Before getting pregnant, I understood constipation from a clinical perspective. Then pregnancy turned pooping into a part-time job between me, my prenatal and a kiwi.
Pregnancy constipation is incredibly common. It can look like going less often than usual, passing hard or lumpy stool, straining or feeling like you never completely finished. It can also leave you bloated, uncomfortable and thinking about your bathroom habits far more than you ever wanted to.
The usual advice is to “eat more fiber and drink more water.” That advice is not wrong, but it skips over quite a few details. How much fiber? Which foods? What if adding fiber makes you more bloated? What if your iron supplement is part of the problem? And what are you supposed to eat if pregnancy nausea has narrowed your diet to six tolerable foods?
Here is how I would approach pregnancy constipation as both a registered dietitian and someone currently living it.
Why Is Constipation So Common During Pregnancy?
Pregnancy hormones can slow the movement of food through the digestive tract. Progesterone relaxes the intestinal muscles, which gives the colon more time to absorb water from stool. The longer stool remains in the colon, the drier and harder it may become.
As pregnancy progresses, the growing uterus can also place additional pressure on the bowel. Changes in activity, hydration and eating patterns may contribute too. If nausea has taken fruits, vegetables and whole grains off the menu, your fiber intake may be much lower than it was before pregnancy.
Then there is iron. Iron needs increase during pregnancy, and many prenatal vitamins contain it. Supplemental iron can cause gastrointestinal side effects, including constipation.
Basically, several constipation risk factors can show up at once. You are not doing anything wrong. Your digestive system is dealing with a very different set of circumstances.
How Much Fiber Do You Need During Pregnancy?
The American College of Obstetricians and Gynecologists recommends aiming for about 25 grams of fiber per day during pregnancy.
But if you are currently eating 10 or 12 grams, jumping directly to 25 or 30 grams overnight may leave you painfully bloated. Your gut needs time to adjust.
Start by adding one or two fiber-rich foods to what you already eat. That might look like adding berries to cereal, choosing whole-grain toast, including beans at lunch or eating a kiwi with breakfast. After a few days, add another source if you are tolerating the change.
Spreading fiber across the day is usually more comfortable than trying to get most of it from one enormous salad or a very aggressive bowl of bran cereal.
The Best Foods for Pregnancy Constipation
No single food can guarantee a bowel movement, but certain foods make it easier to build a constipation-supportive routine.
Kiwi
Kiwi is one of my favorite foods for constipation because it provides fiber and fluid in a relatively small, easy-to-eat package.
In a 2023 randomized crossover trial, adults with functional constipation or constipation-predominant irritable bowel syndrome ate two green kiwis per day for four weeks. The participants experienced improvements in bowel movement frequency and gastrointestinal comfort.
The study was not conducted specifically in pregnant people, so I would not present kiwi as a pregnancy constipation treatment with guaranteed results. Still, it is a practical fiber-rich fruit that many people tolerate well.
Try slicing kiwi over yogurt, adding it to oatmeal or just cutting it in half and eating it with a spoon.
Prunes and Prune Juice
Prunes contain fiber and sorbitol, a naturally occurring sugar alcohol that can pull water into the intestines. Prune juice contains less fiber than whole prunes but may still help because it retains sorbitol.
Start with a small amount. Too many prunes or a large glass of prune juice can cause cramping, gas or diarrhea, especially if your body is not used to them.
You can eat prunes on their own, chop them into oatmeal or pair them with nuts or cheese for a more satisfying snack.
Berries, Pears and Apples
Raspberries and blackberries provide a substantial amount of fiber for their volume. Pears and apples also provide fiber, particularly when you eat the skin.
Fresh fruit is not required. Frozen berries work well in oatmeal, yogurt and smoothies. Unsweetened applesauce may be easier to tolerate during nausea, although it generally contains less fiber than a whole apple.
Oatmeal and High-Fiber Cereal
Oatmeal is useful because it can serve as a base for several constipation-supporting foods. You can add chia seeds, ground flaxseed, berries, kiwi, prunes or nut butter depending on what you tolerate.
High-fiber cereal is another very realistic option. It requires almost no preparation, can contribute iron if it is fortified and may be easier to eat than a cooked meal.
Check the Nutrition Facts panel because fiber content varies significantly among cereals. You also do not need to choose the cereal with the highest possible fiber number. A moderate-fiber cereal you enjoy eating is more useful than a bran cereal you resent.
Beans and Lentils
Beans, lentils and split peas provide fiber, protein, iron and folate. They can also cause gas if you suddenly begin eating large portions.
Start with an amount that feels manageable. Canned beans are convenient and rinsing them can reduce some of the sodium. Lentil soup, bean and cheese quesadillas, hummus, bean-based pasta or a rice bowl with black beans are all low-effort options.
Chia Seeds, Ground Flaxseed and Psyllium
Chia seeds and ground flaxseed can be mixed into oatmeal, yogurt, cereal or smoothies. Begin with a small amount and increase gradually.
Psyllium is a fiber supplement that absorbs water and adds bulk to stool. Current gastroenterology guidelines conditionally recommend psyllium for adults with chronic constipation, although that guidance was not developed specifically for pregnancy.
Talk with your prenatal care provider before starting psyllium or another fiber supplement. Fiber supplements need to be taken with adequate fluid, and they can affect how some medications or supplements are absorbed.
More fiber is not automatically better. If a large dose leaves you painfully bloated and still constipated, taking even more is probably not the answer.
Vegetables and Whole Grains
Vegetables, whole-grain bread, brown rice, quinoa, whole-wheat pasta and potatoes with the skin can all contribute fiber.
Frozen vegetables count. Bagged salads count. A microwaveable potato counts. You are trying to support your digestive system, not prove that you can prepare every food from scratch.
Easy Meals and Snacks for Pregnancy Constipation
The best plan is one you can follow while pregnant, tired and possibly nauseated.
Here are a few combinations that provide fiber without requiring an elaborate meal:
- Oatmeal with kiwi and chia seeds
- High-fiber cereal with milk and berries
- Greek yogurt with berries and ground flaxseed
- Whole-grain toast with avocado and an egg
- Lentil soup with whole-grain bread
- A bean and cheese quesadilla with salsa
- Hummus with whole-grain crackers and baby carrots
- A pear with peanut butter
- Prunes with nuts or cheese
- Microwave rice with black beans, avocado and salsa
- Pasta with white beans and frozen vegetables
- A baked potato topped with lentils or beans
- A smoothie with berries, kiwi and chia seeds
You do not have to eat all of these foods in one day. Pick two or three additions that sound realistic and see how your body responds.
Why Water Is Part of the Fiber Conversation
Fiber holds water in the stool, which can help make it softer and easier to pass. Increasing fiber without drinking enough fluid may leave you feeling even more uncomfortable.
ACOG recommends drinking approximately 8 to 12 cups of water per day during pregnancy, although needs vary with activity, climate, vomiting and individual health conditions.
If plain water is unappealing, try:
- Seltzer
- Water with citrus or fruit
- A different water temperature
- Drinking through a straw
- Milk
- Smoothies
- Broth
- Decaffeinated tea
- An electrolyte beverage, if appropriate for your needs
You do not need to chug a huge amount at the end of the day. Keeping a drink nearby and sipping regularly is usually more manageable.
What If Your Prenatal or Iron Supplement Is Making You Constipated?
Iron supplements can contribute to constipation. But please do not stop taking an iron-containing prenatal or prescribed iron supplement without talking with your physician.
Pregnancy increases the recommended iron intake to 27 milligrams per day, and iron deficiency during pregnancy needs to be taken seriously. I dealt with low ferritin during my own pregnancy, so simply abandoning iron was not an appropriate solution for me.
Talk with your prenatal care team about:
- The amount of iron you are taking
- The form of iron in your supplement
- Whether you need additional iron based on your labs
- Whether a different prenatal or iron product is appropriate
- How to manage constipation while continuing necessary treatment
Iron needs and tolerances vary. One person may need a prenatal with iron built in, while another may use a separate iron supplement under medical supervision.
The goal is to address the constipation without accidentally ignoring an iron deficiency.
Other Habits That May Help
Food and fluid are only part of the picture.
Regular movement can help stimulate the muscles involved in digestion. Walking is often a realistic option, but follow any activity restrictions provided by your prenatal care team.
Respond to the urge to have a bowel movement when you can. Repeatedly delaying it allows the colon more time to remove water from stool, which can make it harder to pass.
Try to give yourself enough time in the bathroom instead of rushing or repeatedly straining. A small footstool can make your position more comfortable by raising your knees, although it will not fix the underlying cause of constipation.
What If Food and Fiber Are Not Enough?
Sometimes constipation needs more than nutritional changes.
A clinician may recommend a fiber supplement, stool softener or laxative depending on your symptoms, health history and other medications. General adult constipation guidelines support several over-the-counter options, but pregnancy adds another layer of safety considerations.
Ask your OB-GYN, midwife or pharmacist before starting a laxative or constipation supplement. Avoid using castor oil or other aggressive “natural” remedies unless your clinician specifically recommends them.
You do not win a prize for treating persistent constipation with food alone.
When to Call Your Prenatal Care Provider
Contact your provider if your constipation is not improving, is causing frequent pain or requires significant straining. Persistent straining can contribute to hemorrhoids and anal fissures.
Seek medical care promptly if constipation occurs with:
- Severe or persistent abdominal pain
- Vomiting or an inability to keep fluids down
- An inability to pass gas
- Significant abdominal swelling
- Rectal bleeding or black, tarry stool
- Fever
- Regular cramping, vaginal bleeding or leaking fluid
Do not assume severe abdominal pain during pregnancy is “just constipation.” Your prenatal care team can help determine what is causing it.
The Bottom Line
Pregnancy constipation is common, but you do not have to quietly accept feeling miserable for nine months.
Start by adding fiber gradually, spreading it across the day and drinking enough fluid to support it. Kiwi, prunes, berries, oatmeal, beans, lentils, seeds, vegetables and whole grains can all contribute. Movement and responding to bathroom urges may help too.
If your prenatal or iron supplement appears to be contributing, talk with your provider before changing it. And if food is not enough, ask about other pregnancy-appropriate treatment options.
Sometimes the solution is a few realistic adjustments. Sometimes you need additional help. Both are valid.
For more practical pregnancy food ideas, see my realistic pregnancy grocery list.
If you want individualized support with prenatal supplements, low iron, digestive symptoms or trimester-specific nutrition, learn more about my TTC and pregnancy nutrition counseling.
Are you a pregnancy, postpartum or women’s wellness brand looking for an RDN content creator or consultant? Learn more about partnering with Claire Rifkin Nutrition.
This article is for educational purposes and is not a substitute for individualized medical care. Discuss supplements, laxatives and persistent pregnancy symptoms with your prenatal care provider.
