Can Pregnancy Cause Constipation? | A Very Common Problem

Yes, pregnancy commonly causes constipation, affecting around 16 to 39 percent of pregnant women due to hormonal shifts.

You probably expected the morning sickness. What often catches people off guard is the sudden, stubborn constipation that creeps in, sometimes before the positive pregnancy test has even dried. It can feel like your digestive system has simply pressed pause, leaving you bloated and uncomfortable right when everything else is already shifting.

The short answer is yes, pregnancy can absolutely cause constipation, and it happens through several overlapping mechanisms. It isn’t just in your head — it’s one of the most common gastrointestinal complaints in pregnancy, affecting roughly 16 to 39 percent of pregnant women at some point. The encouraging part is that understanding the biology behind the slowdown helps you pick the right strategies to manage it safely.

Why Pregnancy Slows Your Digestive System

The main driver is the hormone progesterone. Your body produces much more of it to sustain the pregnancy. The catch is that progesterone relaxes all smooth muscles, including those lining your intestines. This directly slows down bowel motility, meaning waste moves through you much slower than usual.

At the same time, pregnancy hormones cause your colon to absorb more water from the passing stool. This draws moisture out, turning soft waste into hard, dry pellets that are difficult and painful to pass.

During the third trimester, a physical factor joins the hormonal one. Your expanding uterus can press directly against your colon and rectum. This creates a literal traffic jam, making bowel movements mechanically harder to push out.

Why This Symptom Causes So Much Frustration

Beyond the physical discomfort, pregnancy constipation catches many women off guard emotionally. It’s under-discussed, so it’s easy to feel alone or worry something is wrong. Knowing you aren’t alone can make a real difference.

• It compounds other early symptoms. If you’re already dealing with nausea or food aversions, adding bloating and gas can make it harder to eat the nutrient-dense foods you need.
• Iron supplements worsen the problem. Many prenatal vitamins and iron supplements prescribed for anemia can make constipation significantly worse. Your provider may suggest a different form of iron or a stool softener to balance your levels.
• Straining triggers anxiety. Many pregnant women worry that straining on the toilet could harm the baby. While brief straining is generally not dangerous, the fear can make you hold back, which paradoxically worsens constipation.
• Dietary shifts backfire easily. Cravings for refined carbs or aversions to vegetables can drop your fiber intake just when you need it most.
• Hydration becomes a struggle. If you’re dealing with morning sickness, keeping down plain water can be tough. Dehydration is a direct route to harder stools.

Recognizing these patterns helps you troubleshoot effectively. You can start by addressing the root causes most relevant to your current trimester, rather than trying random remedies.

First-Line Defenses That Really Help

Before reaching for a laxative, doctors typically recommend a few foundational lifestyle changes. These are considered the first-line approach for a reason — they address the underlying causes directly.

Cleveland Clinic outlines how progesterone slows digestion in its pregnancy constipation guide. The most effective interventions are gradually increasing fiber to 25-30 grams per day, staying well-hydrated, and getting regular gentle exercise.

Fiber is the star player, but it has to be handled carefully. Adding a sudden pile of bran flakes can cause gas and bloating instead of relief.

Aim for a gentle increase through fruits like prunes and pears, vegetables, oats, and chia seeds. Pair that fiber with plenty of water, or it can actually clog things up further.

Exercise might be the last thing you feel like doing, but even a 20-minute walk can stimulate bowel function. Gentle movement helps offset the slowed motility that progesterone causes.

When You Need More Than Diet and Walking

Sometimes, despite your best efforts with prunes and water, things just aren’t moving. The next step is not to suffer through it — it’s to talk to your obstetrician or midwife about safe options.

1. Check in with your provider first. This is the most important step. While some laxatives are available over the counter, not all are considered safe during pregnancy. Your doctor can recommend a specific type based on your symptoms.
2. Consider bulk-forming laxatives first. Products like psyllium (Metamucil) or methylcellulose (Citrucel) add bulk to your stool and draw water into the colon. They act most like a natural fiber supplement.
3. Stool softeners are a common second line. Docusate sodium (Colace) helps soften the stool so it’s easier to pass. It doesn’t stimulate a bowel movement, just makes the one you have less painful.
4. Know which laxatives to avoid. Stimulant laxatives are generally avoided in pregnancy unless specifically prescribed, as they can stimulate uterine contractions.
5. Revisit your prenatal vitamin. If iron is the culprit, switching to a different formulation or adding a stool softener alongside your current vitamin can make a significant difference.

The goal is to find a solution that provides consistent relief without causing cramping or dehydration. Your healthcare team is your best resource for this balancing act.

Warning Signs That Need Medical Attention

Constipation is extremely common, but some situations require a call to your doctor. It’s important to know the difference between uncomfortable and potentially serious.

Per Mayo Clinic’s guidance on pregnancy constipation, you should contact your doctor if you experience severe abdominal pain, vomit and cannot keep fluids down, or haven’t had a bowel movement in several days and are becoming increasingly uncomfortable.

Also watch for general pregnancy warning signs. These include vaginal bleeding, fever, severe headache, or noticing less movement from your baby than usual. These require immediate attention regardless of your digestive status.

The Bottom Line

Constipation is a normal, albeit frustrating, part of pregnancy for many people. Progesterone, physical pressure, and dietary shifts create a perfect storm. Prioritizing fiber, fluids, and gentle movement is the safest first step for getting things back on track.

Your obstetrician or midwife can help you find the right balance of diet, safe laxatives, and prenatal vitamins that works for your specific pregnancy and digestive system without guesswork.