Too painful to poo?

by | May 25, 2020

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Constipation is a common complaint during pregnancy, but that doesn’t make it any less uncomfortable. Doula and birth coach, Leonie Mynhardt, has some helpful tips to bring you relief.

Between the morning sickness and stretchmarks that usually accompany a pregnancy lies constipation, where you find it difficult, even painful, to pass a stool. It’s not a rare ailment – as many as half of pregnant women get constipated at some point. It most commonly affects moms-to-be between the ninth and 32nd week of pregnancy, as well towards the end of pregnancy.

The perfect storm

The big culprit in this is an increase in the hormone progesterone during pregnancy, which works to keep the placenta functioning well, as well as preventing miscarriage by keeping the uterine lining relaxed, amongst other things. This smooth muscle relaxation isn’t confined to the uterus alone, as this heightened release of progesterone affects your whole bone, including the digestive tract. This means that food passes through the intestines more slowly, resulting in constipation.

Increasing pressure on your bowel from the uterus (and your growing baby) also makes constipation a common companion in the last weeks. Additionally, iron supplements (especially taken in high dosages), stress, anxiety, minimal physical exercise, and a diet that is low in fibre and high in sugar can make constipation worse.

What can I do to help things along?

  • Eat foods that contain a lot of fibre every day. These include cereals and breads made from whole grains, brown rice, legumes (like beans, chickpeas and lentils), and fresh fruits and vegetables daily. Adding a couple of tablespoons of unprocessed wheat bran (available at health food stores) to your cereal in the morning, followed by a glass of water, can also help, though it may take a few days.
  • Drink plenty of water. Your body needs to be well hydrated. Try to drink ten glasses of water, rooibos tea or fruit juice throughout the day. A good sign of proper hydration is clear or pale yellow urine. A daily glass of prune juice can also be helpful.
  • Exercise regularly. Walking, swimming, riding a stationary bike, and doing pregnancy yoga are all safe exercises you can do. Not only doe exercise during pregnancy help you feel fit and aid post-birth recovery, it can also help ease. Just remember to consult with your medical care provider before undertaking any form of in this time.
  • Time it right. Your bowels are most likely to be active after meals, so make time to use the bathroom after you eat and don’t rush the process. Listen to your body, and never put off going to the bathroom when you feel the urge.
  • Be supplement smart. If your prenatal multivitamin contains a large dose of iron, ask your medical care provider about switching to with less iron or a chelated iron product. When taking iron supplements, it is very important to drink enough water.
  • When you get up in the morning, drink a glass of warm water with some lemon in it.
  • Take a tablespoon of coconut oil or olive oil before each meal. The oil will help soften and lubricate the stool.
  • Eat well. If you’re very constipated, limit your meals to fresh fruits such as apples and pears with skins, soups, vegetables like grated carrots with skins, nuts, seeds like sunflower and pumpkin, legumes such as black beans and chick peas, and other easily digested protein such as eggs. Once your bowels have cleared you can go back to a more varied diet that includes meat and starch. Stew half a cup of dried apricots or prunes with a cupful of water on the stove. Mash the fruit once it’s soft it and eat the whole lot (including the liquid) in the morning before eating anything else.
  • Take a probiotic every daily.
  • Avoid caffeinated and sugary drinks. Although they might help move the bowel initially, they are known as diuretics, which means that they compound the problem by causing dehydration. Diuretics can be dangerous in pregnancy.
  • Help your body out. To ease the stool passing, rub some organic oil (like virgin coconut oil) on your bottom area when visiting the bathroom.
  • Chat to your doctor. If nothing else helps, talk to your medical care provider about a pregnancy safe over-the-counter laxative, fibre supplement or stool softener.


Is it serious?

Constipation is usually harmless, but occasionally it can be a symptom of an underlying problem. If you have severe constipation that is accompanied by abdominal pain, alternates with diarrhoea, or you pass mucus or blood, call your doctor or midwife immediately.

Also, the pressure from straining during a bowel movement or passing a hard stool can lead to haemorrhoids, or worsen them. Haemorrhoids, commonly referred to as piles, are swollen veins in the rectal area. They can be extremely uncomfortable, though they rarely cause serious problems. In most cases, they go away fairly soon after your baby is born. However, if the pain is severe or you have rectal bleeding, call your medical care provider immediately.

While this all sounds quite dire, there is light at the end of the tunnel. In most cases constipation clears up after the baby is born and your body returns to its pre-pregnancy state.