Constipation is one of the most common side effects of pregnancy, affecting at least half of all pregnant women at some point. It's usually more troublesome in women who were prone to constipation before pregnancy.

When you're pregnant, an increase in the hormone progesterone causes digestion to slow down, so food passes more slowly through the gastrointestinal tract. In the later months, the ever-expanding uterus puts pressure on the lower bowel. In addition, your colon absorbs more water during pregnancy, which tends to make stools harder and bowel movements more difficult.

Other factors that can contribute to the problem include irregular eating habits, stress, changes in environment and added calcium and iron in your diet. Constipation can give rise to hemorrhoids (see Hemorrhoids).

■ Prevention and self-care for constipation

The first step in dealing with the problem is to evaluate your diet. Eating fiber-rich foods and drinking plenty of fluids each day will help prevent or ease constipation. Follow these suggestions:

• Eat high-fiber foods, including fresh and dried fruits, raw and cooked vegetables, bran, beans and whole-grain foods, such as whole-wheat bread, brown rice and oatmeal. The age-old remedy of prunes — now marketed as dried plums — can help, as can fruit juices, especially prune juice.

• Eat small, frequent meals and chew your food thoroughly.

• Drink plenty of fluids, especially water. Aim for eight 8-ounce glasses a day. Drink a glass of water before going to bed.

• Get more exercise. Just adding a little time to your daily walks or other physical activities can be effective.

• Iron supplements can cause constipation. If your health care provider has recommended iron supplements and you have constipation, take the iron pills with prune juice.

■ Medical care for constipation

If self-care measures don't work, your health care provider may recommend a mild laxative such as milk of magnesia, a bulk-producing agent such as Metamucil or Citrucel, or a stool softener containing docusate. Sometimes, stronger measures are needed, but they should only be used on the advice of your practitioner.

Don't take cod liver oil because it can interfere with the absorption of certain vitamins and nutrients.

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