Pregnancy can bring poo-phoria to a grinding halt. In fact, up to 40% of all pregnant women experience constipation at some point in their pregnancy.
This is more likely in the first and second trimesters. Things may improve a little in the third trimester.
But things can get super slow and those poo-phoric evacuations becoming few and far between.
Women who are prone to sluggish bowels/constipation before pregnancy unfortunately often experience a worsening of their symptoms.
Whilst for those who've never had an issue with digestive regularity, it can come as an uncomfortable surprise.
Either way, it can make you feeling pretty crappy in the process (sorry, couldn’t resist that one).
It can also lead to haemorrhoids, anal fissures and other unpleasant lingering complications.
So why does it happen? Is it just part of being pregnant or are there some natural solutions that can help?
Keeping reading to discover why it happens and what you can do to help yourself.
As with all things in pregnancy, it's the hormones at play. In particular, progesterone.
Progesterone inhibits the secretion of a hormone called motilin.
Motilin is a hormone produced by cells in the small intestine. Its name comes from its ability to stimulate the movement (motility) of the digestive organs. This movement is primarily through intestinal muscle contractions. This literally helps move things along the digestive tract.
So without motilin doing it's thing, there's a mini vacay of the smooth muscles of our digestive tract. The result is an overall slowing in transit time and less bowel action.
But on the flip side, this slower transit time is thought to help increase nutrient absorption from our food.
But wait. There's more.
The hormone relaxin is also involved.
Most pregnant women have heard of this one. As the name implies, this hormone relaxes the body's muscles, joints and ligaments. This is particularly helpful in labour and birth, as our pelvic joints can get nice and mobile to allow baby down and out.
But whilst pregnant, relaxin effects the smooth muscle of the digestive tract. Another vote for slowing things down.
A normal function of the large intestine is to absorb water from the digestive contents, which in turn creates stools (poo).
But the longer the contents sit in the large intestine, the more water is reabsorbed from them. This creates dry, hard, small stools (AKA rabbit poos).
Plus if you're dehydrated, the body will take water from anywhere to help maintain fluid homeostatis.
Then there's aldosterone and renin.
These two hormones are stimulated during pregnancy by the high levels of circulating oestrogen and progesterone.
Aldosterone stimulates sodium and water reabsorption from the colon (known as colonic water). Again, contributing to the dry, hard stools.
ALL OF THIS 👆🏻 will be made much worse if your diet is low in fibre and you're dehydrated!
As you can see the growing uterus shifts and puts extra internal pressure on our digestive organs!
So it's no surprise this contributes to the slow transit time. Remember the slower the pace, the more water is reabsorbed in the colon, the harder the stools.
For many women dealing with an all day quease and/or morning sickness, food choices can change dramatically.
Sometimes refined carbs, salty carbs, fatty carbs (or all three) can be the only foods desired or tolerated.
Breads, hot chips, muffins, crumpets, pastries, cakes etc are not your typical bowel movers. So when theres lots in the pregnancy diet this can contribute to things binding up and slowing down.
(SOME) IRON SUPPLEMENTS
Many women enter pregnancy with low iron stores. This often results in the need for iron supplements at some point to help meet the needs of themselves and baby.
There are some cheap and nasty supplements on the market (Ferro-Grad I'm looking at you). The iron in this supplement is in the form of dried ferrous sulphate, also known as iron sulphate.
Each tablet has a dose of 325mg, which is massive and you'll soon see why.
The issue with iron sulphate supplements is two-fold.
1. It often irritates the digestive system, this can be felt as nausea, heartburn, flatulence, bloating and/or constipation. Ugh.
2. It's absorption rate is pretty unimpressive at around 10%-15% (hence the massive dose). All the unabsorbed iron binds with other undigested substances and creates dark green or black, sticky stools.
Ugh. All that grief for very little return.
There are kinder and better absorbed iron supplements available. I've listed what to look for below.
SO WHAT HELPS?
⚠️ WARNING: Without adequate water intake these fibres may work against you!
So ensure you're drinking enough.
Staying active in pregnancy can definitely have a knock on effect on your bowels. It doesn’t have to be super strenuous, just consistent.
They is a variety of foods that have helped women. Try a few, or try them all (not at the same time though!) to see what works for you.
- Prunes: as a whole fruit snack or cut up into porridge/smoothies/muesli. Aim for 4-5 prunes daily. Or try the unsweetened, natural bottled juice. Try 1/2 - 1 cup day before a meal. Dilute with water if you find the taste is too strong.
- Dried fruits: try dates, figs, apricots. Often helpful but also super high in sugar, so don't go too crazy everyday on these.
- Vegies: chock full of natural fibres, vitamins, minerals and way less sugar than fruits. Include with each meal and incorporate into snacks. Limit fresh fruit/vegie juices to 1 x day as the whole food provides rounded benefits. Many consider cooked rather than raw vegies easier to digest.
- Chia seeds: make a chia pudding (google has a tonne of recipes), or add 1 tablespoon into porridges, smoothies, muesli blends, sprinkle through salads, add into soups
- Healthy unrefined carbs: brown rice, oats, quinoa, buckwheat, spelt
Psyllium husks: the classic, bulk-forming fibre made from the seed husks of the plant, Plantago ovata. It's a form of water soluble plant fibre with prebiotic affects. With the aid of water it forms a viscous gel which helps bulk up the stool, making them more mobile through the gut and easier to pass.
Start with 1 teaspoon in water and/or prune juice in the morning - drink immediately. It will start to solidify within 1 minutes so don't hang about.
It's texture may be a challenge for some, so if you're really struggling consider Metamucil (a commercial product) or simply use as gentle fibres below
- Gentle fibres: These include ground flaxseeds or flaxseed oil, LSA powder (ie. ground linseeds, sunflower seeds, almonds), oat bran; add these into muesli, porridge, smoothies, baked goods such as date slice, banana bread, seeded muffins etc.
Coconut oil: Along with its abundance of medium-chain fatty acids (MCFAs) it also has lubricating and stool softening effects within the gut.
Some add 1 teaspoon - 1 tablespoon into smoothies. Or take it straight off the spoon. Look for certified organic, virgin varieties. Some suggest cod liver oil has similar effects.
Although a renown old school laxative, do not use castor oil during pregnancy due to its potential to bring on contractions!
Including healthy fats in the diet stimulates the gall bladder to release bile into the digestive tract. This helps us digest the fats and stimulates our overall digestive processes.
There are single and combination remedies, in both chewable tablets and/or sprays.
Celloids are another form of using minerals, except that the dosage is different and the minerals are differently prepared. This method was devised Dr Maurice Blackmore, an Australian Naturopathic Physician.
Try to match your symptoms for the right remedy or seek advise from a homeopath. I've found good results with clients using Bryonia, Lycopodium, Nat Mur and Nux Vom.
So there you have it. Hopefully 1 or 2, or perhaps all 10 will provide you some relief and ongoing momentum.