GUIDE
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Progesterone slows the digestive tract, iron supplements can be binding, and the growing uterus compresses the intestines — making constipation extremely common.
Up to 40 percent of pregnant people experience constipation. It can start in the first trimester and persist throughout pregnancy, but dietary changes and safe remedies provide real relief.
Be prepared from day one
Pregnancy constipation means infrequent bowel movements (fewer than three per week), stools that are hard, dry, or difficult to pass, and a feeling of incomplete emptying. Many people also experience bloating, abdominal discomfort, and excessive gas alongside the constipation.
The primary culprit is progesterone. This hormone relaxes smooth muscle throughout the body — including the muscles of the intestinal walls — which slows the movement of food through the digestive tract. When food moves more slowly, the colon absorbs more water from it, resulting in harder, drier stools.
Iron supplements in prenatal vitamins are the other major contributor. Iron is notoriously constipating, and pregnancy requires significant iron intake to support the increased blood volume. The combination of progesterone and iron creates a perfect storm for constipation that affects up to 40 percent of pregnant people.
Constipation can begin in the first trimester as progesterone levels rise, and many people notice it worsening as soon as they start prenatal vitamins with iron. It may improve somewhat in the second trimester for some people, but it often returns or intensifies in the third trimester when the growing uterus physically compresses the intestines.
If you experienced morning sickness in the first trimester, constipation may worsen during that time because nausea limits food and fluid intake — both of which are needed to keep the bowels moving. As nausea resolves, many people find their digestion improves temporarily before third-trimester pressure slows things down again.
By the second trimester, most people have found a fiber and hydration routine that works. Maintaining that routine through the third trimester, when the physical pressure increases, is key to staying comfortable.
The foundation of managing pregnancy constipation is fiber, hydration, and movement. These three strategies together are more effective than any one alone. If lifestyle changes are not enough, safe over-the-counter options exist.
Aim for 25 to 30 grams of fiber per day from fruits, vegetables, whole grains, beans, and flaxseed. Add fiber gradually — too much too fast causes gas and bloating. Prunes are particularly effective; 5 to 6 prunes or a small glass of prune juice daily can make a noticeable difference within a day or two.
Hydration is essential for fiber to work properly. Aim for 10 to 12 glasses of water per day during pregnancy. Warm water or warm lemon water in the morning can stimulate the digestive tract. Without adequate hydration, increasing fiber alone can actually make constipation worse.
Walking, swimming, and prenatal yoga stimulate intestinal motility — the muscle contractions that move food through the digestive tract. Aim for 20 to 30 minutes of gentle activity most days. Even a 15-minute walk after meals can help keep things moving.
Docusate sodium (Colace) is widely considered safe during pregnancy and is often recommended by OBs. It works by drawing water into the stool. If you need more help, polyethylene glycol (MiraLAX) is also generally considered safe. Always check with your provider before starting any new supplement.
If your prenatal vitamin is causing constipation, talk to your provider about alternatives. Iron bisglycinate is a gentler form that causes less GI upset. Taking iron with vitamin C improves absorption, potentially allowing a lower dose. Some providers recommend slow-release formulations.
Your body responds to routine. Try to use the bathroom at the same time each day, ideally after a meal when the gastrocolic reflex naturally stimulates the bowels. Do not rush or ignore the urge to go — suppressing the urge makes constipation worse over time.
These symptoms can occasionally signal something that needs medical attention. When in doubt, call.
Pregnancy constipation is very manageable once you find the right combination of fiber, hydration, and movement. Most people develop a routine that works within a week or two of making changes. And the constipation resolves after delivery when progesterone levels drop.
Be proactive rather than reactive — starting fiber and hydration habits early in pregnancy can prevent constipation from becoming severe. If home measures are not working, your provider has safe options that can help.
You may also find our guides on pregnancy heartburn and pregnancy cravings helpful, as digestive issues often overlap during pregnancy. If bloating and discomfort are keeping you up at night, our pregnancy insomnia guide has tips for getting comfortable.
This guide is for informational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider with any questions about your pregnancy.
