MS, RDN, CDN
Allison is a registered dietitian who holds a Master’s in Nutrition and Physical Fitness. She also loves helping families get creative with their wellness choices.
Although constipation is defined as having fewer than three bowel movements in a week, feeling ‘backed up’ can happen any time your normal routine is disrupted. Sometimes stools can feel hard, dry, small, painful or difficult to pass You may even feel the discomfort of having an incomplete bowel movement.
Unfortunately, your likelihood of experiencing constipation is increased during pregnancy and post-partum. In fact, an estimated 11-38% of pregnant women experience constipation. Raging hormones, decreased physical activity, and increased vitamin supplementation (the main culprits are calcium and iron) can all contribute to constipation while you are growing your sweet babe. Not to mention that in pregnancy, your growing uterus can slow down bowel transit time and increased water absorption in the intestines which can cause stool to dry out.
Remember that everyone is different and there is no normal. Some people regularly move their bowels three times a day while other people only three times a week. Any deviation from your norm can be unpleasant and cause discomfort.
So how can you find relief? A number of daily lifestyle choices affect bowel regularity. By minimizing the possible culprits and increasing healthy behaviors, you can prevent and manage constipation.
Possible culprits of constipation include:
Healthy behaviors to increase include:
While you may think that constipation is just an unpleasant short-term problem, it’s important to address the situation as uncomfortable complications from constipation and strained bowel movements, like hemorrhoids and anal fissure (tears in the anus from passing hard stool), can result. Though more serious long-term complications of constipation like fecal impaction (when stool gets stuck in your intestines) and rectal prolapse (when the intestine protrudes from the anus) are rare.
Incorporate fiber-rich foods at every meal
Eat an overall diet rich in soluble and insoluble fiber like fruits, vegetables, whole grains, nuts, seeds and beans
For breakfast, try a bowl of whole grain, high fiber cereal (with at least 5g of fiber and less than 4g of sugar) with fresh blueberries and ground flax seeds. For lunch, chow down on carrots and hummus, a whole grain sandwich and leafy green salad or lentil soup. At dinner time, include a generous portion of vegetables, whole grains or beans.
Talk with the Happy Family coaches for ways to get the recommended 14 grams of fiber per every 1,000 calories you eat.
In total, most women need about 25-30 grams of fiber daily. As your calorie needs increase while pregnant and breastfeeding, so will your fiber needs. By your third trimester, you may need as much as 35 grams per day.
Slowly add fiber to your diet to work up to this goal, as a sudden increase in the amount of fiber you eat can cause bloating and gas.
Limit low-fiber or “binding” foods
If you are eating a lot of processed and refined grains which have very little fiber, such as white rice, plain white pasta, crackers, white bread, refined hot cereals (like Cream of Wheat) certain cold cereals (with less than 5g of fiber per serving), and pancakes and waffles made from white flour then it is likely you are not getting enough fiber and eating enough of the good stuff. (think whole grains) You may want to take a look at our “What is a Whole Grain” article.
Know your own food triggers
Remember that everyone is different. Pay attention to your own food triggers or reactions and limit those foods.
Get plenty of physical activity
The American College of Obstetricians and Gynecologists recommends, per approval from your healthcare provider, that pregnant and postpartum women get at least 30 minutes or more of moderate exercise most days of the week. Remember that even a short walk counts!
Drink at least 8-13 cups of fluids daily, choosing mostly water.
Start your morning with warm, homemade ginger tea. Simply boil ginger in water and enjoy! (This is also a great thing to try if you are suffering from morning sickness!). Caffeine in coffee and tea are also stimulating (especially when served hot), but make sure you’re not overdoing it with caffeine if you’re pregnant or breastfeeding.
Reap the benefits of probiotics from fermented foods that are safe to consume during pregnancy and breastfeeding
Try yogurt, sauerkraut, miso and kimchi
Because the safety of kombucha during pregnancy and breastfeeding is unclear (it contains both caffeine and alcohol) it’s best to avoid this beverage until you are no longer pregnant or breastfeeding.
If it feels good, enjoy some light abdominal massage, but avoid hard pressure on your belly while pregnant and recovering from childbirth.
Check out Baby massage: benefits and techniques for an example video.
Don’t ignore the urge to go!
Take your time in the bathroom. Allow yourself enough time to have a bowel movement without feeling rushed. While this practice may seem difficult with a newborn, remember that it’s OK to have your baby in the bathroom with you – you won’t be the first or the last mom to do this! Bring a baby pillow or bouncer into the bathroom to keep your baby comfortable and occupied while you take your time doing your business.
Speak with your healthcare provider if you need relief
If you suspect that your pre or postnatal vitamin or medication is causing constipation, your healthcare provider may be able to recommend an alternative with less calcium or iron.
If you have tried increasing fiber, fluids and physical activity without relief, you may be a candidate for laxatives or medication.
If you are experiencing constipation with accompanying symptoms like dry, hard or difficult to pass stool or abdominal pain for more than three months, you may be suffering from chronic constipation.
NCBI/NIH. (Trottier, M., Erebara, A., & Bozzo, P. (2012). “Treating constipation during pregnancy”. Canadian Family Physician, 58(8), 836–838.). Date accessed 6 August 2018.
NCBI/NIH2. Turawa EB, Musekiwa A, Rohwer AC. Interventions for treating postpartum constipation. Cochrane Database of Systematic Reviews 2014, Issue 9. Art. No.: CD010273. DOI: 10.1002/14651858.CD010273.pub2. Date accessed 6 August 2018.
Definition & Facts for Constipation. NIDDK/NIH. Date accessed 6 August 2018.
Nursing Times: McClurg D, Lowe-Strong A (2011) “Does abdominal massage relieve constipation?” Nursing Times; 107: 12, 20-22. Date accessed 6 August 2018.
Increasing Fiber Intake. UCSF Medical Center. Date accessed 6 August 2018.
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