Pregnant & Constipated? Try Our Expert Tips

Constipation may not be your favorite topic, but as a pelvic floor physical therapist who specializes in pregnancy and postpartum care, it's definitely one of mine. Trouble pooping is one of the most common gastrointestinal complaints reported during pregnancy — affecting as many as 40% of pregnant women — so I've helped countless patients learn how to poop comfortably in every trimester.

Why does growing a baby block your BMs? The frustrating backup is likely due to a combination of changes that take place during pregnancy. These include:

• Hormonal fluctuations that can impact the speed at which food passes through your body
• Dietary shifts including the addition of prenatal and high iron supplements
• Lifestyle changes like a drop in activity level or exercise

And, unlike nausea or heartburn, constipation doesn't typically go away immediately after delivery. Even several days after birth, 47% of those who delivered vaginally and 57% of those who delivered via cesarean still experience constipation. At one month postpartum, studies show that 9-15% of those people will continue to have trouble passing poops. That's a long time to deal with stubborn poop.

What's worse, chronic constipation has been associated with increased risk of developing urinary incontinence, fecal incontinence, and pelvic organ prolapse later in life. So learning how to reduce constipation and improve your bowel function now will not only improve your day to day experience in pregnancy, it can also help to support good pelvic floor function in the long run.

If you are pregnant or planning on becoming pregnant, below are five simple tips you can try now in order to reduce your risk of constipation and move things along if you're already having trouble.

1. Poop as soon as you feel the urge

When you feel the need to go #2, don't wait. Going with your body's natural urge can reduce your need to push or strain during a bowel movement. That urge is likely triggered by peristalsis and the gastrocolic reflex which encourages defecation in order to make room in your body for more food. Pay attention to when you most often have these urges and try to be near a bathroom and not stuck in traffic when that happens. Keep in mind that a regular diet, established routines, or simply eating a meal or drinking a cup of coffee can all help promote peristalsis.

2. Relax your backside to let the poop out

In order to pass a bowel movement, your pelvic floor first needs to release its grip on your anal sphincter. For some people, this can be a real challenge, especially in pregnancy, when your pelvic floor muscles can become very familiar with clenching (clenching to hold in your pee with you sneeze, clenching to make it to the bathroom in time, clenching to stabilize your pelvis as your baby grows — it's a lot of clenching).

Here's a 4-step strategy to help your pelvic floor muscles turn off:

1. Use a box or squatty potty to bring your knees above the height of your hips
2. Place both feet flat on the floor and just slightly wider than hip distance apart
3. Allow your belly and the muscles of your jaw to relax
4. Take several slow deep breaths into your abdomen using your diaphragm

If you are experiencing constipation in pregnancy, speak with your healthcare provider about your symptoms. Consider also reaching out to a pelvic floor physical therapist in order to improve your symptoms, get things moving, and learn ways to protect your pelvic floor during pregnancy and beyond.

3. Hydrated to make poop easier to pass

Your body needs a lot of fluid to support a healthy pregnancy. ACOG recommends drinking 8-12 glasses of water throughout the day. This fluid goes towards creating amniotic fluid that supports your growing baby, increasing your blood volume by 45%, and helping remove waste during urination. But fluid intake also helps support good digestion and research shows that lower levels of fluid intake have been associated with increased constipation.

4. Move your body to move your bowels

Movement is beneficial for both the pregnant person and baby for many reasons like reducing the risk of gestational diabetes and cesarean delivery, supporting good mental health and improving cardiovascular function. But exercise has also been shown to support good digestive health. Research shows that 140 minutes or more per week of moderate aerobic exercise, like walking, can help reduce constipation.

5. Yes, it's obvious, but don't forget fiber

Constipation is often tied to a change in bowel movement consistency. If your stool is hard and difficult to pass (like #1-2 on the Bristol Stool Chart below), then increasing fluid and fiber in your diet can help improve that consistency, making your bowel movement soft, well formed (like #3-4) and much easier to pass. Try eating more dietary fiber in the form of fruits and vegetables first, but if that is not enough, speak with your doctor about potentially adding a bulk-forming agent or stool softener to your diet during your pregnancy.

If these tips don't work, talk to your OBGYN and ask if a referral to a pelvic floor physical therapist might be right for you. As the experts in pooping mechanics we can provide you with personalized advice that will help make your trips to bathroom quick and painless.