Constipation and haemorrhoids (piles) in pregnancy

Constipation is difficulty in emptying your bowels, usually associated with hardened faeces and straining. The hormonal changes in pregnancy, which encourage parts of your body to relax and make room for the baby, also make constipation more likely. You may notice you become more constipated early in pregnancy, before many other changes appear. It can also happen later in pregnancy as the uterus enlarges and presses on the bowel.

Avoiding constipation and straining when you go to the toilet is important not only for your comfort, but because it puts less strain on your pelvic floor muscles.

Sometimes constipation can lead to complications including:

• haemorrhoids, commonly called piles, caused by straining to have a bowel movement and/or
• anal fissures (tears in the skin around the anus) caused when hard stools stretch the sphincter muscle.

Heamorrhoids and fissures may cause some bleeding. 

Treating and preventing constipation in pregnancy

There are many things you can do to avoid problems with constipation.

• Drink plenty of water.
• Include plenty of fibre in your diet by eating foods like wholemeal bread, wholegrain breakfast cereals, rice and pasta, fruit and vegetables, and pulses such as beans and lentils.
• Exercise regularly to keep your muscles toned up.
• Avoid iron supplements if they cause constipation - talk to your doctor about whether you need to continue iron supplements or change to a different type.

Other drugs, such as some antacids, can make constipation more likely so it’s worth checking with your doctor if you take regular medication. Your doctor or midwife can suggest suitable treatments during pregnancy.

Diet for preventing constipation

Wholegrain bread, pasta, rice and breakfast cereals contain vitamins and minerals as well as fibre. It may feel strange eating brown pasta to start with, or getting used to wholemeal bread, but it can make a difference. 

If you continue to suffer from constipation, prunes, figs or dried apricots can help. Vegetables such as beetroot and spinach can help, but it’s best not to eat them more than once a day as they contain a substance which prevents the body absorbing calcium.

Heamorrhoids

Haemorrhoids, also called piles, are swollen veins around the anus that can be itchy, feel sore and make it uncomfortable to go to the toilet. In pregnancy they are caused by hormones that encourage your veins to relax, and by the increased pressure on your pelvic blood vessels.

Some ointments and creams are available but there is little evidence on how well these work. Your midwife or GP can give you advice on other ways to get rid of and avoid haemorrhoids, such as changes to your diet (to prevent constipation), exercise, and avoiding standing for long periods of time. Warm baths and ice packs can also help.

Further information

NCT's helpline offers practical and emotional support in all areas of pregnancy, birth and early parenthood: 0300 330 0700. We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

NHS Choices offers information on constipation and haemorrhoids.