Yes, stool softeners are generally considered safe to take during pregnancy. Docusate sodium, the most common stool softener, has no reported problems linked to its use at recommended doses during pregnancy. It works primarily inside the gut rather than being absorbed into the bloodstream in significant amounts, which is a key reason it’s a go-to option for pregnant people dealing with constipation.
Why Stool Softeners Are Considered Safe
Stool softeners work by drawing water into the stool in the upper part of the small intestine. This makes stool softer and easier to pass without forcing your intestinal muscles to contract harder. Because the medication acts locally in the gut, very little reaches your bloodstream, and the risk to a developing baby is minimal.
Data reviewed by MotherToBaby, a service of the Organization of Teratology Information Specialists, found that docusate sodium at recommended doses is unlikely to cause preterm delivery (birth before 37 weeks) or low birth weight. No adverse pregnancy outcomes have been reported at standard doses. However, taking more than the recommended amount can lower magnesium levels in your blood, which is worth noting since magnesium is important for both you and the baby.
Stool Softeners vs. Stimulant Laxatives
Stool softeners and laxatives are not the same thing, and the distinction matters during pregnancy. Stool softeners simply add moisture to stool. Stimulant laxatives, on the other hand, force the muscles of your intestines to contract and push stool through more quickly. That stronger action can cause abdominal cramping and electrolyte imbalances, neither of which you want during pregnancy.
There also isn’t enough research on stimulant laxatives in pregnancy to confirm their safety. People can build up a tolerance to them over time as well, requiring higher doses for the same effect. For these reasons, stool softeners are the preferred over-the-counter option when lifestyle changes alone aren’t enough.
Why Constipation Is So Common in Pregnancy
If you’re dealing with constipation during pregnancy, you’re far from alone. Rising progesterone levels relax smooth muscle throughout the body, including the muscles that move food through your digestive tract. This slows everything down. On top of that, prenatal vitamins containing iron are a well-known contributor to harder stools. As your uterus grows, physical pressure on the intestines can make things worse, particularly in the second and third trimesters.
Lifestyle Changes to Try First
Before reaching for a stool softener, or alongside one, dietary and activity changes can make a real difference. The goal is to work up to about 25 to 30 grams of fiber per day from foods like fruits, vegetables, beans, and whole grains. If your current diet is low in fiber, add it gradually over several days. Jumping from very little fiber to a lot at once can cause gas, cramping, and bloating that actually make you feel worse.
Hydration matters just as much as fiber. Water is what helps fiber bulk up and soften stool effectively. As you increase your fiber intake, increase your fluid intake at the same time. Hot beverages can also help by speeding up digestive movement.
Physical activity is another powerful tool. Even a short walk can help get things moving through your intestines. It’s easy to skip exercise when you’re feeling bloated and uncomfortable, but movement tends to help rather than make things worse.
Other Options Your Provider May Suggest
If stool softeners and lifestyle changes aren’t providing enough relief, bulk-forming fiber supplements like psyllium are another option commonly used in pregnancy. These work by absorbing water in the gut and increasing stool volume, which triggers your intestines to move things along. They’re available over the counter and are not absorbed into the bloodstream.
For more stubborn cases, your provider may recommend an osmotic laxative, which draws water into the colon. These are typically used as a next step when gentler approaches haven’t worked. The key is to avoid self-treating with stronger laxatives, particularly stimulant types, without guidance.
Signs That Constipation Needs Medical Attention
Most pregnancy constipation is uncomfortable but manageable. However, if you notice blood in your stool, severe abdominal pain, constipation alternating with diarrhea, or you haven’t had a bowel movement in more than a week despite trying stool softeners and dietary changes, it’s worth bringing up with your provider. Persistent straining can also contribute to hemorrhoids, which are already more common during pregnancy due to increased blood volume and pressure from the uterus.