Constipation During Pregnancy: Why Your Body Hits Pause

Let’s get something out of the way immediately. Nobody likes to talk about constipation.

Think about it: Is there ever a good moment to mention, “Hey, yeah, I’m not pooping so much these days, because the food waste in my body has hardened in the lower part of my digestive tract”?

Talk about being fun at parties!

Look, we get how embarrassing it is to talk about bowel movements — because we’ve all been there.

This is all the more reason why we should try to get more comfortable talking about unpleasant topics regarding our bodies. Constipation (or having fewer than three bowel movements a week), unfortunately, is a common occurrence, affecting approximately 2.5 million people annually in the US.

And for pregnant women, constipation, if you’ll pardon the expression, seems to rear its ugly head rather often.

Is constipation normal during pregnancy?

Yes, constipation is perfectly normal during pregnancy, and, honestly, pretty common too. Around 16% to 39% of pregnant women experience it at some point. That’s because your body is going through major hormonal and physical changes that can slow down digestion.

It can happen in any trimester (and even hang around for a few months after giving birth), but it tends to peak in the third trimester. By then, your baby is taking up more space and putting extra pressure on your intestines, making it harder for things to, well, move along. Add in rising progesterone levels and iron supplements, and you’ve got the perfect storm for sluggish bowels.

While uncomfortable, pregnancy constipation is rarely dangerous, just annoying. The good news? With a few mindful tweaks to your hydration, fiber intake, and daily movement, most people find relief without needing medication.

Does pregnancy cause constipation? Understanding why it happens

Yes, being pregnant can indeed cause an increased likelihood of constipation for a few reasons.

• Hormone changes: “Rising progesterone and other hormones in pregnancy cause the digestive system to slow, which leads to constipation,” explains Dr. Adriana Wong, a reproductive endocrinology and infertility fellow at HRC Pasadena. Progesterone is a hormone that helps maintain the early stages of pregnancy, and it can cause your intestines, or bowel, to become more relaxed. As a result, your bowel isn’t working as hard to expel waste from your body. If your body isn’t expelling food waste in a timely fashion and the food remains in your bowel, the waste dries out and then becomes difficult to pass when you poop.
• The fetus: As previously mentioned, the fetus puts extra pressure on your bowel, which can make it harder to poop.
• Iron in prenatal vitamins: Many prenatal vitamins contain iron, which can harden stools and make them harder to pass.
• Lifestyle changes: Pregnancy can make it more challenging to consume enough fiber, drink sufficient water, and engage in regular exercise. All three contribute to the potential for constipation.

When does constipation start in pregnancy?

Pregnancy constipation can start at any time, though many people notice it as early as the first trimester, sometimes just a few weeks in. That’s because rising progesterone levels start relaxing your muscles, including the ones that help move food through your digestive system.

As your metabolism slows to support your growing baby, your gut slows down too. For some, that means mild bloating and fewer bowel movements right from the start. For others, it may not show up until later when iron supplements, less activity, or pressure from the uterus start to add up. Either way, it’s one of those not-so-glamorous pregnancy symptoms that’s completely normal, but absolutely manageable.

Recognizing constipation pain during pregnancy

Constipation pain symptoms during pregnancy can present in several different forms, including:

• Difficulty passing stools
• Hard, lumpy, and small stools
• Irregular or infrequent bowel movements
• Light cramping
• Lower belly pain
• Passing gas
• Uncomfortable, bloated, or sluggish feeling

In addition, constipation can increase the risk of hemorrhoids. When you’re constipated, it’s common to strain during bowel movements, which results in those painful, swollen veins in and around your anus.

Pregnancy constipation: When to worry

Although getting constipated can be a nuisance, it’s important to remember that this condition won’t harm your baby. Overall, pregnancy constipation isn’t usually dangerous and shouldn’t be cause for alarm.

But if you are experiencing any of the following symptoms, Dr. Wong recommends calling your healthcare provider right away, as they may be signs of something more serious:

• Severe abdominal pain
• Vomiting
• Inability to pass gas
• Rectal bleeding
• No bowel movement despite escalating therapy

Pregnancy constipation remedies: Your complete toolkit

Unfortunately, there’s no such thing as a quick fix for constipation, especially because you need that progesterone for a healthy pregnancy. But there are some easy lifestyle changes you can make that will (hopefully) bring you some relief.

“It's usually recommended to try conservative measures like exercising regularly, increasing fiber intake, and ensuring adequate hydration,” says Dr. Wong.

She also suggests giving yourself grace when heading to the toilet: “Having unhurried toilet time helps,” says Dr. Wong. “Go to the bathroom when you feel the urge to have a bowel movement, don't wait.”

Other recommendations include “using a footstool while on the toilet,” as this “can help move stool more easily.”

Eat more fiber

Aim for 25-30 grams of fiber in your daily diet, as fiber-rich foods help soften your stools. Good sources of fiber include:

• Apples
• Bananas
• Lentils
• Raspberries
• Split peas
• Whole-wheat pasta
• Prunes
• Avocados
• Bran
• Potatoes
• Quinoa

Drink more water

Since dehydration is one of the most common causes of constipation, increasing your water intake to 8 to 12 cups a day is a no-brainer here. (Water also acts as a natural stool softener!)

And you don’t need to only sip plain, still water as part of this new routine. Seltzer water works just fine, as well as water-rich fruits and veggies such as:

• Carrots: 86-95% water
• Celery: 95% water
• Lettuce: Up to 96% water
• Melons: Up to 90% water
• Oranges: 86% water
• Strawberries: 92% water

Develop an exercise routine

Exercise can help relieve pregnancy constipation because regular movement, especially cardio, encourages food to move through the large intestine faster, thus allowing you to poop more, well, smoothly.

It’s a good idea to shoot for 30 minutes of moderate activity on most days, like walking, biking, or swimming. Make sure you speak with your healthcare provider before starting any new workout routine, as certain exercises may not be safe in pregnancy.

Adjusting (or adding) supplements

Even though you do need extra iron for a healthy pregnancy (27 mg a day or more), this additional iron can increase your chances of constipation. If you’re taking extra iron (usually in prenatal vitamins), and you’re still constipated, talk with your doctor at your next prenatal appointment.

Also, “follow your doctor's recommendation for whether or not you need to take iron postpartum, since this can worsen constipation,” says Dr. Wong.

Your healthcare provider may decide to reduce your iron supplement intake, and instead recommend adding more iron-rich foods to your diet (beans, green and root vegetables, lean meats).

Another option is integrating more probiotics into either your diet or supplement routine. Probiotics contain good bacteria (Lactobacillus or Bifidobacterium) that help move food faster through the body (plus they soften stools, resulting in a more regular and comfortable poop).

You can increase your probiotic intake by eating certain types of yogurts or even pickles! Your healthcare provider can also prescribe an oral probiotic supplement after discussing your options.

Over-the-counter remedies

While most first-line recommended therapies for pregnancy constipation continue to be increasing your fiber-rich-food intake, increasing hydration, and adopting a regular exercise routine, in some cases, over-the-counter remedies will be necessary.

If you weren’t pregnant, you’d probably reach for a laxative or stool softener to ease your constipation, right? Well, the good news is, most OTC laxatives and stool softeners are still safe to use in pregnancy.

“Your doctor may recommend trying something like polyethylene glycol solution (which is known by the brand name Miralax),” says Dr. Wong. “This is the laxative of choice in pregnancy and is considered safe.”

But, as with any medication or supplement, you will want to speak to your healthcare provider first before trying any of these remedies to relieve your constipation. Your physician will want to ensure you take a laxative whose active ingredient isn’t significantly absorbed by your body.

Don’t be scared of pregnancy constipation

Pregnancy constipation doesn’t last forever. As in, it will likely resolve itself postpartum.

“[Pregnancy constipation] typically improves as hormones normalize,” assures Dr. Wong. “Though some symptoms can persist briefly after delivery. It is common to be prescribed a stool softener while recovering after delivery to allow your pelvic floor to rest and minimize straining while healing.”

Of course, if your symptoms don’t improve after delivery, “this warrants an exam by your doctor,” says Dr. Wong. “Pelvic floor dysfunction or perineal pain after laceration/repair can perpetuate stool holding and constipation.”

Sometimes, it seems like the scariest part of pregnancy constipation is our unwillingness to talk about it. Sure, no one wants to talk about our poop (or lack thereof), but if we don’t, then the cycle of women’s health silence will simply perpetuate.

So if you find yourself straining when you go, remember that you don’t have to, well, keep it all inside.

Constipation in pregnancy is totally normal, common, and, more importantly, it’s treatable with just a few small lifestyle adjustments.

Alert your healthcare provider at your next prenatal appointment (or sooner) that you’ve been experiencing constipation so they can walk you through a recommended treatment plan.

Before you know it, you’ll be feeling the relief in more ways than one!

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Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist dedicated to reporting on women's health, parenting, mental health, TV, and pop culture. Her work has appeared in HuffPost, Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. Subscribe to her Substack, the Critical Communicator, and follow her on Instagram, BlueSky, or Threads.