Constipation is a condition in which there is difficulty in emptying the bowels, usually associated with hardened feces. Constipation is also described as having fewer than three bowel movements in a week. It is also defined as difficulty in emptying the bowels, infrequent bowel movements, or difficult passage of usually hardened feces that persists for many days, often several weeks or longer. 

Constipation is among the most frequent and uncomfortable complaints during pregnancy affecting most pregnant women. In order for your body to grow a healthy baby, hormones slow down the digestive process during pregnancy and allow food to spend more time in the absorption phase. While this is healthy, the longer the food spends in the intestine, the more water is pulled from waste resulting in constipation during pregnancy.

Causes of constipation

You and your baby need more calories, healthy vitamins, and nutrients when you are together than you ever will need apart. In order for you to grow a healthy baby, hormones slow down the digestive process and allow food to spend more time in the absorption phase. While this is healthy for everyone involved, the longer the food spends in the intestine, the more water is pulled from waste. By the time last night’s meal makes it to the colon, it can be dried out and hard to pass and therefore cause constipation. This constipation is normal and not often harmful to health but can leave you feeling sluggish and uncomfortable.

Some constipation during pregnancy is normal, but mom needs to watch her body carefully. If a bowel movement has not passed in several days, seeking help from her attending physician may be in order. If waste is left in the body for too long, impaction can occur and that means someone has to dig out what mom can’t pass.

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Treatment for constipation

Treating constipation during pregnancy is all about preparation and realizing that water is the number one health food while pregnant. Water helps to lubricate the bowels and keep them moving in the right way.

• Drink a lot of fluids: Drinking plenty of fluids is important during pregnancy, particularly with your increase in fiber. Drink 10 to 12 cups of fluids each day. It is the combination of a high-fiber diet and lots of liquid that will be the best way for you to try and eliminate your waste. Sweat, hot/humid climates, and exercise may increase your need for additional fluids.
• Eat a high fiber diet: Ideally, you will consume 25 to 30 grams per day of dietary fiber from fruits, vegetables, breakfast cereals, whole grain bread, prunes, and bran.  Eating extra fiber can also help you pass old waste, but with more fiber comes the need for more water. Fiber is a bulk-forming laxative that requires water to work. Without extra water, constipation during pregnancy may become worse.
• Exercise routinely: If you are inactive, you have a greater chance of constipation. Walking, swimming and other moderate exercises help the intestines work by stimulating your bowels. Schedule exercise three times a week for 20-30 minutes each.
• Reduce or eliminate iron supplements: Iron supplements may contribute to constipation. Good nutrition can often meet your iron needs during pregnancy. Taking smaller doses of iron throughout the day rather than taking it all at once can reduce constipation.
• Over-the-counter remedies: There are over-the-counter products such as Metamucil (Category B) which may help soften your bowel movements and reduce constipation. Always speak to your doctor before using over-the-counter medications.
• Laxative pills are not recommended for the treatment of constipation during pregnancy because they might stimulate uterine contractions and cause dehydration.
• Mineral oils should not be used during pregnancy because there is an increased reduction in nutrient absorption.
• Eat healthy fruits and green vegetables, and try eating smaller meals throughout the day as opposed to large meals that may put too much pressure on the digestive system.
• 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.
• If your prenatal multivitamin contains a large dose of iron (and you're not anemic), ask your doctor about switching to a supplement with less iron
• Eat high-fiber foods such as cereals, whole-grain bread, and fresh fruits and vegetables every day. 
• Add a couple of tablespoons of unprocessed wheat bran (available at health food stores) to your cereal in the morning and follow it with a glass of water. 
• Use fiber supplements like Metamucil® or Citrucel®. Even with a healthy, balanced diet, the fiber content may not be adequate. Although you may think of Metamucil and Citrucel as laxatives, they are simply a concentrated source of fiber, and therefore safely serve a useful purpose. The powder forms work better than tablets for most people. Fiber supplements are safe even if taken on a daily basis.
• Pick a time of day to routinely try to move your bowels. Many people find that trying to have a BM after breakfast or after a cup of coffee is better than waiting until they feel the urge. Rushing around all day ignoring the mild signals you get from your body is not conducive to normal bowel function!

Medications for constipation

Stool softeners (like Colace®) and mild laxatives like Milk of Magnesia (we call it M.O.M. in the hospital!) are safe to use during pregnancy. M.O.M. can also be used for heartburn. It is always best to avoid stimulant laxatives (like Dulcolax®, Ex-lax® and Correctol®) unless directed by your doctor. If you are not sure about a laxative's safety, be sure to ask your doctor.