Up to 40% of pregnant women experience constipation. We researched which laxatives OB-GYNs recommend during pregnancy and which to avoid completely.
OUR #1 PICK
The most widely recommended stool softener during pregnancy — OB-GYNs have been prescribing Colace for decades with an excellent safety profile for mother and baby.
If you're pregnant and constipated, first: you're in very good company. Up to 40% of pregnant women deal with constipation at some point, thanks to the delightful combination of progesterone slowing your digestive system, prenatal iron supplements backing things up further, and a growing baby pressing on your intestines. The good news is there are safe, effective options — but "safe during pregnancy" narrows the field significantly, and that's exactly what we sorted through for you.
The single most important rule for pregnancy constipation: avoid stimulant laxatives (Dulcolax, Senokot, Ex-Lax, castor oil) unless your OB specifically tells you otherwise. These products force intestinal muscle contractions, and while the risk to pregnancy is theoretical rather than proven, OB-GYNs universally recommend avoiding them when safer alternatives exist.
Understanding why this is happening helps explain why certain products are recommended:
Progesterone relaxes smooth muscle — including the muscles of your intestines. Your entire digestive tract slows down, meaning stool sits longer and loses more water, becoming harder and more difficult to pass.
Prenatal iron supplements are a major contributor. Iron is constipating even outside of pregnancy. Combined with the progesterone slowdown, iron supplements can turn mild constipation into a significant daily problem.
Physical compression — especially in the second and third trimesters — means the growing uterus physically presses on your intestines, further slowing transit.
Reduced physical activity in later pregnancy contributes as well. Movement stimulates gut motility, and reduced activity means reduced motility.
Dietary changes due to morning sickness, food aversions, and fatigue often reduce fiber and fluid intake — both of which are critical for regularity.
For this guide, we heavily adjusted our standard weights to prioritize safety:
Pregnancy Safety — 40% (the defining criterion — nothing else matters if it's not safe) Effectiveness — 25% (does it actually work for pregnancy-specific constipation?) Tolerability — 20% (will it worsen nausea, bloating, or other pregnancy symptoms?) Ease of Use — 10% (compliance during a time when you have 100 other things to manage) Value — 5%
We consulted OB-GYN guidelines, FDA pregnancy categories, and the American College of Obstetricians and Gynecologists (ACOG) recommendations in making these selections.
Most OBs recommend a layered approach:
Start with diet and water. Aim for 25-30 grams of fiber daily (prunes, pears, beans, whole grains) and at least 8-10 glasses of water. This resolves mild constipation for many women without any medication.
Add Colace if diet alone isn't enough. One capsule twice daily is the standard starting regimen. Give it 3-5 days to take effect.
Add Metamucil (or switch to capsule form) if you need more fiber but food aversions make it hard to eat high-fiber foods. Start with half a dose to minimize gas.
Escalate to MiraLAX with your OB's approval if Colace plus fiber isn't cutting it. Many OBs add MiraLAX for patients in the second and third trimesters who aren't getting relief from softer interventions.
Talk to your OB if none of the above is working after 1-2 weeks. Prescription options exist for severe pregnancy constipation, and hemorrhoid prevention becomes more important as the pregnancy progresses.
If your prenatal vitamin contains iron and constipation is severe, ask your OB about slow-release iron formulations or taking iron every other day instead of daily. Research shows that every-other-day iron dosing can actually improve absorption while significantly reducing constipation. This one change resolves constipation for some pregnant women entirely, without needing any laxative at all.
Your OB can also check your iron levels — you may not need supplemental iron if your levels are already adequate, in which case switching to an iron-free prenatal eliminates the biggest constipation contributor.
Our Pick
Our Pick
“Standard-sized soft gel capsules with a slightly oily feel. The liquid form has a bitter medicinal taste that most people find unpleasant — stick with capsules if you can.”
Colace (docusate sodium) is the stool softener OB-GYNs most commonly recommend during pregnancy. It works by softening stool rather than stimulating contractions, which makes it the gentlest option available. The tradeoff: it's the mildest product in this guide, so if you're severely constipated, it may not be enough on its own. But as a daily preventive during pregnancy, it's the safest starting point.
$6 – $18
Runner Up
Runner Up
“The orange flavor is strong and the psyllium gives it a thick, slightly gritty texture that takes getting used to. Must drink immediately after mixing — it gels fast and becomes undrinkable.”
Metamucil is a natural fiber supplement that's safe during pregnancy and addresses one of the root causes of pregnancy constipation: insufficient fiber intake (which often drops when morning sickness limits food choices). The psyllium fiber adds bulk and softness to stool naturally. The gritty texture can be challenging when you're already dealing with nausea, so consider the capsule form if texture triggers your gag reflex.
$15 – $35
Also Safe
Also Safe
“Unflavored powder dissolves completely in any liquid — truly tasteless, which is its biggest advantage over flavored competitors.”
MiraLAX is generally considered safe during pregnancy, and many OB-GYNs recommend it when Colace and fiber alone aren't providing relief. It's not classified as a Category A drug during pregnancy (very few products are), but the active ingredient (PEG 3350) is minimally absorbed into the bloodstream, which is why most OBs are comfortable recommending it. Always confirm with your own doctor before starting.
$10 – $30
| Product | Type | Active Ingredient | Onset | Price | Rating | Best For |
|---|---|---|---|---|---|---|
| Colace | stool-softener | Docusate Sodium | 1-3 days | $6–$18 | Pregnancy (OB-recommended) | |
| Metamucil | fiber | Psyllium Husk | 12-72 hours (daily use for best results) | $15–$35 | Daily constipation prevention | |
| MiraLAX | osmotic | Polyethylene Glycol 3350 (PEG 3350) | 1-3 days | $10–$30 | Daily use |
OTC products work well for most people, but see a doctor if you experience any of the following:
A GI doctor can evaluate your symptoms and prescribe treatments not available over the counter. Online consultations are quick and private — no waiting room, no awkward conversations.
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Medical Disclaimer
This content is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional before starting any new medication or supplement, especially if you are pregnant, nursing, taking prescription medications, or have a pre-existing medical condition. Product recommendations are based on publicly available clinical research and are not a substitute for professional medical guidance.
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