Constipation in pregnancy: 10 practical tips, fibre and fluids (plus a note on indigestion)

Not going to the toilet as often as usual, a heavy feeling in the tummy, hard stools that are difficult to pass… Constipation is one of the most common digestive complaints in pregnancy, and many people meet it at some point. It is uncomfortable, but it usually eases with changes in food, fluids and movement. This article focuses on constipation and covers indigestion and gas only briefly.

Why does it happen?

The rising progesterone in pregnancy relaxes the muscles of the bowel and slows down the movement of food. More water is absorbed from the stool that stays in the bowel, so it hardens. Later on, the growing womb presses on the bowel. Iron-containing supplements, moving less, not drinking enough and tiredness can also increase constipation. Changes to your eating pattern during the nausea phase can affect bowel habits too.

What is usual varies from person to person. Some go once a day, others every two or three days. What matters is that you move clearly away from your own pattern and have to strain.

10 tips that help right away

You do not have to try everything at once; building a few into your day is often enough.

1. Raise fibre gradually. Vegetables, fruit, pulses, wholegrain bread, oats and dried fruit are natural fibre. Increasing a lot all at once can cause gas; go step by step.
2. Spread fluids across the day. Fibre works together with water. Keeping a water bottle with you is a good reminder.
3. Start the morning with a warm drink. A glass of warm water or another warm drink triggers bowel movement in many people.
4. Prunes, apricots and figs. A few can help some people; more may cause tummy ache and gas, so keep to moderation.
5. Keep moving. A brisk half-hour walk each day, if your doctor agrees, gets the bowel going. Stay at a comfortable level.
6. Yoghurt and yoghurt drinks. Fermented dairy products suit digestion for some people.
7. Set a regular toilet time. For many people the time after a meal works best. Do not postpone the urge.
8. Adjust your posture. A small footstool under your feet, bringing your knees slightly above your hips, makes emptying the bowel easier.
9. Do not strain. Straining a lot can cause haemorrhoids. If nothing happens in five or ten minutes, get up and try again later.
10. Do not use laxatives on your own. Do not take stool softeners or laxative products without asking your doctor; your doctor can suggest a suitable option.

Fibre and water in practice

There is no need to chase numbers; having a vegetable or fruit on your plate at every meal and pulses or wholegrains at least once a day is a good start. For example: oats with dried apricots at breakfast, lentil soup or a vegetable dish at lunch, fruit and a handful of walnuts in the afternoon, salad and bulgur in the evening. If you increase fibre without raising fluids, constipation can actually get worse. If your urine is pale yellow, you are usually drinking enough.

At work, travelling and on irregular days

When your usual routine is disrupted (travel, shifts, a busy day), the bowel often slows down too. Carry dried fruit, a bottle of water and a fibre-rich snack such as walnuts or almonds. If you sit for long periods, stand up and walk briefly every hour. Putting off a visit to the toilet at work can reinforce constipation; do not hesitate to go when you need to.

Iron supplements and constipation

Iron supplements recommended by your doctor can increase constipation for some people. Do not stop them on your own; tell your doctor. It may be possible to change the time, form or schedule. Fibre-rich food and plenty of fluids are even more valuable then.

Haemorrhoids and fissures

Constipation and straining can lead to haemorrhoids (piles), which are common in pregnancy. You may notice bleeding after the toilet, itching or pain. For most people they improve after birth. A warm sitz bath, not sitting long on the toilet and a high-fibre diet bring relief. If bleeding continues or pain is strong, contact your doctor. Also make a note if you see a rapid change in the colour or amount of your stool.

A brief look at indigestion and gas

A feeling of fullness, burping or burning after a meal is indigestion. Small, frequent meals, eating slowly, not lying down straight after eating and keeping fatty and fried foods moderate help many people. If burning is the main problem, you can look at the heartburn and reflux article in the Guide, and for gas and bloating the article on gas and bloating in pregnancy. Which medicine is suitable should be decided by your doctor.

When to contact your doctor

• Constipation lasts longer than a few days and does not respond to these measures
• There is bright red blood in the stool, black stool or severe rectal pain
• It comes with abdominal pain, fever, constant vomiting or marked swelling of the abdomen
• You cannot pass any gas or stool at all
• Constipation comes with weight loss or a long-lasting sudden change in bowel habits
• Severe pain in the upper right abdomen, blurred vision or a sudden severe headache needs prompt assessment
• If you have severe abdominal pain, bleeding or shortness of breath, call 112 (in Turkey) or your local emergency number, or go to the nearest emergency department

Frequently asked questions

Does constipation harm the baby? No, constipation does not directly harm the baby. It does bother you, and straining can cause haemorrhoids, so it is worth taking steps.

How often should I go to the toilet? There is no single right answer. A clear change from your own pattern, and having to strain, are what matter. If you are worried, ask your doctor.

What if natural measures do not work? Talk to your doctor. There are options that are suitable in pregnancy; your doctor decides which one fits you.

Does exercise really help? For most people, yes. Gentle walking supports bowel movement. If your doctor has set limits on exercise, follow them.

Should I stop my iron supplement? No, do not stop it without asking your doctor. Your doctor will consider alternatives.

Can I use fibre supplements or fibre products? Raising fibre through food is usually the first step. Before using ready-made fibre products or supplements, tell your doctor or pharmacist you are pregnant and ask; fibre taken without more fluids can increase constipation.

Will constipation go away after birth? For most people it improves as hormones settle. Continuing fibre and fluids in the first days after birth helps.

Even if your bowel pattern is thrown off from time to time, simple and gentle steps usually bring it back in most people. If you wonder about a certain food, you can check it in the Is it safe to eat? section. This article is for information only; your doctor's or midwife's advice for your own situation comes first.