Pregnant women may experience constipation, which can be very uncomfortable.
This is because the whole digestive system is influenced by hormonal changes during pregnancy. It is important for pregnant women to look after their diet and maintain regular bowel habits to avoid unnecessary discomfort.
What happens to the bowel during pregnancy?
During pregnancy, the body produces more female hormones than normal. It is the job of these hormones to make sure that the pregnancy develops normally. But they also automatically slow down the woman's intestinal movements.
One of these hormones, called progesterone, acts by relaxing muscle. The wall (outside) of the bowel is made of muscle and relaxes, and so is less able to move food and bodily waste along.
Pregnant women should make sure their diet is rich in fibre and includes plenty of liquid. That is the best way of guaranteeing normal intestinal activity.
What are the signs of constipation?
- More than four days between each bowel movement.
- Faeces are hard, which makes them difficult to pass.
- There is a feeling that not all the faeces are being passed.
- If the faeces are very hard, they may cause bleeding from the rectum.
- Constipation can also be a cause of lower abdominal pain.
- In extreme circumstances, a constipated bowel can result in difficulties giving birth.
Rarely, these symptoms can be the signs of other more serious diseases. Always consult your doctor if you are concerned.
What can be done about constipation?
The following hints are helpful in maintaining regular bowel habits:
- eat enough fibre
- drink sufficient liquid
- take exercise.
If these measures don't help, talk to your GP for advice about laxatives.
Fibre is important because it pushes the intestines to work harder. It also absorbs liquid and will help ensure that the faeces do not dry out, but remain soft. The following types of food contain lots of fibre. It is a good idea to eat a variety of these foods every day:
- wholemeal bread
- breakfast cereals
- prune juice.
If there is not enough liquid in the diet, the process of digestion will slow down, the intestine can't do its job and the faeces will become hard and difficult to pass.
There are no specific rules, but you should aim for at least six tumblers of fluid per day.
Drink as much water as you like. A good supplement can be tea, a little coffee or some fruit juice.
To make sure that the intestine works as well as possible, it is necessary to keep the faeces soft.
Exercise gently stimulates the bowel, which leads to improved digestion.
During pregnancy, walking or swimming for about 20 to 30 minutes, three times a week will help digestion. It will also enhance general wellbeing and fitness in preparation for the actual delivery.
Constipation is a common complaint in pregnancy with approximately 40 per cent of women being affected. It is thought to be caused by progesterone-induced intestinal smooth muscle relaxation.
There is very little published epidemiological information available on the potential risks associated with the use of commonly used laxatives during pregnancy.
Initial treatment of constipation in pregnancy should be medicine free, such as exercise, dietary measures and increased fluid intake.
If this is not effective, bulk-forming laxatives, such as ispaghula husk, sterculia or wheat bran may be considered. Lactulose, bisacodyl and senna may also be considered.
Provided there are no other risk factors involved, exposure to any of the agents included in this monograph during pregnancy does not constitute medical grounds for invasive diagnostic techniques or termination of pregnancy.
Recommended stepwise treatment of constipation in pregnancy:
- Increased fibre.
- Increased fluids.
- Increased exercise.
- Bulk-forming laxatives.
- Glycerin suppositories.
- Docusate sodium – low doses.
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