Digestive Health

Updated 02 March 2017

Constipation in pregnancy

SPONSORED: Constipation is seldom discussed, yet it affects around one in three people and pregnant women are particularly susceptible.


It’s not the sort of pregnancy problem women happily share, like being unable to reach past their belly to paint their toe nails.

But constipation can be an all too real problem, especially in the second and third trimester.

Constipation is the most common gastrointestinal complaint in South Africa, affecting 29 % of people in all ethnic groups, and prompting 43 % of white people and 76.6 % of black people to turn to laxatives (1)

Research suggests that women suffer more than men as they appear to have slower movement of the intestinal tract (2), and studies show that up to a third of pregnant women may be affected (3).

Doctors define constipation as having a bowel movement fewer than three times a week, with stools that are dry, hard and small but difficult to pass. It can cause pain, bloating, straining and if untreated, haemorrhoids.

Pregnant women are especially susceptible to haemorrhoids because of their increased abdominal pressure, and they are more at risk of constipation.

Along with general risk factors, such as intestinal problems like IBS, consuming too little dietary fibre and liquid, and doing too little exercise, they have increased levels of pregnancy hormones, especially progesterone, which slows gastrointestinal movement.

Most pregnant women also take supplements of dietary iron, for which constipation is a common side effect.

The ideal solution is to drink more water and consume more dietary fibre from vegetables, fruits, legumes and whole grains.

Most contain two types of fibre in different proportions: insoluble fibre, the portion of ingested plant food that can’t be digested and adds bulk to the stool; and soluble fibre, which absorbs water and turns to gel during digestion, softening the stool (4). Both help food pass through the intestinal tract. 

When you don’t manage to consume enough fibre-rich foods, Agiolax® is a natural solution, combining both insoluble and soluble fibre (seeds of Plantago ovata and Ispaghula husk), together with senna, which acts on the intestinal wall, gently stimulating movement in the colon. 


1 Meiring, P.J., & Jouberg, G. (1988). Constipation in elderly patients attending a polyclinic. South African Medical Journal, 88(7), 888-890.
2 Choung, R.S., Locke III, G.R., Zinsmeister A.R., Schleck, C.D., & Talley, N.J. (2007). Epidemiology of slow and fast colonic transit using a scale of stool form in a community. Alimentary Pharmacology & Therapeutics Volume 26, Issue 7. Ryan, J.P., & Bhojwanif, A. (1986). Colonic transit in rats: effect of ovariectomy, sex steroid hormones, and pregnancy. American Journal of Physiology, 251(1Pt1): G46-50. 
3 Bonapace, E.S., & Fisher, R.S. (1998). Constipation and diarrhea in pregnancy. Gastroenterology Clinics of North America, 27(1): 197-211. Vazquez, J.C. (2008). Constipation, haemorrhoids, and heartburn in pregnancy. British Medical Journal Clinical Evidence: 1411. Published online 2008 February 20.
4 MedicinePlus Medical Encyclopaedia, NIH/US National Library of Medicine: References:  Lembo, A.J., & Ullman, S.P., Constipation. In Feldman, M., Friedman, L.S.,  Sleisenger, M.H., eds. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 9th edition. Philadelphia, P.A.: Elsevier Saunders. (2010). Chapter 18.


Ask the Expert

Digestive Health Expert

Dr. Estelle Wilken is a Senior Specialist in Internal Medicine and Gastroenterology at Tygerberg Hospital. She obtained her MBChB in 1976, her MMed (Int) in 1991 and her gastroenterology registration in 1995.

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