Constipation During Pregnancy: Why It Happens and How to Get Things Moving Safely

Nobody expects constipation on the list of pregnancy milestones. But for a lot of people, it shows up right next to the nausea and sleepiness.

Constipation is one of the most common complaints in all the nine months of pregnancy. The Canadian Family Physician found it affects somewhere between 11% and 38% of pregnancies. Thankfully, most cases can be fixed with simple changes.

We’ll cover all you need to know about pregnancy constipation in this guide, including why it happens, how to get quick relief, what’s safe to take, and when you should call your OB-GYN or midwife.

Is Constipation a Sign of Pregnancy?

Not really. Constipation has plenty of causes that have nothing to do with pregnancy. Maybe you’re not eating enough fiber. Maybe you started a new medication. Being constipated doesn’t mean you’re pregnant. If you want a real answer, take a test.

Early Pregnancy Poop: Pooping a Lot During Pregnancy First Trimester

Some people get constipated right away, while others poop a lot in the first trimester. Both are totally normal.

If you’ve typed “do you poop a lot when pregnant” into Google before, you’re not alone. Pregnancy can make you poop more. Your bowels can lossen up from new prenatal vitamins, a sudden diet change (all those vegetables you suddenly feel guilty not eating), and changing hormones. People often change their diet after a positive test, and that alone can cause early diarrhea. So your bathroom habits can swing either way in early pregnancy, and neither one is something to panic about.

When Does Pregnancy Constipation Start? 1st Trimester and Beyond

Usually not on day one. Cleveland Clinic OB-GYN Dr. Stacie Jhaveri says pregnancy constipation usually doesn’t show up until month two or three, once progesterone rises enough to slow your gut down, and you’ve started taking iron in your prenatal vitamins. So while pregancy constipation usually starts in the first trimester, but rarely in the first few weeks.

It tends to creep in slowly as hormone levels climb. It stops for some people in the second trimester once the nausea calms down enough for them to eat and drink like normal again. Others just keep dealing with it.

And when does constipation stop in pregnancy? Often not until after the baby is born. Your growing uterus keeps pushing on your bowel, you’re probably still taking iron, and progesterone stays high right up to delivery. Things usually calm down a few weeks after birth. If they don’t, bring it up at your postpartum checkup.

Why You Get Constipated During Pregnancy

Being pregnant and constipated is just biology and a few things working against you at the same time.

• Progesterone: This hormone relaxes your muscles, including your intestinal wall. A relaxed bowel moves slower, so your colon has more time to soak water out of your stool. Slow movement and dry stool makes it harder to poop.
• Iron in your prenatal vitamin: Pregnancy bumps your iron needs up to 27 mg a day, and the NIH Office of Dietary Supplements says higher doses of iron are a common cause of constipation. If your prenatal seems to be the problem, ask your provider about switching formulas.
• Your growing uterus: By the second and third trimesters, it’s literally pressing down on your rectum and lower bowel.
• Not enough fiber: Nausea and food aversions push a lot of people toward crackers, toast, and plain pasta. These aren’t great sources of fiber.
• Less movement: When you’re exhausted and your back hurts, it easy to not move as much as you should. And movement is what keeps your bowel active.

Pregancy constipation can be worse if you dealt with irritable bowel syndrome or chronic constipation before getting pregnant. Medications that slow digestion, like some nausea drugs and antacids with aluminum in them, pile on top of that.

Why Does It Hurt to Poo While Pregnant?

The pain starts stretching to pass hard, dry stool. Over time, straining adds more damage to the tissue around your anus, and that’s what causes most people pain.

Hemorrhoids can also cause pain. Cleveland Clinic says 30% to 40% of pregnant people get hemorrhoids. The third trimester is the worst stretch for this, because straining, extra weight, and more blood in your body all put pressure on the veins in your rectum and anus.

Then there are anal fissures, which are small tears in the skin around your anus, and they cause sharp pain plus a streak of bright red blood on the toilet paper. Both hemorhhoids and anal fissures get better once your stool softens up, but you should still mention any bleeding to your healthcare provider.

How to Relieve Constipation During Pregnancy Immediately

If you need relief today, not next week, start with what works fast and carries the least risk. Think of this as your starter kit.

• Drink something warm: Drink a mug of warm water or decaf tea first thing in the morning and drink it all day. A warm drink can nudge your gut into gear. Cleveland Clinic suggests aiming for 10 to 12 glasses of fluid throughout the day.
• Try prune juice: Prunes have sorbitol in them, a sugar alcohol that pulls water into your bowel. This can help move things in your bowel.
• Go for a walk: Just twenty minutes of easy movement works your stomach muscles and gets your colon moving.
• Answer the urge: Go the second you feel like you need to go. Holding it in just makes the next try harder.
• Eat fiber alongside your fluids: Eat fiber-rich foods like berries, pears with the skin still on, oats, beans, and chia seeds. You should eat at least 25 grams of fiber a day. Takeit slowly, though, or you’ll get bloated.

Check out our guide on relieving constipation immediately for more tricks, including some you can try while you’re already sitting there.

The Best Position to Relieve Constipation During Pregnancy

Sitting up straight on a toilet keeps the puborectalis muscle partly clenched, which kinks your rectum. You can loosen up that muscle by squatting. But you don’t have to actually squat. A small step stool under your feet works just as well, since it raises your knees above your hips the way a squat would. Leaning forward with your elbows on your thighs helps too.

In summary, put your feet on a stool, knees up, lean forward, let your belly relax, and breathe out instead of forcing it. If nothing happens after five minutes, just get up and try again later.

What Can I Take for Constipation While Pregnant?

There are medications most providers consider low risk if you’re still constipated after the lifestyle changes listed above. Before you take any of them, though, talk to your OB-GYN or midwife first. Your provider knows your history, and they’ll know if anything about your pregnancy makes these options unsafe for you.

Can I Take Stool Softener While Pregnant?

Usually, yes, once your provider says it’s fine. The most common one is docusate sodium, which you’ll find under several brand names or as a plain generic. It lets water soak into your stool, so it stays soft, and barely any of it gets into your bloodstream. The MotherToBaby fact sheet, hosted by the National Library of Medicine, does mention one case where a newborn had low magnesium after the mom took way more docusate than the label allowed. So stick to the dose recommended by your provider.

MiraLAX and Pregnancy Constipation

MiraLAX is polyethylene glycol 3350, meaning it’s an osmotic laxative. It holds water in your colon so your stool stays soft. MotherToBaby says osmotic laxatives barely get absorbed by your body, so very little of it should reach the baby. Cleveland Clinic includes it on their list of pregnancy-safe medications, but only for occasional use.

Take that word “occasional” seriously. The Canadian Family Physician review says osmotic and stimulant laxatives should only be used short-term, or you risk dehydration and electrolyte imbalances. If you find yourself reaching for MiraLAX every single day, tell your OB-GYN or midwife about it

Can You Take Laxatives While Pregnant?

Thereare some that are safe, while others are not. “Laxative” is actually a whole category of medications, and below is a breakdown of how they interact with pregnancy.

• Bulk-forming laxatives, also called fiber supplements: Psyllium, methylcellulose, and polycarbophil usually top the list because your body doesn’t absorb them at all. ACOG names them the safest option, and a Cochrane review found fiber supplements helped pregnant women go more often. Just take them with a full glass of water.
• Osmotic laxatives. This group includes MiraLAX, lactulose, and milk of magnesia. Only use these once in a while, and get the go ahead from your provider first.
• Stimulant laxatives. Senna and bisacodyl work by making your bowel muscles contract. The Cochrane review found these work better than fiber supplements, but they also bring more cramping and diarrhea. ACOG says use them carefully and stop once things are moving again. Only with your provider’s approval.
• Castor oil and mineral oil. Just skip these two. MotherToBaby says castor oil can cause severe diarrhea and cramping in both your bowel and your uterus, and mineral oil does get absorbed in small amounts.

One more time, talk to your OB-GYN or midwife before taking anything, even the “natural” options.

Straining to Poop While Pregnant: Will Pushing Hurt the Baby?

No, it can’t hurt the baby. Your baby is cushioned inside the uterus, floating in amniotic fluid, behind a closed cervix. The pressure from a bowel movement just doesn’t reach them.

Straining is a problem for you, not the baby. Too much straining is exactly what causes hemorrhoids and fissures. That’s the real reason to soften your stool instead of forcing things out. 

Can Constipation Cause Miscarriage?

No evidence points to that. Most first-trimester losses happen because of chromosome problems in the embryo, and Mayo Clinic estimates that’s the cause behind half to two-thirds of them. Everyday stuff like exercise, sex, and going to work doesn’t cause a miscarriage, and constipation falls in that same bucket. Laxatives haven’t really been studied for miscarriage risk either, which is one more reason to only take what your provider has already cleared.

Constipated Before Labor: Third Trimester Constipation

Third trimester constipation is an entire experience. Your uterus is at its biggest, the baby may have dropped into your pelvis and is now sitting right on your rectum, and you’re probably moving around a lot less than you were at 20 weeks. Hemorrhoids tend to peak here too, for the same reasons.

Being constipated right before labor is common, and it doesn’t mean anything’s wrong. Some people notice the opposite near the end, with looser stools instead. The American Pregnancy Association says diarrhea in the third trimester shows up more near your due date, and it might mean labor is close, or it might mean nothing at all. Both patterns are normal.

Extreme Constipation During Pregnancy: When to Worry?

Most pregnancy constipation is annoying but harmless. Every once in a while, though, severe constipation turns into something called fecal impaction, where hard stool piles up in the rectum and just can’t pass. According to Cleveland Clinic, warning signs include belly pain, bloating, nausea or throwing up, and sometimes watery stool leaking around the blockage, which a lot of people mistake for diarrhea. When this happens, see a doctor instead of using a bigger dose of laxatives. 

Call your OB-GYN or midwife the same day if your constipation comes with any of these:

• Bad or worsening belly pain, or pain that comes and goes in waves
• Throwing up, or not being able to keep any fluids down
• Blood in your stool beyond just a streak on the paper, or stool that’s dark and tarry
• No bowel movement in a week or more, even with fluids, fiber, and an approved stool softener
• Any vaginal bleeding or fluid leaking, alongside the constipation

Your gut is part of good prenatal care too. Bring up your bowel habits at any appointment instead of picking something off a pharmacy shelf.

Frequently Asked Questions

When to worry about constipation during pregnancy?

Worry when it comes with bad abdominal pain, vomiting, rectal bleeding, or no bowel movement for a week or more, even with fluids, fiber, and an approved stool softener. Those signs can point to fecal impaction or something else that a doctor needs to check. Regular hard stools are typivcally nothing to worry about.

Is it bad to push hard when constipated while pregnant?

Pushing hard won’t hurt the baby, since they’re protected inside the uterus. It is bad for you, though, because straining is the main reason people get hemorrhoids and anal fissures during pregnancy. I’s better to soften things up with fluids, fiber, prune juice, and a footstool instead of forcing it.

What to do to avoid constipation during pregnancy?

Drink 10 to 12 glasses of fluid a day, get at least 25 grams of fiber from fruit, vegetables, beans, and whole grains, and try to move your body most days. Go the second you feel the urge. And if your prenatal vitamin seems to be the cause, talk to your provider about changing the iron formula.

How can I manage constipation during pregnancy?

Start with fluids, fiber, movement, and the squat-style position on the toilet. If that’s not cutting it, talk to your OB-GYN or midwife about a fiber supplement like psyllium, a stool softener like docusate sodium, or MiraLAX every once in a while. Save stimulant laxatives for when your provider tells you to use them, and avoid castor oil and mineral oil.