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Elimination Changes

The changes a woman's body goes through during pregnancy can affect her digestive system and elimination habits. Read below to learn what you should be concerned about and how to relieve some discomfort.


Constipation can develop in pregnancy in the second or third trimester. It is thought to result from decreased movement from relaxation of muscle of the large bowel due to hormones. The enlarging uterus and infant displacing or compressing the bowel may be a factor as well. The problem may be compounded by iron supplementation, as constipation is a common side effect.

The following can help prevent and relieve constipation and are most effective when used in combination:

  • Drink adequate fluids- a minimum of 8 glasses per day
  • Eat prunes or prune juice (a natural, mild laxative)
  • Obtain adequate rest, including rest periods during the day
  • Drink warm liquids on rising; a cup of hot water 3 times per day may be helpful
  • Eat raw fruits, vegetables, and whole-grain or bran cereals (any foods with roughage, bulk, and natural fiber)
  • Establish regular and good bowel habits; have a regular time of day for having a bowel movement, do not ignore the urge to go
  • Do regular exercise such as walking and abdominal exercises
  • Use good posture and body mechanics

Try the following Recipe for Constipation: 1 cup raisins, 1 cup dates, 1 cup prunes, 2 cups prune juice Cook in crock pot until thick and soft. Cool. Blend with water to consistency of apple butter. Eat two tablespoons per day until better, then 1 tablespoon per day to maintain.

Medication should not be used unless the natural methods are not effective. Mild laxatives, stool softeners, and glycerin suppositories can be used if needed. Dependence on laxatives should be avoided as it may continue after birth.


Diarrhea during pregnancy is often of food origin. Occasionally it is a side effect from a disease such as the flu. Acute short term diarrhea is best left to resolve itself but basic supportive therapy can include replacing fluids and avoiding high fiber foods. Unrefined cereals, fruits, and vegetables should be limited

Several antidiarrheal medications are available; discuss the risks and benefits with your healthcare provider before using any medications.

Dehydration is a particular concern with pregnancy as it is associated with preterm labor. It can usually be avoided with vigorous fluid replacement. In the rare cases where it does not resolve itself in 24-48 hours, you should contact your healthcare provider

Flatulence (Gas)

Increased flatulence (gas) in pregnancy is thought to be related to decreased movement of the stomach and intestines that leads to delayed emptying. Swallowing air may also contribute to the problem. Flatulence can increase throughout pregnancy, but is more likely in the second and third trimesters.

The following are relief measures to try:

  • Avoid gas-forming foods (dried beans, peas,etc.)
  • Establish a regular pattern of bowel movements
  • Getting into the knee-chest position can help to relieve discomfort from unexpelled gas
  • Chew your food thoroughly
  • Engage in regular exercise


Hemorrhoids result from the influence of progesterone (a hormone) which causes relaxation of the vein walls and the large bowel. In addition, the enlarging uterus causes pressure on the pelvic veins. Hemorrhoids can occur at any time during pregnancy but are more common in the later months.

Prevention of hemorrhoids goes hand-in-hand with prevention of constipation and includes: adequate fluid intake, regular exercise to promote bowel motility, warm liquids in the morning, increased dietary fiber, and avoiding straining when passing stools. Active rectal bleeding should be reported to your healthcare provider.

Relief measures for hemorrhoids include:

  • Take a sitz bath
  • Apply one of the following: Witch Hazel compresses (Tucks), an ice bag, Epsom salt compresses, or analgesic ointments and/or topical anesthetics
  • Take frequent rest periods with hips and lower extremities elevated
  • Use Preparation H or Anusol suppositories
  • Reinsertion of hemorrhoids into the rectum can be done by your health care provider if needed
  • Do Kegel exercises
  • Sit on firm surfaces or in tailor fashion on the floor

Urinary Frequency/Increased Nighttime Urination

Urinary frequency and nocturia (increased nighttime urination) occur in both first and third trimesters. In the first trimester they are caused by the softening of the uterus and increased weight in the pelvis. During the third trimester, direct pressure of the presenting part on the bladder causes it to occur again. 

It is important to be aware of signs and symptoms of urinary tract infections to differentiate between normal pregnancy frequency and potential infection. Symptoms include discharge, foul odor, and burning with urination in addition to frequency.

Other suggestions include decreasing fluid intake before bedtime to promote uninterrupted sleep, decreasing fluids before going places where restrooms aren’t readily available and drinking plenty of water.

If you have questions or would like more information, please contact our Women's Center at 605-322-3444.

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