Constipation is a common problem in pregnancy sometimes aggravated by the iron supplements frequently prescribed to treat or prevent anemia. Calcium supplements may also constipate. Several natural factors contribute to constipation in pregnancy. Motility of the gut is reduced, water reabsorption in the colon is increased (extraction of water from the stool), and the enlarging uterus may actually crowd the colon.

Much of the natural influence which contributes to constipation can be countered with a diet high in fiber and water. Unfortunately, these strategies will only partially address the problem of reduced gut motility, that is, peristalsis, the muscular action which propels food through the intestines.

So there are some things you can do. Increase the amount of fiber you eat. Most people do not eat nearly enough. Fruits and vegetables are the food sources rich in fiber. You should be eating at least 5 servings of fruits and vegetable every day. If you still need something to add “bulk” to your digestive tract, products which contain psyllium provide a person with a type of vegetable fiber which absorbs water. This helps keep one’s stool both soft and bulky (that is, in sufficient quantity to provide the urge to defecate). Avoid products which contain senna until you have tried all these other things. Senna has a mild to moderate laxative effect, and can produce a bit too much, a bit too fast.

If you are on an iron supplement, find out which iron compound it is and switch to another. There are three common iron compounds (ferrous sulfate, ferrous gluconate, and ferrous fumarate). One type of iron may be better than another for you.

One last thing while we’re on the subject of defecation (bowel movements). The modern toilet is poorly designed with regards to the nature of human defecation. Human beings were meant to squat during bowel movements. When a person squats to defecate, different muscular forces come in to play which rely less on the “Valsalva maneuver” and more on natural colon peristalsis. The Valsalva maneuver is the conscious act of straining by closing the glottis on the windpipe and using chest and abdominal muscles to increase the pressure inside the abdomen. Straining like this can cause or aggravate hemorrhoids.

The modern toilet forces one to strain more with the wrong set of muscles. The increase in venous pressure produced during the Valsalva maneuver can cause hemorrhoids to form. Try this. Get a small step stool or box and keep it next to your toilet. When you have a bowel movement, place your feet on the stool to more approximate the act of squatting. It will surprise you how much easier it is to move your bowels.