Pregnancy constipation is extremely common, and there are several safe, effective ways to get things moving. The hormone progesterone, which rises throughout pregnancy, relaxes smooth muscle tissue everywhere in your body, including your intestines. That slowed digestion is the main reason you’re backed up, and it can start as early as the first trimester and persist until delivery. The good news: a combination of dietary changes, physical techniques, and safe over-the-counter options can help.
Why Pregnancy Makes It So Hard to Go
Progesterone doesn’t just sustain your pregnancy. It also relaxes the muscles that push food through your digestive tract, slowing transit time in both your small and large intestines. Food sits longer, more water gets absorbed from it, and the result is harder, drier stool that’s difficult to pass.
On top of that, prenatal vitamins containing iron can make constipation worse. As your uterus grows, it physically compresses parts of your intestine, adding another layer of resistance. These factors stack on top of each other, which is why constipation often worsens in the second and third trimesters.
Eat More Fiber Than You Think You Need
The recommended fiber intake during pregnancy is about 28 grams per day, and fewer than 30% of pregnant women actually hit that number. Most fall short at around 24 grams. That gap matters. Fiber adds bulk and water to your stool, making it softer and easier to pass.
The fastest way to close that gap is to add a few high-fiber foods to what you’re already eating. A cup of raspberries has 8 grams. A cup of cooked lentils has about 15. A medium pear with the skin on delivers around 6 grams. Oatmeal, black beans, chia seeds, and broccoli are all reliable sources. Increase your intake gradually over a few days to avoid gas and bloating, which are already common enough during pregnancy.
Drink More Water Than Usual
The American College of Obstetricians and Gynecologists recommends 8 to 12 cups of water a day during pregnancy, which works out to 64 to 96 ounces. If you’re increasing your fiber, water becomes even more important. Fiber without adequate fluid can actually make constipation worse by creating bulkier, drier stool. Keep a water bottle nearby and sip throughout the day rather than trying to catch up all at once.
Try Prunes or Prune Juice
Prunes work because they contain sorbitol, a natural sugar alcohol that draws water into the intestines. They also provide fiber and plant compounds that help stimulate the gut. In a clinical trial on chronic constipation, participants drank about 54 grams of prune juice daily (roughly 2 ounces) and saw improvements in stool consistency over several weeks. For a quicker effect, eating 4 to 5 whole prunes or drinking a small glass of warm prune juice in the morning is a reasonable starting point. Many pregnant women find this is enough on its own.
Use Your Body Position to Help
The angle of your body on the toilet makes a real difference. Sitting upright on a standard toilet puts your pelvic floor in a position that partially kinks the rectum, making it harder to fully empty. Elevating your feet on a small stool (about 6 to 9 inches high) brings your knees above your hips and mimics a squatting position. This straightens the pathway and lets your pelvic floor relax more naturally.
While you’re in that position, try slow diaphragmatic breathing. Breathe deeply into your belly, then gently bear down as you exhale. Avoid holding your breath and straining hard, which can worsen hemorrhoids, a problem that already becomes more likely during pregnancy. Deep squats during the day (not on the toilet) can also help lengthen and relax your pelvic floor muscles over time, which supports easier bowel movements.
Gentle Movement Helps Your Gut
Physical activity stimulates the muscles in your intestines. Even a 10 to 15 minute walk after a meal can noticeably speed up transit time. Swimming, prenatal yoga, and light stretching all work too. You don’t need intense exercise. Consistent, gentle movement is what matters. If you’ve been sedentary due to fatigue or nausea, starting with short daily walks is the simplest change you can make.
Safe Over-the-Counter Options
When diet, hydration, and movement aren’t enough, certain laxatives are considered safe during pregnancy. There’s a general order of preference based on how they work and their safety profiles.
- Bulk-forming agents (like psyllium husk, sold as Metamucil) work similarly to dietary fiber by absorbing water and adding bulk to stool. They aren’t absorbed into your bloodstream and have no association with birth defects, making them safe for daily, long-term use.
- Stool softeners (like docusate sodium, sold as Colace) make stool easier to pass by drawing water into it. Multiple studies have found no adverse effects during pregnancy, and many OB-GYNs recommend them as a first-line option.
- Osmotic laxatives (like polyethylene glycol, sold as MiraLAX) pull water into the intestines to soften stool. Polyethylene glycol is very poorly absorbed from the digestive tract, meaning almost none enters your bloodstream. It’s generally considered safe but best used occasionally rather than daily during pregnancy to avoid dehydration or electrolyte shifts.
- Stimulant laxatives (like bisacodyl or senna) directly trigger intestinal contractions. These are effective but should only be used short-term and occasionally during pregnancy.
Start with the gentlest option and move down the list only if needed. Give each approach a few days to work before escalating.
Magnesium as a Supplement Option
Magnesium has a natural laxative effect because it draws water into the intestines. Many pregnant women already take magnesium for leg cramps or sleep, and the bowel benefits are a welcome side effect. Doses under 350 mg daily are considered safe during pregnancy. Higher doses can cause diarrhea and potentially raise magnesium levels in the blood too high. Magnesium citrate tends to have the strongest laxative effect among the common forms.
Timing and Habits That Help
Your colon is most active in the morning, especially after eating or drinking something warm. A glass of warm water or warm prune juice first thing in the morning can trigger what’s called the gastrocolic reflex, a natural wave of intestinal contractions that follows eating. Give yourself unhurried time on the toilet after breakfast. Rushing or ignoring the urge to go trains your body to suppress the signals, which makes constipation worse over time.
If iron in your prenatal vitamin seems to be contributing, talk to your provider about switching to a form of iron that’s gentler on digestion, or adjusting the timing of your supplement.
When Constipation Needs Medical Attention
Most pregnancy constipation is uncomfortable but manageable. However, severe abdominal pain, rectal bleeding, mucus in your stool, or constipation that alternates with diarrhea are signs to call your provider right away. These symptoms can indicate something beyond routine pregnancy constipation that needs evaluation. If you haven’t had a bowel movement in several days despite trying the approaches above, that’s also worth a call.