6 Tips To Combat Constipation During Pregnancy by Fiona Grouber

Constipation; it is one of the uncomfortable, not-so-glamorous and regularly reported symptoms of pregnancy. Unfortunately, sometimes it is referred to as a ‘normal’ part of being pregnant. While constipation may be common, it is most definitely not normal. 

Various factors are responsible for causing constipation during pregnancy including:

·      Hormones shifts which can slow the movement of stool through the bowel
·      Reduced physical activity
·      Changes in diet (especially if you are feeling nauseous or have aversions)
·      Iron supplements
·      Physical weight of the growing uterus 

Up to 1 in 4 women experience constipation during their pregnancy, with some statistics showing these numbers up to 40%.

Besides the discomfort during pregnancy, consistent constipation and straining increases the overall downwards pressure on the pelvic floor muscles (which are already working hard with the increased demands of your growing baby). This may contribute to haemorrhoids, leakage (incontinence) and prolapse. 

If you have been experiencing reduced bowel motions, feelings of incompletely emptying when pooing, pain or abdominal discomfort when trying to empty your bowels (or day-to-day), or nausea/bloating, then you may be constipated!

The good news is that there are several lifestyle modifications that can provide relief of your symptoms. Here are my top tips for combating constipation during pregnancy: 

1. Increase Fibre
·      Wholegrains like oats, bran, brown/wholegrain rice and pasta
·      Nuts and seeds of all types
·      Fruits (think prunes, peaches, papaya and my secret sidekick…. kiwi… with the skin on!) and variety of vegetables
·      Fibre supplements like psyllium husk

2. Increase Water Intake
Keep fluid intake (primarily water) high, aiming for approximately 2 litres most days, especially on days you are exercising. We also know that increasing fibre without adequate fluid intake can lead to constipation, so drink up! Trying to keep hydrated regularly throughout the day is best. 

3. Movement & Exercise
Sometimes exercising is tough during pregnancy, but even gentle movements like a walking, pregnancy-friendly yoga/pilates, swimming or some whole body stretches may be all you need to get your bowels moving. Exercise guidelines recommend 150 minutes of moderate intensity activity per week. 

4. Optimising Body Mechanics
Optimising your position on the toilet will mechanically open the bowels and give your stools the best chance of emptying effectively with minimal strain. When sitting on the toilet you want to: 

·      Sit, not hover
·      Lean forwards, with your back straight, and elbows supported on your thighs
·      Let your stomach to ‘let go’ and relax forwards
·      Practise deep belly breathing
·      Use a stool/shoebox under your feet, so your knees are slightly higher up (a Squatty Potty is great too!)
·      Avoid tightening your stomach or draw it inwards
·      Refrain from holding your breath
·      Make sure you take your time, don’t rush and take your time
·      Listen to your bowel urges rather than ignoring them (or waiting hours till you get home)

5. Laxatives
There are a range of laxatives that all work differently and may aid in supporting your bowel function. Be sure to speak to your health care provider regarding what may be right for you.

6. Pelvic floor muscle training
During pregnancy, our pelvic floor muscles are working hard to support our bladder, bowel and growing uterus. Daily pelvic floor exercises are recommended as part of the National Exercise Guidelines during Pregnancy. Unfortunately, research shows that 50% of us are incorrectly activating our pelvic floor so ensuring you have an individualised assessment by a pelvic health trained physiotherapist is beneficial. Usually this involves an internal examination, however this is painless and very educational in learning how your internal muscles are working! Often people who experience constipation have a poorly relaxing pelvic floor so learning how to turn your muscles on (and off) can be extremely beneficial.

Fiona Grouber is a Women’s & Pelvic Health Physiotherapist and a mama-to-be! She is passionate about supporting women through their pregnancy and postnatal period and breaking taboos associated with pelvic floor problems. Fiona enjoys educating and empowering her patients by guiding them to reach their health and wellness goals. She consults privately and works on a maternity ward providing care to new mothers. Follow her @pelvicwellnessphysio on Instagram or visit her website www.pelvicwellness.com.au