Constipation affects up to half of all pregnant women, and the fixes are straightforward: more water, more fiber, regular movement, and in some cases, a safe over-the-counter laxative. The condition is driven by hormonal shifts that slow your digestive tract, but a few targeted changes can make a real difference within days.
Why Pregnancy Causes Constipation
Rising progesterone levels relax the smooth muscles throughout your body, including the ones that move food through your intestines. This means digestion slows down significantly, giving your colon more time to absorb water from stool and leaving it harder and more difficult to pass. The effect starts early, often in the first trimester, and tends to intensify as pregnancy progresses.
Your growing uterus adds physical pressure on the intestines later in pregnancy, compounding the slowdown. Prenatal iron supplements are another common culprit. The most widely prescribed form, ferrous sulfate, is well known for causing constipation, nausea, and abdominal pain. If your iron supplement seems to be making things worse, ask your provider about switching to an iron bisglycinate (also called chelated iron), which causes significantly less gastrointestinal irritation and is absorbed just as effectively.
Drink More Water Than You Think You Need
The baseline recommendation during pregnancy is about 1.6 liters per day, which works out to roughly six to eight glasses. That’s a minimum. If you’re constipated, you likely need more, because your body is already pulling extra water from your intestines. Warm water first thing in the morning can help stimulate a bowel movement. Herbal teas (check that they’re pregnancy-safe) count toward your total, as do soups and water-rich fruits like watermelon.
One practical approach: keep a water bottle with you at all times and aim to refill it at least three times throughout the day. If plain water feels unappealing, adding lemon or cucumber can help. Dehydration makes constipation dramatically worse and is easy to overlook when nausea or frequent bathroom trips make drinking feel like a chore.
Fiber: What to Eat and How Much
Most adults need 25 to 30 grams of fiber per day, and most don’t come close. During pregnancy, hitting that target matters more than ever. Focus on both types of fiber: soluble fiber (found in oats, beans, lentils, apples, and flaxseed) absorbs water and softens stool, while insoluble fiber (found in whole wheat, vegetables, and nuts) adds bulk and helps move things along.
Prunes and prune juice deserve special mention. They work as a natural laxative because of their sorbitol content, a sugar alcohol that draws water into the intestines. Start with a small serving of two to three prunes or a quarter cup of juice and increase as needed. Many women find that a small glass of prune juice in the morning, paired with breakfast, is enough to get things moving within a day or two.
If you’re not used to eating much fiber, increase your intake gradually over a week. Adding too much at once can cause bloating and gas, which are already common pregnancy complaints. Pair every fiber increase with extra water, since fiber needs fluid to work properly.
Movement That Helps Your Gut
Physical activity stimulates the muscles in your intestines, helping push stool through your digestive tract. You don’t need intense exercise. A 20- to 30-minute walk most days of the week is one of the most effective things you can do. Swimming and prenatal yoga work well too.
Certain gentle movements are especially good at targeting the abdominal area and encouraging bowel motility:
- Cat-cow: Start on your hands and knees. Inhale while arching your back downward and lifting your head, then exhale while rounding your back and tucking your chin. This rhythmic motion massages the organs in your abdomen.
- Child’s pose: Kneel on the floor, sit back onto your heels, and stretch your arms forward while lowering your chest toward the ground. This gentle compression on the belly can help stimulate the intestines.
- Diaphragmatic breathing: Breathe in through your nose and out through your mouth, expanding your belly, ribcage, and back. Deep breathing activates the muscles around your digestive organs and can be done anywhere.
As your belly grows, you may need to widen your knees during floor exercises to stay comfortable. Avoid lying flat on your back for extended periods after the first trimester, since this can compress a major blood vessel.
Safe Over-the-Counter Options
When diet and lifestyle changes aren’t enough, certain laxatives are considered safe during pregnancy. They fall into two main categories.
Bulk-forming agents like psyllium husk (the active ingredient in products like Metamucil) work the same way dietary fiber does. They absorb water in your intestines, making stool softer and easier to pass. These are the gentlest option and are fine for daily use. Drink a full glass of water with each dose.
Osmotic laxatives, including polyethylene glycol (MiraLAX) and magnesium hydroxide (Milk of Magnesia), draw water into the colon to soften stool. They have minimal absorption into your bloodstream, which is why they’re considered safe in pregnancy. However, regular long-term use can lead to electrolyte imbalances, so they’re better suited as an occasional tool rather than a daily habit.
Stimulant laxatives (like senna or bisacodyl) are a different story. They work by forcing the intestinal muscles to contract, and their safety profile in pregnancy is less clear. Most providers recommend trying the gentler options first and only considering stimulant laxatives under guidance.
Daily Habits That Make a Difference
Beyond the big three of water, fiber, and movement, a few smaller habits can keep things on track. Try to eat meals on a consistent schedule, since your digestive system responds to routine. Eating a larger breakfast can take advantage of your body’s natural morning digestive reflexes. Don’t ignore the urge to go, even if the timing feels inconvenient. Delaying a bowel movement allows more water to be absorbed from the stool, making it harder to pass later.
A small footstool under your feet while on the toilet can also help. Elevating your knees above your hips mimics a squatting position, which straightens the angle of your rectum and makes elimination easier. This is a simple change that many women find surprisingly effective.
When Constipation Signals Something More Serious
Ordinary pregnancy constipation is uncomfortable but not dangerous. Rarely, severe constipation can overlap with symptoms that point to a bowel obstruction, which is a medical emergency. The key differences: a bowel obstruction typically involves sharp stomach pains that come in waves and may become constant, complete inability to pass gas or stool, vomiting, rapid heartbeat, and signs of dehydration like dark urine. If you experience these symptoms together, get to an emergency department.
Short of that, it’s worth flagging constipation to your prenatal provider if you’re going more than three or four days without a bowel movement, if you notice blood in your stool, or if you’re experiencing significant pain. Hemorrhoids, which are swollen veins around the rectum, are a common side effect of straining during pregnancy and can cause bleeding and discomfort on their own. Your provider can help distinguish between the two and adjust your plan accordingly.