Constipation is a common pregnancy complication. Most women can relieve it by staying active and increasing their fiber and water intake. However, if it persists, the doctor may prescribe laxatives. But is it safe to take laxatives during pregnancy?
Laxatives or purgatives are medicines used to treat constipation. You can get them over-the-counter (OTC) under different brand names. However, medical guidance is vital to select a safe laxative to avert any side effects and complications.
Keep reading as we tell you about laxatives, their safety during pregnancy, their possible side effects, and some safe laxatives you may try after consulting your doctor.
What Are Laxatives?
Laxatives are drugs that help relieve constipation by inducing a bowel movement or bulking the stools. They contain chemicals that help stool motility, frequency, and bulk.
The laxatives are available in the form of pills, capsules, foods, gums, and liquids for oral consumption or through the rectum in the form of enemas and suppositories (1).
Is It Safe To Take Laxatives During Pregnancy?
Usually, doctors advise natural remedies and probiotics to improve bowel function during pregnancy to ensure maternal health and fetal health. If these remedies seem ineffective, the doctor will prescribe mild laxatives as the second line of treatment (3).
Among the various mild laxatives, bulk-forming laxatives such as Metamucil (psyllium hydrophilic mucilloid) are not absorbed and are not known to increase the risk of malformations in the fetus. Therefore, these are considered safer than the others.
Emollient laxatives like mineral oil and stimulant laxatives like castor oil must be avoided during pregnancy due to their potential for maternal and fetal morbidity (4).
It must be noted that these laxatives only help temporarily relieve constipation; your doctor will advise you to change your diet and lifestyle to retain your natural bowel movements.
Prolonged usage of laxatives can result in dehydration and create an imbalance of mineral and salt levels in your body.
Laxatives Safe To Take During Pregnancy
1. Bulk-forming laxatives
Also called fiber supplements, they work similarly to the fiber in your diet by increasing your fiber intake. They add bulk to the stools by helping them retain liquid for an easy bowel movement. They take around 12 to 24 hours to work and are unlikely to cause any pregnancy complications since they do not get into the blood.
Psyllium (Metamucil), methylcellulose (Citrucel), carboxymethyl-cellulose, and sterculia are some bulk-forming laxatives.
2. Stool softener laxatives
Stool softeners cause water and fats to penetrate the stools, thus encouraging them to move quickly through the gastrointestinal tract. They take 12 to 72 hours to work. Multiple clinical studies have shown no harmful effects, and thus, these laxatives are considered safe medications during pregnancy.
Docusate sodium (Colace) and Dicoto are such medications.
3. Stimulant laxatives
They stimulate the intestinal wall lining to speed up the bowel movements and stool frequency. They give quick relief within 6 to 12 hours. There is no risk to the baby as the absorption is minimal. However, long-term use can have some side effects such as electrolyte imbalances on the mother.
Senna (Senokot) and Bisacodyl (Correctol) are considered safe in small doses.
4. Osmotic laxatives
They soften the stools by drawing fluid into the gastrointestinal tract from the surrounding tissues. They take around 30 minutes to six hours to be effective. Their use is not associated with any adverse effects on the baby. Long-term use might affect the mother in the same way as stimulant laxatives do.
Sodium bisphosphate (OsmoPrep), magnesium hydroxide (milk of magnesia), sugars including polyethylene glycol (Miralax) and lactulose are some effective osmotics.
In spite of their effectiveness, laxatives are prescribed only as a second option because of some side effects.
What Could Be The Side Effects Of Laxatives During Pregnancy?
The side effects of laxatives vary depending on the type of laxative taken. As with any medication, laxatives have potential side effects, but those with strong safety profiles typically have fewer adverse effects.
The common side effects include (3):
- Abdominal cramps
- Dark urine
Excessive or prolonged intake of laxatives could result in the following side effects.
- Reduced absorption of nutrition and other medicines into the blood as laxatives increase the rate of food passage through the intestinal tract.
- Lower levels of magnesium salt in the blood. One study has found that mothers who had docusate sodium when pregnant had babies with low magnesium levels and suffered temporary jitteriness (7).
Therefore, it is important to consult with your obstetrician prior to using laxatives during pregnancy in order to determine the appropriate and safe medication dosage
Next, we answer a few commonly raised queries.
Frequently Asked Questions
1. Can laxatives cause miscarriage?
2. Can the use of laxatives during pregnancy cause birth defects?
Laxatives are not known to increase the probability of birth defects or other major pregnancy issues.
3. How long can a pregnant woman safely use laxatives?
Moderate use for short periods is considered safe during pregnancy. Occasional use and use up to a week at a time are generally recommended (9). Stop using laxatives upon the improvement of the condition. Consult a doctor and ascertain the course of further treatment if symptoms do not improve after a week.
4. Can laxatives increase the risk of premature labor?
Studies on the effects of laxatives on pregnancy and the fetus are limited. However, the available studies suggest that the use of laxatives in recommended dosages does not harm the fetus. According to Dr. Kevin Huffman, a board-certified bariatric physician from Vermilion, Ohio, “There is no compelling scientific evidence documenting a link between inducing labor and specific forms of discomfort or cramping attributed to certain types of laxative use. However, using laxatives in an attempt to instigate labor is not advisable as it could lead to unexpected, potentially harmful consequences such as dehydration and other complications.”
5. Can using laxatives regularly during pregnancy lead to dependence?
The use of stimulant laxatives for constipation may be habit-forming. Laxative abuse is predominantly observed in women who had eating disorders before or during pregnancy (10).
Before using laxatives during pregnancy, it is advised that you consult your doctor or gynecologist and ensure that it will not bring about any complications in the pregnancy. Try incorporating fiber-rich food into your diet, and bring specific changes in your lifestyle to help improve your bowel functions and reduce the chances of constipation. However, if these remedies do not work, try using laxatives that are safe to be used during pregnancy for the recommended number of days so that they will not harm you or your baby.
Infographic: Complications Of Untreated Constipation During Pregnancy
If constipation is left untreated, it may cause problems in the long term. Refer to the infographic below to know the complications of chronic constipation and lifestyle changes for prevention.
This post is for informational purposes only and is not a replacement for a doctor’s consultation. Do not use any medication without talking to your doctor.
- Laxatives help relieve constipation by facilitating smooth bowel movements.
- Pregnant women should only take mild laxatives if recommended by a doctor.
- Some laxatives contain chemicals and oils that may harm the fetus.
- Safe laxative options during pregnancy include fiber supplements, stool softener laxatives, stimulant laxatives, and osmotic laxatives.
- Overuse or prolonged intake of laxatives can cause malabsorption of nutrients and decrease levels of magnesium salt in the blood.
Pregnant women need to be careful when taking laxatives. Learn what kinds are safe to take during pregnancy in this video.
- Erin Larowe; Laxative information; C. S. Mott Children’s Hospital (2013)
- What can help with constipation during pregnancy?; American College of Obstetricians and Gynecologists
- Magan Trottier MSc Aida Erebara MD and Pina Bozzo; Treating constipation during pregnancy; The College of Family Physicians of Canada
- Jessica Servey Jennifer Chang; Over-the-counter medications in pregnancy; American Family Physician.
- Laxatives; National Health Services
- Meredith Portalatin & Nathaniel Winstead; Medical management of constipation (2012)
- Prescribing in Pregnancy Fourth edition; Perpustakaan Pusat Universitas Pancasila; Organization of Teratology Information Specialists (2013)
- Gulsah Gurol Arslan Ismet Eser; An examination of the effect of castor oil packs on constipation in the elderly; Complementary Therapies In Clinical Practice (2011)
- Laxatives; National Health Service
- Pregnancy Complications and Neonatal Outcomes in Women With Eating Disorders