Constipation during pregnancy: what risks and how to avoid it?

When can we talk about constipation?

Each individual has a more or less rapid transit, without it being possible to speak of intestinal disorder. When some will go up to three times a day in the saddle, others will go only three times a week while doing very well.

Aurélia Bardot, nutritionist: “Constipation is classically defined by a decrease in the frequency of bowel movements to less than three times a week, associated with difficulty in evacuating.”

A person who passes stools of normal consistency three times a week is not constipated. “Constipation is associated with hard, dehydrated stools“says Aurélia Bardot.

Why are we constipated from the beginning of pregnancy and how long does it last?

Hormonal variations, increase in the size of the uterus, decrease in physical activity… several factors act together on the intestinal transit of women during pregnancy.

Progesterone

From the beginning of pregnancy, the woman secretes more progesterone, which allowsincrease the thickness of the uterine wall so that the egg can lodge there. Secondly, this hormone secreted by the placenta has an effect relaxing on the uterine muscle, preventing it from contracting for most of the pregnancy. Problem: progesterone does not only act on the uterine muscle, but also on the intestinal muscles, slowing intestinal peristalsis – namely the intestinal contractions allowing the progression of stools along the digestive tract. Along with this, this hormone tends to increase water absorption at the intestinal level, and therefore to dehydrate the stool. Two effects which, together, promote constipation during pregnancy.

The growing uterus

In the second half of pregnancy, the uterusincreases in volume and starts to compress the large intestine. This mechanical action can make stool evacuation more complicated for some women.

Other factors

  • Other causes of constipation during pregnancy include decline in physical activity in pregnant women, who may fear that sport will harm the smooth running of her pregnancy. It is important to remind pregnant women that the practice of a gentle sports activity is not only not contraindicated but even recommended during pregnancy.
  • Iron supplementation, which is often offered to anemic women in early pregnancy, also tends to slow intestinal transit.
  • Finally, women prone to nausea and vomiting in early pregnancy often have difficulty drinking, which can also promote constipation.

What are the risks of constipation during pregnancy?

If constipation is often unpleasant for pregnant women, it can also be a source of concern for her. So, what are the possible repercussions of severe constipation during pregnancy?

Hemorrhoids

Severe constipation – associated with pregnancy which puts pressure on the rectum – increases the risk of the onset ofhemorrhoids in pregnant women. This risk is linked to the increase in blood pressure in the veins of the anal region, when the mother-to-be “pushes” to expel the stool.
Hemorrhoids pose no risk to the baby, but can be very painful and disabling for the woman.

A risk of miscarriage?

At the end of pregnancy, the constipated mother-to-be may be afraid of pushing too much on the toilet, for fear of expelling the baby.

Barbara Forster, midwife: “Constipation can induce contractions but not enough to generate a real threat of premature delivery.”

In order to minimize defecation efforts while having a bowel movement, it is essential to adopt a so-called physiological position. “We recommend that the mother-to-be sit on the toilet with a small stool under her feet so that her knees are a little higher than her hips,” explains the midwife. “The woman will then exhale as if she wanted to tuck her belly into too tight pants, which will favorably mobilize her transverse muscle and prevent her from pushing on her internal organs: uterus, bladder, rectum”, specifies the latter.

If it affects nearly one in two women, constipation during pregnancy is not inevitable! By adopting a healthy lifestyle, it is even easy to miss this inconvenience.

To drink a lot

A good transit starts with good hydration. “We recommend to women whose transit is a little lazy, to drink between 1.5 and 2 liters of water a daynamely 8 to 10 glasses of water” advises the nutritionist. Water increases the volume of the stool and stimulates the peristaltic waves of the intestine.
It may be wise to give priority to highly mineralized watersand particularly rich in magnesium, such as Hepar®, Contrex® or Courmayeur®.
Drinking a fresh fruit juice when you wake up is also a very good way to gently restart the transit.

Increase fiber intake

The dietary fiber, in particular the so-called soluble fibers, have the ability to form a gel on contact with water, which promotes the sliding of the food bolus in the intestine. These soluble fibers include pectins, gums and mucilages, and are mainly found in fruits, vegetables, legumes, seeds and cereals.

“We recommend reaching an intake of 25 to 30g of fiber per day, by consuming 3 servings of vegetables and 2 of fruit each day, and favoring whole grains, legumes and wholemeal bread.”

From high fiber foodsWe find: prunes, kiwi and melon, spinach, leeks, celery, whole grains, pulses (or legumes) and oilseeds.

Maintain regular physical activity

Sport is essential to stimulate and wake up the digestive and abdominal muscles, and to boost transits that are a little lazy. “The mother-to-be can seek advice from her gynecologist or midwife, and check which sports she can practice without fear during her pregnancy” advises the nutritionist.
active walking, prenatal yogapilates and gentle gymnastics are for example completely compatible with pregnancy.

Consuming flax seeds

Linseeds are known for their laxative properties, due to their great richness in mucilages and pectins. “However, be careful not to consume too much, at the risk of creating intestinal discomfort”, tempers Aurélia Bardot who recommends not to exceed 4 tablespoons per day. Flaxseeds can be crushed beforehand and soaked in water or milk.

Avoid paraffin oil

This oil, which is not absorbed by the intestine at all during digestion, is particularly effective in the fight against constipation. “However, paraffin oil is not recommended, especially during pregnancy, insofar as it causes a defect in the assimilation of vitamins and minerals, which it carries with it in the stool”, notes the nutritionist.

Laxative and plants: always on medical advice!

Laxatives, suppositories, enemas as well as laxative plants and herbal teas should never be taken without medical advice. “In particular, we absolutely avoid aloe, buckthorn and senna, which can trigger uterine contractions”, insists Aurélia Bardot.

Massages

For stimulate intestinal transit gently and relieve pain in case of constipation, it may be useful to perform small abdominal massage. “We can make circular movements, clockwise, namely the direction of progression of the stool in the intestine” indicates the dietician.

Constipation or diarrhea during pregnancy?

If constipation is frequent during pregnancy, it can happen on the contrary that pregnant women suffer from diarrhoea. While they can have benign causes – stress, change in diet – they can also be linked to an infection.

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