Seven steps to a healthy bowel during pregnancy

19 August 2019

Dr Benjamin Disney, Consultant Gastroenterologist, University Hospitals Coventry and Warwickshire NHS Trust

Parenting on Female First

Pregnancy is a time of many changes for women’s bodies – some of them wonderful, others not so nice. One issue that many women experience, but few are able to discuss without embarrassment, is constipation, which can occur in up to 40% of pregnancies. It is caused by an increase in the hormone progesterone which reduces gut motility, and generally resolves after childbirth. Pregnancy supplements containing iron may also cause constipation. To raise awareness about the scale of the impact of constipation, the Bowel Interest Group published its Cost of Constipation report this summer.

Here are seven useful tips extracted from the report to help you avoid or manage constipation during your pregnancy:

Talk to your GP. GPs and other healthcare professionals (midwives, pharmacists) are the first port of call for patients suffering with constipation; yet one in five are too embarrassed to talk to their GP. As there is a lack of understanding about what constipation is, what is ‘normal’ when it comes to bowel health and how it should be treated, it is vital for sufferers to be able to speak comfortably to a medical professional.
Act early. The stigma attached to constipation means that people are suffering in silence needlessly until the condition becomes too difficult to bear, necessitating more intensive treatment. In 2017/18, constipation was the cause of 71,430 hospital admissions, the equivalent of 196 people a day! Constipation is a treatable and manageable condition, so acting early on can save a lot of unnecessary discomfort. Constipation can cause significant physical and psychological distress which affects a patients’ quality of life. One such example is the development of piles or an anal fissure.
Relieve your mind. Seeking help for constipation can also help improve mood. Hormone level changes during pregnancy can be difficult to handle and constipation is yet one more complication that can amplify anxiety and depression. In fact, 40% of patients with constipation experience an anxiety disorder.
Take things seriously. The perception that constipation is a minor health issue that can be easily treated at home without professional support can lead to avoidable aggravation of the problem. Bowel habits are an important indicator of our health and any complaints in this area should be given the same attention and care as other ailments.
Make recommended lifestyle changes. Patients suffering from constipation may simply require advice about fluid intake, diet, exercise and laxatives. Ensure that you listen to your body and go to the toilet when you get the urge. A survey on constipation, commissioned by the Bowel Interest Group, questioned GPs on their experiences of dealing with patients with constipation. When asked what the major cause of constipation was in the patients that they saw, the majority (62.7%) cited ‘Patient lifestyle’ as the main culprit.
Stay active. Regular gentle exercise should be continued during pregnancy unless you have a specific underlying condition that makes this unadvisable. You may think of joining classes specifically targeted at keeping fit during pregnancy at your local gym or swimming pool.
Stay hydrated and eat well. A diverse diet rich in fibre can help avoid constipation during pregnancy but staying hydrated and eating at regular times are also important to maintain bowel health and can often be overlooked. If these don’t work, probiotics and over the counter laxatives help people with chronic constipation, but consult with a healthcare professional before taking any supplements or medication, to ensure that they are safe during pregnancy.