Constipation and pregnancy often go hand in hand. Between changing hormones, and a changing body, a woman's gastrointestinal health is bound to be affected when she's having a baby. This often results in hard stools that are difficult to remove. To learn more about constipation and pregnancy, we talked to Nazatul Amira Hamzah from Primabumi Sdn Bhd, a qualified pharmacist with 10 years of experience in pharmacy practice involving both hospital and community settings. Nazatul Amira Hamzah, Pharmacist and Key Account Manager at Primabumi Sdn Bhd Q1: What is constipation, and what are the symptoms? Constipation is when you\u2019re having trouble passing motion or maintaining regular bowel movements. You know you\u2019re constipated when you experience the following symptoms: \tYou\u2019re only able to poop a few times a week. \tYour stools become dry, hard, and difficult or painful to pass. \tYour belly feels gassy and bloated. \tYou might feel the need to strain harder than usual. \tYou feel like you\u2019re struggling to empty your bowels fully, forcing you to spend more time on the toilet. Q2: I heard constipation is a real issue during pregnancy. Is that true? Yes, it\u2019s true. Constipation is common among pregnant women. About two out of five mothers experience constipation at some point during pregnancy. Q3: What causes constipation in pregnancy? Pregnant women are more likely to get constipation because of the changes they experience in the gastrointestinal tract as a result of pregnancy. These are some of the pregnancy changes that can be blamed for constipation: Hormonal Changes When you're pregnant, a hormone called progesterone increases in your body. Progesterone makes your intestines more relaxed, which gives your body extra time to take in nutrients and water from the food you eat. But there's a downside: this also means your gut doesn't do a great job at pushing waste out quickly. The longer food stays in your intestines, the more water your body absorbs from it, making your poop dry and hard. Growing Baby As your baby develops in your belly, it increases the weight on your uterus, exerting additional pressure on your bowel. This makes it hard to pass motion when you go to the toilet. Prenatal Vitamins The iron you\u2019re getting from your pregnancy supplements or prenatal vitamin helps your body make more red blood cells, which are responsible for delivering oxygen throughout your and your baby\u2019s bodies. However, excessive iron levels can make it harder for bacteria in your bowel to break down food. Lifestyle Not having enough fibre in your diet, not drinking enough fluids, and a lack of physical activity all play a role in making you constipated. Q4: What month does constipation start in pregnancy, and when does it stop? Constipation may happen at any time during pregnancy. However, you\u2019re more likely to experience it during the third trimester. This is when the baby is the heaviest and places the greatest pressure on your intestines. Depending on your hormonal changes, diet, lifestyle, and medication intake, constipation is often a temporary issue. However, there have been cases where constipation persisted for up to 3 months after giving birth. Q5: Is it OK to push hard to poop while pregnant? Straining hard when you pass motions doesn\u2019t harm your unborn baby. However, it does increase your risk of developing any number of the following conditions: \tHaemorrhoids or piles: swollen veins in the rectal area \tAnal fissure: a small tear in the skin that lines the opening of the anus \tRectal prolapse: part of the large intestine's lowest section, the rectum, becomes stretched and sticks out from the anus These complications could be extremely uncomfortable and painful. Moreover, you may continue to experience them long after you\u2019ve delivered your baby. Q6: How do I find relief from constipation? Making a few changes to your lifestyle is the first-line approach you should take when dealing with constipation, with or without pregnancy. Stay Hydrated Drink plenty of fluids throughout the day. Aim for 10\u201312 cups of water or other beverages like milk, smoothies, tea, and juices to keep yourself hydrated. Eat High-Fibre Foods Include foods rich in fibre in your diet. Aim for 25\u201330 grams of fibre each day to help keep your bowel movements smooth. Watch What You Eat Limit foods and drinks that can make constipation worse, like coffee, chocolate, and black tea. Stay Active Try to get 20\u201330 minutes of light exercise three times a week to keep your digestive system active. Check Your Iron Supplement If your iron supplement is causing constipation, talk to your healthcare provider about switching to one that's easier on your stomach. Consider Probiotics Probiotics are helpful bacteria that can support a healthy gut. You can find them in yogurts with active cultures or ask your doctor or pharmacist for probiotics in capsule or powder form. Eat Regular, Small Meals Instead of big meals, opt for smaller, more frequent ones, especially when you're less active. This can help your body digest food more easily and reduce the risk of constipation. Q7: What is some fibre-rich foods that I can try? Fruits, vegetables, breakfast cereals, whole-grain bread, lentils, prunes, and prune juices have a high content of fibre and some other nutrients that are great for both you and your baby. Q8: Can you give me examples of light exercises suitable for pregnant mums, and when shall I start? Going for brisk walks, swimming, doing yoga, Pilates and low-impact aerobics are all great choices to stay active while you're pregnant. You can start these exercises at any point in your pregnancy. However, some doctors suggest taking it a bit easy during the first three months to make sure the baby gets off to a good start in development. Q9: What else can I do if I\u2019m still constipated even after trying all those tips? If all you can\u2019t seem to find relief from your constipation your constipation does not go away after 2 to 3 weeks, it\u2019s time for a visit to the doctor. They may give you a fibre supplement or a laxative to help. Q10: What are laxatives, and what options do I have? Laxatives are a type of medicine you can get. These medications help loosen stools and make it easier for you to pass motion. Laxatives are the most helpful solution for temporary constipation. Here are some commonly used laxatives in Malaysia: Type of Laxative Mechanism of action Onset of Action Bulk-forming agents Form bulkier stools and thus get more water retained in the stools, making them easier to pass. 12-72 hours Saline enemas Increase the water content in the intestine to hydrate and soften the stools. 5-15 minutes Osmotic laxatives Gently draw water into the bowel, thereby providing softer stools and more frequent bowel movements. 48-72 hours 24-48 hours Stimulant\/contact laxatives Cause the intestines to contract, thus pushing and reducing water absorption from the large intestines. 6-12 hours However, it's usually not a good idea to use stimulant laxatives when you're pregnant. They can lead to stomach cramps and mess up the balance of important substances in your body called electrolytes. When your electrolytes, like calcium, potassium, sodium, magnesium, and phosphate, get out of balance, it can affect how your body works. So, if you really need to take a stimulant laxative during pregnancy, make sure to talk to your doctor first. Before you try any laxatives, supplements, or home remedies while pregnant, it's always smart to check with your doctor. Not all of them have been tested to make sure they're safe and effective during pregnancy. Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!