Constipation In Pregnancy
Constipation is technically defined as having less than 3 bowel movements a week. It is one of the most common problems in pregnancy. Pregnant women often complain of increased difficulties in having a bowel movement, in addition to experiencing excess gas and bloating. This is usually nothing to worry about, it's just another side effect of all those changes taking place in the body. Interestingly enough, studies show that pregnant women are just as likely to experience an increase in bowl activity (diarrhea) as decrease. So, you may experience both, one or none. Every woman’s pregnancy is unique.
Constipation most frequently occurs in the first trimester of pregnancy and the last trimester. Scientists are not particularly clear as to the causes, but a number of factors are likely to play a role. In the first trimester, pregnancy hormones can cause the intestinal muscles to relax, and in the process become 'lazier' than normal. In particular the Luteinizing Hormone (LH, also known as lutropin) plays a major role as it can inhibit a substance known as enterokinesia, which leads to fewer intestinal contractions and constipation. LH levels reduce again by the second trimester, often relieving symptoms. By month 6, on entering the third trimester constipation can reappear when the enlarged uterus presses down on the colon. This, in addition to poor blood circulation, sometimes triggers pregnancy hemorrhoids. Also, prenatal vitamins usually include a high level of iron, which is known to cause constipation. However vitamins should be continued, if at all possible. You may consider just lowering the dose if necessary. In a few instances, constipation may be a symptom of thyroid disease - it is worth reading our article thyroid disease and pregnancy.
Treatment options for constipation primarily involve lifestyle changes, incorporating both diet and physical activity. They include:
Fiber: If you are constipated, it is usually relieved by eating high fiber foods such as bran, figs, prunes, whole grain bread, raisins and nuts. Including these foods in your diet regularly can help prevent constipation in the first instance. For more tips on looking after you and baby see our pregnancy care guide.
Hydration: Increase your water intake to 6-8 glasses a day. You can also count fruit juices (especially prune juice) and even a little coffee and tea towards your 8 a day. If you are attending birthing classes, don't be embarrassed to discuss any issues you may have, whatever they are, millions of women before you have experienced them.
Exercise: Low-impact exercise such as walking or swimming three times a week for 20 minutes a session will help move food along in the digestive system. Always consult your doctor before starting any new exercise routine while pregnant.
Don't Ignore: Try not to ignore the urge to have a bowel movement.
Stool Softeners Remedies: These are taken to soften the stool and some are considered safe to take during pregnancy. These include the brands: Metamucil, Peri-Colace, Colace and Surfak. They are recommended when someone needs to avoid straining in order to pass a bowel movement - for example after childbirth and delivery or after surgery.
Avoid: Laxatives that contain saline (such as Milk of Magnesia) which can cause salt retention, as well as castor oil which can cause uterine contractions and cascara which can cause diarrhea in your new born baby. Herbal remedies should also be avoided during pregnancy. Always check with your doctor before taking anything. For other do's and don'ts while expecting, see pregnancy tips.
Minor postpartum complications such as constipation are quite common. If you have had a long labor without food, or experienced a bowel movement during birth, it may take you a few days to defecate, simply because there is nothing in your intestines. If you had a c-section delivery, it can take 3 or 4 days for your system to function normally again. If you continue to have problems with bowel movements, another cause could be the drugs which were prescribed to ease labor induction. If you were given medication, they may still be slowing down your digestive system. Some women who experience hemorrhoids, or a tear or episiotomy during childbirth can naturally worry about 'pushing' and putting strain on the anal area or stitches. This worry can lead to temporary constipation. If you do experience constipation postpartum, your OB/GYN or someone else in your pregnancy healthcare team will be able to advise you. Usually treatment is the same as during pregnancy.
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