While pregnancy has its share of amazing highs, it also comes with its fair share of not-so-fun side effects – including constipation. Constipation is not only uncomfortable, but the “bearing down” on the toilet that it can lead to spikes intra-abdominal pressure, which places further stress on the abdominal wall and pelvic floor.
In this piece, Registered Dietitian and PROnatal Advisory Board Member, Madison Milmeiser, MS, RD, shares 10 tips for reducing constipation. But first, let’s understand why it’s so common during pregnancy in the first place.
What Causes Constipation
Pregnancy Hormones: During pregnancy, there is an increase in the hormone, Progesterone. Progesterone helps prepare and maintain a supportive environment in the uterus for the fertilized egg. Unfortunately though, it also “loosens” the muscles in your intestinal tract, which makes digestion slower and more difficult, and therefore often leads to constipation.
Expanding Uterus: As your pregnancy progresses, your uterus expands and can compress your intestines, thus causing constipation and discomfort.
Potentially Your Prenatal Vitamin: Prenatal vitamins contain extra iron — critical during pregnancy. Occasionally the increased iron could contribute to constipation, but the benefits of prenatal vitamins still outweigh this small side effect.
How to Help Prevent or Reduce Constipation
- Eat Larger, Consolidated Meals: Wait WHAT?! Yes… that’s right. Larger meals. This will help you trigger what’s called the gastrocolic reflex (GCR), a nerve signal that stimulates your colon (the last part of your intestines). This works by activating stretch receptors inside the stomach, which detect how full the stomach is getting from a meal. The receptors then send the message down to the colon to make more room for incoming content by pushing everything onward and outward. The greater the trigger, the stronger the response. Small mini meals will not have this same effect. So, when trying to clear out constipation – eat three more sizable meals each day to take advantage of this natural evacuation mechanism.
- What is a sizeable meal? It’s something that fills you up, but doesn’t push you over the edge. One a scale of 1-10 hunger — with 1 being famished and 10 being the fullest, you should be at about a 7. Also, it’s a meal, so it should include a good mix of fiber-filled carbohydrates (think vegetables here – broccoli, sweet potatoes, kale, squash, etc.), protein, and healthy fats (like cheeses, olive oil, avocados, etc.)
- Hydrate! Hydrate! Hydrate! When you’re not hydrating adequately, your body retains water to prevent dehydration. Staying hydrated can actually reduce water retention. Additionally, drinking enough water can help prevent constipation. The National Academy of Science recommends pregnant women drink about 100oz of fluid per day (100 oz = about 3 liters).
- Eat Enough Fat: Don’t avoid all fats in an effort to lose weight. Fat stimulates the release of bile from the gall bladder, which naturally stimulates the movement of your intestines and facilitates propulsive contractions of your colon which helps get the waste out. Focus on healthy fats like nuts, avocados, olive oil, coconut oil, fatty fish, nut butters and full fat dairy.
- Get Enough Fiber: You want to get a good balance of both fiber types – soluble and insoluble. Soluble fiber helps soak up the moisture in food and give waste an easier ride through the digestive tract. Insoluble fiber adds bulk to your stool, speeding up transit time and can ultimately help relieve constipation. Focus on fruits, vegetables, beans and legumes for great sources fiber sources. While whole grains do contain fiber as well, they are often not the best sources when eaten in a modified form like in breads and cereals.
- Increase your vegetable intake to 1-2 cups per meal
- Add chia seeds! You can add these to your oatmeal, yogurt, etc. PRO tip: For every tbsp of chia seeds you add, increase your water intake by 8 oz (this will help you avoid additional constipation).
- Use Potty Assistance: The position in which you “do the doo” matters. Our bodies are actually designed to excrete waste in a squat position. Squatting puts your colon and pelvic floor muscles in the proper alignment to allow for easier and more effective waste excretion, which may also help you avoid those dreaded pregnancy hemorrhoids (3). Try placing your feet on an 8-12” stool when making a bowel movement. Or better yet, try the squatty potty, a stool that adjusts in height and can be pushed under the toilet when not in use. Try not to hold your breath and “bear down” during difficult bowel movements. Not only does this increase the pressure on your abdominal wall and pelvic floor, but ironically it can actually lead to greater constipation. Wait for the natural feeling of a bowel movement before actively pushing.
- Drink Coffee in the Morning: Coffee contains a compound called chlorogenic acid, which stimulates the motility of the colon. Due to the naturally higher morning levels of cortisol, your bowel is primed to relieve itself before 10am. Adding a well-timed dose of coffee to this natural rhythm can help you clear out some old waste. Of course, it is important to ensure you do not overdo it on your caffeine intake during pregnancy. The official recommendation by the American College of Obstetrics and Gynecologists (ACOG) is no more than 200mg of caffeine per day (8).
- Use a Magnesium Supplement: Magnesium supplements can help alleviate constipation because certain types of magnesium draw water into the bowel and soften your stool, making them easier to pass. If you’re feeling bloated as a result of constipation, try a magnesium supplement. The kind you take matters. For constipation, take magnesium citrate.
- Try a Probiotic: Although probiotics usually get touted as a cure-all for any gut issue, they are actually a highly specific supplement. This means you need to match the type of probiotic you take to the symptom you’re trying to relieve. In the case of constipation, look for a probiotic that has a combination of Lactobacillus and Bifidus This combination has been shown in studies to be effective at treating constipation.
- Move Daily: Although the exact mechanism of how exercise effects your bowels is still up for debate, one thing is for sure: Body movement = Bowel movements. Studies show that sedentary subjects are three times more likely to report constipation. The PROnatal Fitness self-guided training programs are a great way to do this! In addition to your workouts, try to ensure you get movement throughout your day. Try to increase the amount you walk each day by taking short walks after meals, parking in the back of the lot so you have farther to walk, opting for the stairs vs. elevator (even for a flight or two), pacing while on the phone, etc.
- Mindful Meditation: It may seem like a pipedream to think about getting some quite time to yourself to meditate. But if you can… you should. Studies show that mindful meditation can have a very positive impact on your bowels. By stimulating changes within the brain—changes that affect the way we process sensations, our thoughts, and our emotional responses, mindful meditation can help reduce anxiety related GI symptoms like constipation (what expecting parent doesn’t have anxiety?!). Even if you can’t find a large block of time to devote to this, try a few 5-10 minute mindful meditations.
Get Workouts + Nutrition Guidance in One Program
Our prenatal self-guided training programs take you through a complete training program tailored to your pregnancy stage. These programs also include additional nutrition guidance from RD, Madison Milmeister (below).
About the Author
Madison Milmeister is a registered dietitian – and mother — who specializes in fertility and pregnancy nutrition. She holds an undergraduate degree in Nutrition Science and a master’s degree in Clinical Nutrition. She is currently completing a Master of Education at Columbia University with thesis work that highlights the important role of diet in human fertility. Madison loves working with and inspiring women to pursue peak health early on in their pregnancy journey because she wants to help create a healthier next generation, indefinitely. Her research and practice have led her to the motto, “A person’s health starts with the effort of their parents.” Have questions for Madison? Reach out to her at email@example.com.
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- Bradley, C. S., Kennedy, C. M., Turcea, A. M., Rao, S. S. C., & Nygaard, I. E. (2007). Constipation in Pregnancy. Obstetrics & Gynecology, 110(6), 1351–1357.
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- Oh, J. E., Kim, Y. W., Park, S. Y., & Kim, J. Y. (2013). Estrogen rather than progesterone cause constipation in both female and male mice. The Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology, 17(5), 423–426.
- Lakhan, S. E., & Schofield, K. L. (2013). Mindfulness-Based Therapies in the Treatment of Somatization Disorders: A Systematic Review and Meta-Analysis. PLoS ONE, 8(8).