This Integrative Health tool focuses on what one might consider as part of an Integrative Health approach to a number of pregnancy-related complaints including constipation, gastroesophageal reflux, nausea and vomiting, back pain, and round ligament pain.

Constipation

Constipation is prevalent among pregnant women, starting early in pregnancy and continuing into the postpartum period.  The relaxin hormone causes slowing of the smooth muscle of the intestine, thus slowing intestinal transit.  Constipation may be aggravated further by the use of prenatal vitamins that contain ferrous sulfate (a commonly used form of iron).

Ways to address constipation include the following:

·         Lifestyle measures, such as increasing exercise, as well as increasing fluid and fiber intake, are a good start.

·         Beet molasses is traditionally used at a dose of 1-2 tablespoons daily, and it may be worth trying.

·         Ground flaxseed, prunes, and prune juice may also be added to the diet.

·         Magnesium citrate supplementation at a dose of 120-240 mg by mouth, at bedtime, can be titrated so that a woman has one soft bowl movement daily.  This is likely safe to use right up to delivery, although data is very limited.¹

·         Commonly used for constipation, senna, aloe, and cascara sagrada should be avoided in pregnancy, due to the risk of dependency and possible uterine-stimulating effects late in pregnancy.

Gastroesophageal Reflux

Reflux and heartburn are experienced frequently by pregnant women, especially as they approach term.  In addition to the usual lifestyle advice, one might consider suggesting a few supplements that may be beneficial.  Unfortunately, none have been specifically studied for treating pregnancy-related gastroesophageal reflux.

·         Chamomile (Matricaria recutita) is traditionally used for dyspepsia and is safe in pregnancy.²  It can be consumed as a tea and is noted to have sedative properties.

·         Marshmallow root (Althaea officinalis) is an herb which contains mucilage polysaccharides known to coat the esophagus and protect it from irritation.³  To prepare it, patients should steep one-half to one ounce of dried herb in 1 quart of hot water for 30 minutes and drink as a tea.