Constipation during Pregnancy

by Serena Ma, ND, MS, LAc

Hey, I am a naturopathic doctor, so I have to talk about poop at some point!!  This is not a topic we like to talk about, but it's something we are ALL familiar with, so there's really no shame.

Right now my biggest complaints during pregnancy are my allergies (old issue) and constipation (new issue).  I'm the girl who always had great bowel movements: within an hour of wakening.  Sure, sometimes travel would throw me off, but in general they were daily and satisfying.  :-)

But since early on in pregnancy, it all changed.  My bowels have s-l-o-w-e-d down B I G time!  And I don't like this.  This is a very very common issue during pregnancy.

  • The increased progesterone relaxes the smooth muscles of the GI tract slowing everything down.  I've heard that this is so that the body is better (has more time) to absorb the nutrients from food.
    • There's even suggestion that it's estrogen that causes constipation - but the more common belief is still progesterone.  Either way, it's the hormones (I see the same issues in those undergoing IVF stimulation).
  • The extra iron in the prenatal vitamins can also contribute to constipation.
  • Then in late pregnancy, it's the physical compression on the intestines that cramps everything up.

My typical suggestions are:

  1. More water
  2. More fiber 
  3. Exercise
  4. Probiotics
  5. Homeopathy

And those usually work for my patients!  Well I tried it all.  I stopped taking my prenatal temporarily. I drank more water.  I am already somewhat physically active.  I took probiotics.  I did homeopathy.  I ate prunes. I drank prune juice.  I get massage and acupuncture.  Nothing was a permanent solution.


But when we did our group detox (Mark Hyman's 10-Day Detox Diet) back in November (hallelujah!), it was back to pre-pregnancy poops!!!  Every morning started out with a smoothie which was chock full of FIBER and FAT - chia seeds, flax seeds, avocado, coconut oil, nuts.  


After the smoothies, I experimented a little, trying to figure out what my imbalance is and what would make me go.  Was it just the fiber?  So I had fruit and fiber-rich cereals.  Uh no - I actually think that made me more constipated.


Ok, this makes sense for me.  According to Chinese Medicine, all my blood and yin substances are being diverted to sustaining the baby.  I realized that for me, it was the FAT.  Ingestion of fat triggers bile release.  Bile increases intestinal motility (movement).  Around this time, I also discovered that dried pineapple and sometimes lemon or apple cider vinegar in water in the morning also helped! Pineapple contains papain, often used as a digestive enzyme - and acid (lemon and vinegar) are naturopathic tricks to stimulate digestion.  (I never tried herbal bitters but I'm sure that would have done it too!).


So for me, to combat progesterone's effect of slowing everything down, in the morning, I have to do things to stimulate my GI tract - whether it's eating something fatty, eating dried pineapples, or having water + lemon - or, sometimes all three!


We are all very different.  And what works for me does not work for everyone - but perhaps it will for a few others out there.  :-)