What Can I Take for Constipation While I’m Pregnant?

When you're pregnant, your belly goes through a lot of changes. It doesn't exactly help when constipation is added to the list of things you may deal with. But sadly, it’s pretty common. Constipation occurs in up to 38% of pregnant women. Hormones released during pregnancy slow down the normal movement of your digestive system.

If you develop constipation during pregnancy, you’ll likely be curious about safe and effective options for relief. Taking measures like improving your fluid, fiber, and exercise levels are preferred. But sometimes a little extra help is necessary. This is when constipation medications can come in handy.

Here, we’ll review the different types of constipation medications that are generally safe in pregnancy.

What over-the-counter constipation medications are generally safe during pregnancy?

There are many over-the-counter (OTC) constipation medications. They're all slightly different, so it’s important to know which ones are safe to use during pregnancy.

Laxatives are the most commonly used medications to treat constipation. Most laxatives focus on changing the consistency of your stool, making it easier to pass. Others affect the movement of your digestive system, which helps stool to pass as well. Safe options to consider are discussed below.

Keep in mind: This list provides general information. It’s recommended to talk to your healthcare provider before using any OTC products during pregnancy. This is especially important during your first trimester. Many medications can cause harm to an unborn baby during this time.

Bulk-forming laxatives

Bulk-forming laxatives add fiber to your digestive process and help your intestines absorb water. This makes larger, softer stools that are easier to pass.

Bulk-forming laxatives are considered first-choice treatment options for constipation during pregnancy. These medications are not well absorbed by your whole body, and they’re generally safe to take throughout pregnancy.

Examples of bulk-forming laxatives include:

• Psyllium (Metamucil)

• Calcium polycarbophil (FiberCon)

• Methylcellulose (Citrucel)

It’s worth noting that these medications can take about 48 to 72 hours (2 to 3 days) to achieve their desired effects. Side effects may also limit their use during pregnancy. Side effects include gas, bloating, and cramping. Psyllium may cause a serious allergic reaction and difficulty breathing.

Docusate 

Docusate (Colace) belongs to a group of medications called stool softeners. Stool softeners moisten your stool, making it easier to pass. Studies show no evidence of side effects linked to docusate use during pregnancy.

Docusate is considered safe to use during pregnancy. But it’s only recommended to use as a short-term option for occasional constipation. 

Osmotic laxatives

Most osmotic laxatives are considered second-choice treatment options for constipation during pregnancy. Polyethylene glycol (Miralax) is considered a first-choice option and is recognized as safe during pregnancy by the American College of Obstetricians and Gynecologists.

Osmotic laxatives can provide relief when options like bulk-forming laxatives don’t work. These medications also keep water in your intestines instead of being absorbed by your body.

Common osmotic laxatives available OTC include (Miralax) and Glycerin (Fleet suppositories).

Plus, magnesium hydroxide (Milk of Magnesia) is also an option. It belongs to a group of medications called saline laxatives. These are also a type of osmotic laxative. Milk of Magnesia is considered a mild laxative that’s generally safe to take during pregnancy. But some healthcare providers prefer to avoid magnesium-containing products in pregnancy. So make sure to check in with your care team before using Milk of Magnesia.

What prescription constipation medications are safe during pregnancy?

Most constipation medications are available OTC, but a few are available only with a prescription. However, many prescription constipation medications are questionable or unsafe to use during pregnancy. This is because there's limited information about them during pregnancy. Pregnant women are often excluded from research studies.

One that is considered safe to use is lactulose. Lactulose is an osmotic laxative that’s only available with a prescription. Like the OTC products, it raises the amount of water in your stool.

But osmotic laxatives have side effects that limit their use. For example, lactulose may cause uncomfortable bloating, gas, and nausea. It may also cause electrolyte imbalances. Electrolytes, such as sodium and potassium, are important for the normal function of your cells. Even slight changes may cause serious harm.

What constipation medications have mixed evidence during pregnancy?

A few medications have more mixed evidence. You may be able to use these in certain situations after talking to your obstetrician or midwife. 

Stimulant laxatives

Stimulant laxatives work by supporting the movement of your intestines. This helps stool move through your digestive tract. They also lower the absorption of water from your large intestine.

Common OTC stimulant laxatives include bisacodyl (Dulcolax) and senna (Senokot, Ex-Lax).

In general, it's recommended to use stimulant laxatives with caution when pregnant and nursing. They should only be used short-term due to lack of evidence of how they may affect a pregnancy.

Plus, stimulant laxatives have their fair share of side effects. Bisacodyl and senna may cause low potassium levels (hypokalemia) and low sodium levels (hyponatremia). It’s also recommended to only take bisacodyl as a rectal suppository to help avoid colic.

Linzess

Linzess (linaclotide) is a prescription medication used to treat chronic constipation. It can also treat constipation caused by irritable bowel syndrome (IBS).

Linzess isn't well absorbed into the body, and it’s not usually expected to have a negative effect during pregnancy. But we don’t know this for sure. Studies suggest it may be an option for treatment during pregnancy if the benefits outweigh the risks.

Your provider can tell you if Linzess may be an option for you.

What constipation medications are not safe during pregnancy?

Not all constipation medications are safe to take during pregnancy. Plus, medications used to treat other conditions may also be used off-label for constipation. Some of these medications should also be avoided during pregnancy. Common examples of these are listed below.

Misoprostol

Misoprostol (Cytotec) helps prevent stomach ulcers. But it can also sometimes treat chronic constipation. Exposure to misoprostol during pregnancy has been linked to birth abnormalities. This includes brain, limb, and organ defects. It can also cause contractions and induce labor. 

Colchicine

Colchicine (Mitigare, Colcrys) is a medication that’s commonly used to treat gouty arthritis. But it may also be used as a treatment for constipation, even though there's limited supporting evidence.

Some data shows that colchicine can negatively affect cell growth. Cell growth is an important process during pregnancy for the development of a baby. 

Castor oil

Castor oil is a type of stimulant laxative that's been linked with premature birth. It can also stimulate contractions in your uterus.

Mineral oil

Mineral oil is a relatively common lubricant laxative. However, it shouldn’t be used in pregnancy. It’s been connected to bleeding disorders in newborns. It can also lower nutrient absorption.

What are other things I can do to treat constipation while I’m pregnant?

Eating foods that contain fiber can help with pregnancy constipation relief. The American College of Obstetricians and Gynecologists (ACOG) recommends getting about 25 g of fiber every day. Foods that are good sources of fiber include:

• Chickpeas (garbanzo beans)

• Oatmeal

• Nuts

• Fruits

• Vegetables

• Whole grains

ACOG also recommends drinking more water if you plan on boosting your daily fiber intake. And diet aside, exercising also helps improve constipation during pregnancy. It’s recommended to exercise for about 30 minutes each day if possible.

But before making any sudden changes to your diet or exercise routine, please talk to your healthcare provider. They can tell you more about safe dietary and exercise decisions to make during pregnancy.