthcare provider about switching supplements, or...
10. If none of these tips seem to work for you, it’s worthwhile chatting to your healthcare provider to assess whether or not you may benefit from gentle laxatives such as lactulose.
REFERENCES
1 - Shin GH, Toto EL, Schey R. Pregnancy and Postpartum Bowel Changes: Constipation and Fecal Incontinence. Am J Gastroenterol. 2015;110(4):521-9. https://www.ncbi.nlm.nih.gov/pubmed/25803402
2 - NHS. Constipation [Internet]. NHS [updated 2017 Dec 20; cited 2019 Jun 23]. https://www.nhs.uk/conditions/constipation/
3 - Longo SA, Moore RC, Canzoneri BJ, Robichaux A. Gastrointestinal conditions during pregnancy. Clin Colon Rectal Surg. 2010;23(2):80-9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2967327/
4 - Vazquez JC. Constipation, haemorrhoids, and heartburn in pregnancy. BMJ Clin Evid. 2010 Aug 3;2010:pii 1411. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907947/
5 - Cullen G, O’Donoghue D. Constipation and pregnancy. Best Pract Res Clin Gastroenterol. 2007;21(5):807-18. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418980/
AUTHOR CREDIT
© Migneon Marais
KIRSTIN KADE
MSc Human Nutrition at the University of Surrey
Registered Associate Nutritionist (AfN)
Kirstin Kade has a passion for wholesome, nourishing food with a specific interest in learning more about how what we eat can impact our long-term health and wellbeing.
www.tasteandseeblog.co.za
Health Bloggers Community Award for Best Nutrition and Science Blog
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