Constipation is probably one of the most irritating symptoms of pregnancy. The condition can lead to quite a lot of discomfort and pain, and finding an effective treatment is important. In most cases, making changes to your diet and lifestyle can relieve the problem, but you may find that these suggestions, such as increasing water intake and adding more high fiber foods to your diet, do not work for you.
If this is the case, you may think that laxatives are the only way to help ease your discomfort. However, before you consider taking laxatives for your condition, it is important to consult your physician and learn whether or not it is safe to take laxatives during pregnancy.
Causes Of Constipation During Pregnancy:
It is estimated that approximately 11 to 38 percent of women experience constipation during their pregnancy (1). Anxiety and stress, a low fiber diet and minimal physical exercise may lead to constipation while you are expecting. However, other factors also play a role in contributing to constipation during pregnancy (2). Due to anatomic and physiological changes in the gastrointestinal tract, pregnant women become more inclined to develop the problem. For example, rising levels of progesterone and reduced levels of motilin hormone result in increases in bowel transit time (3). Additionally, the stool dried out because water absorption from the intestines increases.
Apart from these situations, maternal activity decrease and vitamin supplementation increase (e.g. Calcium and iron) can further play a role in the development of constipation. During the later stages of pregnancy, the onward movement of feces may be slowed down due to an enlarging uterus (4). Serious complications such as fecal impaction are common side effects of constipation; however, such complications rarely occur. Constipation is the most common gastrointestinal complaint among pregnant women after nausea.
[ Read: Constipation During Pregnancy ]
Treating Constipation During Pregnancy:
Preventing and treating constipation during pregnancy involves offering suggestions to people who are not pregnant. Here are a few ways that you can prevent the condition, or prevent it if you are already experiencing it:
1. Eat More Dietary Fiber:
One of the first things that doctors recommend for constipation is including more high fiber foods to your diet. Ideally, you should eat 25 to 30 grams per day. Include foods like breakfast cereals, fruits, bran, prunes, whole grain bread and vegetables.
[ Read: Fiber During Pregnancy ]
2. Drink Plenty Of Fluids:
It is important to make sure that your body gets adequate fluids, especially when you increase your fiber intake. You should drink 10 to 12 glasses of fluids every day. The best way to regularly eliminate waste is to combine a high-fiber diet with plenty of fluids (5). Exercise, sweat, and a hot or humid climate may increase fluid requirement.
[ Read: Iron tablets During Pregnancy ]
3. Get Regular Exercise:
People who are not physically active have a greater chance of developing constipation. Moderate exercise like walking or swimming stimulates the bowels and therefore, helps the intestines work efficiently. During your pregnancy, make sure that you exercise for 20 to 30 minutes three times a week (6).
4. Eliminate Or Reduce Iron Supplements:
Iron supplements may contribute to constipation. During pregnancy, eating a well-balanced, nutritious diet can be sufficient to meet your iron requirements (7). If you reduce your iron supplements, you can reduce constipation. You should talk to your doctor about your iron levels and ask for suggestions on how you can manage your intake of iron during your pregnancy.
5. Say No To Coffee:
It may seem cruel to exclude your favorite cuppa from your pregnancy diet. But coffee or cola will only worsen your constipation. These drinks are diuretics and will make you pee more, which means you lose more water and feel dehydrated.
If these remedies do not help alleviate your constipation, you may need to talk to your doctor about using laxatives. It is very important to remember not to take any without consulting your doctor first.
[ Read: Coffee During Pregnancy ]
Is It Safe To Take Laxatives During Pregnancy?
If eating high-fiber foods, drinking plenty of fluids and exercising regularly don’t help ease your constipation, the second line of therapy is laxatives. In general, the data on laxative use during pregnancy is insufficient. However, limited studies on specific laxatives have been performed, and doctors do prescribe some pregnant women laxatives to regulate their bowel movements.
Mild laxatives are considered safe laxatives during pregnancy and for many years, several have been used without any known effects on the developing baby. However, you should not take laxatives for long periods while you are pregnant as it can result in dehydration and create an imbalance of mineral and salt levels in your body (8).
Information About Specific Laxatives During Pregnancy:
Here is a look at some of the types of laxatives that doctors prescribe to pregnant women:
1. Bulk-Forming Laxatives:
- These laxatives are commonly used during pregnancy, and there have been no reports connecting it to any problems in the developing baby. Bulk-forming laxatives are also not linked to increased risk of malformations. They are not absorbed into the bloodstream but help in moving stools along the bowel by increasing their bulk (9). However, they are not always effective and have been associated with unpleasant side effects such as bloating, cramping and gas.
- Bulk-forming laxatives that are commonly prescribed are methylcellulose, ispaghula husk, and sterculia. You need to drink plenty of fluids when taking such laxatives (10). Also, remember not to take them before you go to bed. It usually takes 2 to 3 days for bulk-forming laxatives to take effect.
2. Stool Softeners:
- Many studies have been conducted on docusate sodium, and there is no report associating it with any adverse effects in pregnancy (11). Thus, it is considered as safe laxatives during pregnancy.
- Another stool softener that is often recommended for pregnant women is lactulose, which is a type of sugar. Because it is not digested, it draws water into the bowel, softens the stools and aids bowel movement. There have been no studies to examine whether its use during pregnancy causes any problems to the unborn baby. However, as mentioned, it is commonly used during pregnancy and manufacturers of laxatives that have lactulose state that their products can be used during pregnancy if necessary (12).
3. Lubricant Laxatives:
- Glycerin suppositories are laxatives that lubricate and stimulate the bowel but are used for cases of constipation that are more severe (13). There have been no studies conducted to find out if their use during pregnancy causes any problems for the developing baby. However, they are commonly used by pregnant women, and there have been no reports linking them to problems.
- Mineral oil is not properly absorbed from the gastrointestinal tract. It also does not appear to be connected to any adverse effects. However, there is some controversy about whether using mineral oil for long periods of time decreases the absorption of fat-soluble vitamins, although it seems to be a theoretical risk rather than an actual one.
4. Stimulant Laxatives:
- Bisacodyl and Senna are two stimulant laxatives. Because of its poor bioavailability, bisacodyl absorption is minimal (14). IIt helps stimulate the bowels and increases the water content of the stool. Although there have been no studies to examine its effects on unborn babies, no problems have been reported.
- Senna helps move stools along, by stimulating the bowel muscles. One study concluded that women who used it during the first 12 weeks of pregnancy, or the main baby formation period, did not increase the risk of having a baby with a birth defect when compared to women who did not. However, experts advise against using Senna during your third trimester as your digestive system partially absorbs it.
- It is important to note that there can be unpleasant side effects like abdominal cramps when you take stimulant laxatives. Moreover, theoretically, the long-term use of this laxative may result in electrolyte imbalance.
- Senna is an age old traditional remedy for constipation and is considered safe in small doses during pregnancy. However, avoid consuming this herb in your third trimester as it can cause contractions. These contraction or Braxton Hicks contraction, can stimulate your womb and cause premature delivery.
5. Osmotic Laxatives:
- Lactulose and polyethylene glycol are osmotic laxatives, and they are both poorly absorbed systemically. There have been no reports of adverse effects associated with the use of osmotic laxatives in pregnant women. However, there is a chance that you may experience certain side effects such as bloating and flatulence.
- Just like stimulant laxatives, taking this type of laxative for long periods of time may cause electrolyte imbalances.
- As with bulk-forming laxatives, you need to make sure that you take plenty of fluids when you take osmotic laxatives in pregnacy (15). You will also need to wait 2 to 3 days before you start to feel their effect on your body.
Using Laxatives During Pregnancy:
Although doctors often prescribe laxatives to pregnant women, there are some laxatives that are better than others. If you are using one during pregnancy, you should keep the following points in mind:
- Some laxatives contain high amounts of sugars or sodium, bulk-forming ones in particular. The added sugar and sodium may trigger an increase in blood pressure or water retention in the body.
- You may need to avoid saline laxatives that contain magnesium, phosphates or potassium if you do not have normal kidney function (16).
- Mineral oil is avoided and not used as a laxative for pregnant women. It may interfere with the absorption of vitamins and nutrients in your body. Additionally, prolonged use of mineral oil during pregnancy may cause the newborn baby to bleed severely (17).
- If not used properly, you may experience unwanted effects with stimulant laxatives. You should not use castor oil in particular as it may cause contractions of the womb.
What Is Fecal Impaction?
Although it is rare, constipation can cause complications like fecal impaction and thus, preventing or treating the condition becomes especially important. Fecal impaction is a condition that occurs when stools get dry and hard and becomes unable to pass out of the colon or rectum (18). If it is not quickly and properly treated, it can worsen and ultimately, cause death.
Fecal Impaction is caused by untreated constipation and the overuse of laxatives (19). When laxatives are repeatedly used and in increasing doses, the colon becomes unable to respond naturally to the need to pass stool. Other causes of this complication include opioid painkillers, changes in diet, and little or no physical activity.
Fecal impaction patients do not suffer from gastrointestinal symptoms. Instead, the common problems are those with the heart, breathing or circulation. Other symptoms include:
- Nausea and vomiting
- Inability to have a bowel movement
- Infrequent bowel movements than usual
- Straining to pass stool and small semi-formed stools
- Rectal bleeding
- Back or abdominal pain
- Inability to urinate, or more or less urination than usual
- Low blood pressure, rapid heartbeat, breathing problems, swollen abdomen, and dizziness
- Sudden diarrhea
- Leaking stool when coughing
- Confusion and loss of sense of place and time along with high or low blood pressure, fever, sweating, and rapid heartbeat
If you experience any of these symptoms, you should report them to your doctor immediately.
Effective Natural Laxatives During Pregnancy:
Natural remedies are great if you want to avoid using laxatives prescribed by your doctor. There are several excellent natural laxatives that you can take as an alternative. They work effectively in relieving constipation, and what is more, they are better in every aspect of your health. Here is a look at some of the best natural laxatives for pregnancy that are safe and effective:
This is one of the most effective natural laxatives that are especially great for pregnant women. Steep one tablespoon of horseradish in a cup of water for 5 minutes and drink the tea 3 times every day. Also, you can use it as a dressing for salads. It will ease your bowel movement and relieve the pain and discomfort.
Another wonderful and safe, natural laxative, is flax seed (20). It adds bulk to stool due to its rich fiber content, making it easier for your body to eliminate it. All you need to do is steep a tablespoon in a cup of boiled water for 15 minutes. Drink the tea once every day and you will find it much easier to get rid of the waste from your body. It can be the best laxative for pregnant ladies.
[ Read: Flax Seeds During Pregnancy ]
This vegetable is loaded with fiber, not to mention many other nutrients your body needs (21). It is easy to incorporate into your diet. You can eat it raw as part of a salad, stir fry it or simply blanch it. This is another effective natural laxative that will work wonders while you are pregnant.
[ Read: Cabbage During Pregnancy ]
High in fiber, beet is another great vegetable to add to your daily diet if you are experiencing constipation during your pregnancy (22). It is delicious and can be used in a variety of ways in recipes. Beets are another best laxative during pregnancy.
For pregnant women experiencing constipation, there is nothing quite like chamomile tea. It helps in relaxing the intestinal tract, thus making it easy for you to pass stool. Known for its calming effect, it also helps in soothing anxiety and eliminating insomnia, which is another woe that pregnant women go through. 2 cups of chamomile tea can help relieve constipation. Experts advise against drinking more as although there is no scientific evidence, it is said that high doses of the tea can cause miscarriage (23).
[ Read: Chamomile Tea During Pregnancy ]
6. Magnesium Supplements:
If you are pregnant and experiencing a lot of discomfort due to constipation, you should consider high-dose magnesium supplements. Milk of Magnesia is an effective treatment for the problem (24). Along with plenty of water, take magnesium supplements to regulate bowel movement and get rid of the pain and discomfort that comes with constipation.
You should keep in mind that using herbal remedies during pregnancy is not safe even if they are natural. While there are many effective herbal laxatives, it is best to avoid them while you are expecting. Remember to consult your doctor before taking any herbal remedy for constipation.
As mentioned earlier, laxatives should only be the second line of treatment when making dietary changes, drinking plenty of fluids and exercising moderately every day do not help relieve constipation. Short term use has not been associated with an increase of risk of malformations. However, pregnant women are advised to use stimulant and osmotic laxatives only occasionally or in the short term, as recommended to everyone else, so that electrolyte imbalances or dehydration and the theoretical “cathartic colon” risk are avoided.
[ Read: Magnesium Rich Foods During Pregnancy ]
Complementary Therapies To Treat Constipation During Pregnancy:
Many women claim that a combination of complementary therapies can help reduce constipation. Though there is mixed evidence on the results, they are worth a try. Before you try any of the therapies, have a quick word with your doctor, if it is safe for you. Avoid colonic irrigation at any cost, as this can be unsafe for your baby. Colonic irrigation a complementary therapy that often helps people with constipation, but it can increase the risk of vaginal infections during pregnancy.
Listed below are a few of the many complimentary therapies that are safe during pregnancy:
1. Acupressure Or Acupuncture:
Acupressure like you already may know, works on the principle that there are energy points in your body that can be stimulated to improve general health and fight specific ailments. The digestion point lies in the middle of your tummy section at about three finger distance from your navel.
All, you need to do is gently massage or press this point two dozen times, or as many times as you need every day for relief from constipation. In the unlikely case that constipation persists, visit a qualified acupuncture practitioner who guides you better. Acupressure is also said to help greatly in relieving the many symptoms associated with irritable bowel syndrome.
Add 4 to 5 drops of an essential oil of your choice to your bath. Three to four drops of lemon, bergamot, orange, lime, or even to half a bowl of grapeseed carrier oil to a bath of warm water. Soak in the bath for as long as you like, and massage your tummy gently in a clockwise direction, while relaxing. Be sure not to massage to firmly if your doctor has told you that you are at risk of premature labor or placenta praevia.
[ Read: Aromatherapy Oils During Pregnancy ]
3. Potent Herbal Remedies:
A cup of dandelion or mallow tea can do wonders in easing constipation naturally. Steep the leaves in a vessel of boiling water, strain and drink it up for quick relief. Drink no more than 3 cups a day.
Reflexology is an emerging treatment method helps treat various ailments including constipation. What’s more? It is safe to try during pregnancy! The treatment stems from the principle that your feet correspond to a map of the body. Stimulating the arch of the foot will help improve circulation in the body and thereby help in curing various ailments.
You can ask a friend or your partner to massage the arches of your feet gently as this is the part that corresponds to your digestive system. Get both your feet massaged in gentle circular clockwise motions for at least 5 minutes each.
If you cannot have someone massage your feet, you can place two bottles under the arches of both your feet while you are sitting and gently move them using your feet. Roll the bottles backward and forwards a few times. You can gain the same benefits by massaging the reflexology zones on your palms with a few drops of essential oil. Many young women have testified that this helps to some extent in treating constipation and is extremely relaxing, especially when pregnant.
To sum it all up, if you are considering using laxatives while pregnant, make sure that you consult your doctor first.
Do not try to self-medicate during pregnancy as it can be fatal. Meditate, perform yoga and do things you like the most, to distract your mind. At the end of 9 months, it will be worth it all, when you see your baby beam at you!
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