Constipation In Pregnancy

During Pregnancy, our body goes through a whirlwind of changes. One of the most commonly experienced side effects I see in clinic is constipation.

I have a lot of beautiful mummas coming to me daily with this concern and looking for ways to treat constipation naturally with nutrition.

 Pregnancy does predispose women to constipation so you are not alone.  A general rule of thumb to  confirm whether constipation is present is whether you are experiencing low frequency of defaecation (less than 3 per week), passage of hard stools and/or experiencing difficulties when emptying the bowels.

 Constipation can occur at any time during pregnancy but is more commonly experienced in the first two trimester. It is due to a combination of both mechanical and hormonal factors affecting the normal functioning of the Gastrointestinal tract. During pregnancy our digestion starts to slow down and the movement of our food and bowels tend to feel sluggish and stagnate. When we than add a rise of our hormone progesterone and a reduction in our motilin hormone (a peptide hormone which is responsible for smooth muscle motility) this can inhibit and decrease bowel transit times. A further hormonal cascade that occurs and results in an increased rate of water absorption by the small intestines, is due to high amounts of circulating oestrogen and progesterone which stimulates the production of aldosterone. Aldosterone stimulates sodium and water reabsorption in the small intestines which is what causes stools to dry out and harden.

There are also some further reasons why constipation may be present. This can simply be due to the fact that the mother is not drinking enough water or consuming enough dietary fibres, or she is taking particular medications or supplements such as iron, which can affect bowel motility.

 Constipation concerns aren’t only experienced during pregnancy. You can also experience constipation during the fourth trimester ( 1 – 3 months postpartum). Especially if there is haemorrhoids or anal fissures present; you may be at a higher risk of postpartum constipation.

When looking at the following treatment aims, even if you do not have constipation these objectives are great preventative methods to consider:

• Increase daily dietary fibre. Both soluble and insoluble fibre play their part in improving motility.  The daily fibre requirement for pregnancy is around 25-35g daily. This can be easily met by the following sample diet day:

BF - wholegrain oats with flaxseed and mixed seeds.

S – banana and almonds

L – Mixed Salad sandwich with poached chicken

S – Greek yoghurt with mixed berries

D - Grilled Fish with a lentil salad

S – Vanilla Chia seed pudding

 Further Fibre rich foods include: wheat bran, oatmeal, grains, dried plums (prunes), kidney beans, raw fruits, Brussel, dark leafy greens, broccoli, seeds.

 Include bulk forming agents into the diet. Physilium husk is one of my favourites and assists in bringing moisture to the stool and stimulate peristalsis movements of the GI tract. Making passing the stool more comfortable and fluid. Note: ensure you are drinking adequate water alongside bulk forming agents and always speak with your health professional prior to consumption.

• Increase Fluids. Daily water requirements for pregnancy is 2.3 litres daily. From my personal experience in clinic, this is very rarely met and essential to prioritise.

• Daily exercise. Moving the body during regency has many proven benefits. Physiologically when we move our body we increase fluid (blood & lymph) circulation, increase oxygen transportation and therefore contribute to increased organ function.

• Probiotics. Due to the high demands of pregnancy our bacteria in our gut can be easily jeopardised. Leading to an imbalanced or disturbed microbiome. Addressing this with a probiotic can help restore normal bowel function and increase stool frequency. that alter the colonic flora may improve bowel function.  Not all probiotic supplements are treated equally so it is important to ensure you get the right product that is strain specific. This should include: Bifidobacterium Lactis, Bifidobacteriun Animalis, Lactobacillus Acidophilus & Lactobacillus Rhamnosus.

 Lastly, it is important to note that there is insufficient data on the use of laxative in pregnancy and as laxative can increase fluid and electrolytes loss it is always best to consult with your obstetrician prior to use.

*Please always consult with your obstetrician and health practitioners prior to making any of the above changes whilst pregnant that way they can cater to your personal needs and requirements.*

By Kahili Blundell