Constipation During Pregnancy and After the Birth

  • Stool softeners: In some cases, a stool softener is needed to relieve constipation. Obstetricians often recommend that patients use Docusate. Docusate works as a surfactant to decrease the wall tension between the stool and the colon. It is not habit forming and acts mainly to keep the stool soft for easy, natural passage. It is well tolerated, it comes in 100 mg capsules, and Docusate can be taken 1-3 times every night.
  • Alternating hot and cold: Drinking cold fluids or eating ice chips, then drinking warm fluids, like decaffeinated tea, helps to stimulate and tone the bowel, and also helps to pass gas.
  • Incentive spirometer: If you are on bed rest during your pregnancy, an incentive spirometer (a device into which you inhale deeply, either raising balls or creating bubbles depending on the model) will be essential to keep your bowels moving and to keep your lungs clear. The incentive spirometer cannot be over-used. Every ten minutes is perfect.
  • Nursing: After the baby is born, nursing can actually help to alleviate constipation. Stimulation resulting from the baby's sucking causes the uterus to contract, and helps to move the bowels.
  • Enema: An enema is an effective way to empty the colon. It is, however, a rather invasive measure, and may be uncomfortable for women who have had cesarean deliveries, or episiotomies.

Unsafe constipation remedies

I do not recommend senna, the herbal remedy for constipation. This substance, although advertised as natural, causes cramping and secretion of electrolytes and water from the colon. This is called a secretory diarrhea, which at best is unpleasant and at worst causes an electrolyte imbalance in the blood. Some patients drink prune juice for constipation, but I do not recommend this either since its active ingredient is phenolphthalein, which can also cause a secretory diarrhea as well as bowel dependence.

If you have any constipation or abdominal discomfort during or after your pregnancy, you should consult with your doctor. Sometimes a medical condition such as a thyroid problem (hypothyroidism) may develop during pregnancy and cause constipation.

Dr. Christine Frissora is board-certified in Internal Medicine and in Gastroenterology. She is currently a faculty member in the Division of Gastroenterology and Hepatology at the Weill Medical College of Cornell University and is an Assistant Attending at The New York Presbyterian Hospital.

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