Constipation during Pregnancy

Do you go to the toilet fewer than 2 times per week? Do you need to strain to open your bowels? Do you have abdominal pain or bloating? Sounds like you could be constipated!

What causes constipation?

Constipation is very common during pregnancy for a few different reasons.

Pregnancy hormones (mainly progesterone) slow down the movement of food through your digestive system.
Morning sickness can result in a change of diet, possibly resulting in reduced fibre intake.
Pressure of the growing uterus on the bowel and rectum can cause the bowels to slow down.
Pregnancy supplements, particularly iron, can cause constipation.
Anti-nausea medications can also cause constipation.

So what can you do to manage this?

We know that to keep our stools (poo!) soft they need a good balance of fluid, fibre and exercise.

You should aim to…

Stay hydrated and keep your fluids up, particularly if vomiting.
Aim to consume 25g of fibre each day.
Regularly exercise/keep active to keep the gastrointestinal and digestive systems ticking over.

Great sources of fibre!

How to kick these sluggish bowels into a higher gear!

Bowels are like babies… they can easily be retrained.

Just because they’re naughty now, doesn’t mean they’ll be like that forever. They may just need a good routine to keep them in line.

The gastro-colic reflex (ie. when your gut starts to contract and push poo down into your rectum ready for emptying) is stimulated when…

You first wake in the morning
You have a hot drink (coffee is particularly good at stimulating bowels… I’m sure some of us have experienced this!)
You perform physical activity/exercise
You eat a small meal

These activities naturally stimulate your bowels to start working. Sometimes when our bowels are a little lazy, doing these activities can spur them on and kick them into a good routine.

So try waking up (how easy is that?!), having a hot drink, eating a small meal and doing some form of physical activity (it doesn’t need to be strenuous).

Then sit on the toilet for no longer than 10 minutes and just wait and see if the bowels are ready to start working yet.

Don’t push… don’t force it.. just sit and wait.

If you have a bowel motion… great!

If not… that’s fine. Try again tomorrow 🙂

How to poo correctly (you must read this!)

Number one rule of poo club. DO NOT STRAIN. EVER.

It is bad for your pelvic floor.

It increases your risk of incontinence, prolapse, weak pelvic floor muscles, haemorrhoids and anal fissures.

Instead you should…

1. Place your feet on a small stool (this allows your knees to be slightly higher than your hips which puts your rectum in a nice, straight position to empty from).
2. Lean forward slightly, maintain a nice and relaxed posture.
3. Bulge your tummy out (like you’re pregnant or your tummy is an expanding balloon). This helps to relax your pelvic floor and ensure you don’t strain through your pelvis and give yourself a prolapse. If you suck/squeeze your tummy inwards, you will generate too much force and we don’t want any strain!
4. Make a gentle “Moooooooo” sound. This is both funny and important as it encourages your tummy to bulge outwards.
5. Do this each time you open your bowels.

How to poo properly!

So what exactly is “normal” for bowel function?

It is normal to empty your bowels anywhere from 3 times/day, up to 3 times/week.

It is normal to take up to 10 minutes to empty your bowels completely.

It is normal to feel like you have completely emptied your bowels.

It is ideal to aim for a type 4 stool (see below) which is soft, but formed, and easy to pass.

It is normal for opening your bowels to be a “non-event”. By this I mean, you don’t have to try too hard, think about it too much or worry.

Eeek.. I’m definitely NOT normal!

How many of us are normal?!

As a general rule.. if you go to the toilet more than 3 times/day or have stool types from 5-7… it is likely that you have some type of irritable bowel or food sensitivities.

If you go to the toilet fewer than 2-3 times/week and have a stool type of 1-3… it is likely that you have a sluggish bowel and issues with constipation.

If you have tried fluid, fibre and exercise and things still don’t seem quite right.. make sure to chat with your health professional (pelvic health physio, doctor or dietician).

You may need extra supplements/medications or further investigation.