6 Things No One Tells You About Pregnancy Constipation

Though constipation can set in at any point throughout pregnancy, it tends to get worse with time as your intestines become more squished by the growing fetus and your body continues to relax muscles in preparation for labor, Dr. Elborno says. What I’ve learned is that figuring out a strategy to mitigate constipation early is important, so that you can have a game plan for when it inevitably strikes again.

3. Forcing it is one of the worst things you can do.

Unless you want hemorrhoids, it’s not a good idea to just sit on the toilet and push hoping that you’ll eventually get relief.

Why? Well, without getting too technical, pushing harder to try and force a bowel movement can increase intrabdominal pressure, potentially leading to other GI issues, like hemorrhoids and anal fissures, Dr. Elborno says. Hemorrhoids are swollen veins in the anus that cause pain, swelling, and bleeding; fissures are essentially small tears in the lining of the anus. Ouch. Neither is a pleasant addition to pregnancy—or really any time in life.

Straining to poop also puts a lot of stress on muscles of the pelvic floor, Dr. Paik says. Straining will further weaken those muscles, which will already be put through the wringer during pregnancy and labor. “This can contribute to urinary incontinence and fecal incontinence,” Dr. Paik says.

Instead, you want to make it easier for the poop to make its way out with just a normal amount of effort. “The ultimate goal is to try and make poop softer and easier to pass and a lot of times that’s going to come from increasing hydration, having a more physically active lifestyle—movement will increase your intestinal motility—and having a good amount of fiber in your diet,” Dr. Elborno says.

4. Fiber truly is your best friend—even if it comes in powder form.

Of course, hydrating, exercising, and eating a well-balanced, fiber-rich diet are all easier said than done when you’re exhausted, nauseated, and just simply trying to make it through each day. Luckily, you can totally cheat on the fiber front.

“A lot of pregnancy is about survival,” Dr. Elborno says. “I’ve had patients that are like, ‘All I can keep down are Warheads and Pop-Tarts,’ and at the end of the day, you have to get nutrition from somewhere.” If you’re having a really tough time eating fiber-rich veggies and grains, it’s okay to turn to something else like powdered fiber that you mix into water and quickly chug. That’s what I did. The generic form of Metamucil, called psyllium husk, is a powder you spoon into water, mix, and then drink quickly before it gets gelatinous. It works by adding bulk to the stool, which helps prompt the intestines to contract and move stool through.

The one I bought was orange flavored, and it was very palatable, even when I was dealing with some nausea and terrible heartburn. But if the powder stuff in water makes you gag (your aversions could be totally different than mine!), Dr. Elborno suggests sneaking it into smoothies, or adding other fiber-rich ingredients like flax seeds. That way, you can get the benefits without having to stomach the taste or texture of something you’re not used to. (I haven’t met a pregnant person yet who didn’t enjoy a fruit smoothie, though I’m sure they exist and if that is you I am terribly sorry!) You can also blend fibrous veggies or powders into soups if it’s easier for you to stomach something hot and brothy, Dr. Elborno adds.

5. Don’t be afraid to use other OTC medications.

Beyond fiber powder, I also have become quite partial to Miralax (the generic name is polyethylene glycol 3350) on occasion. It’s what’s known as an osmotic laxative, which means it works by drawing water into the stool to make it softer and easier to pass. A few days of twice-daily psyllium husk and once-daily polyethylene glycol finally gave me the relief I needed—and is now my go-to whenever I run into constipation again. Of course, always get the okay from your doctor but, generally, these things are all considered safe in pregnancy as long as you take them as directed.