MINOR AILMENT DURING

PREGNANCY:
CONSTIPATION & NURSING
MANAGEMENT
NUR 3112 Obstetric Nursing
Dr. Siti Mariam Muda
GROUP 5
Fatin Izzati Saiful Bahri 1312426
Mimi Nor Aliza Setapani 1311120
Noor Isnani Mohd Zaki 1313236
Nor Asma Athirah Mohamad Zaki 1310030
Nurfarhain Mohd Kamarulzaini 1317608
Wan Nur Shahirah Wan Abdul Hamid Shukri 1318978

OBJECTIVES
At the end of the presentation, our fellow students should:
At the end of the presentation, our fellow students should:
Know the definition of constipation during pregnancy.
Know the definition of constipation during pregnancy.
Study the anatomy and physiology between normal people and
Study the anatomy and physiology between normal people and
constipation of a pregnant mother.
constipation of a pregnant mother.
Identify common complications in constipation during pregnancy.
Identify common complications in constipation during pregnancy.
Investigate common causes of constipation during pregnancy.
Investigate common causes of constipation during pregnancy.
Differentiate the changes of the GI System during pregnancy.
Differentiate the changes of the GI System during pregnancy.
Categorize the medical management/pharmacological management
Categorize the medical management/pharmacological management
in constipation during pregnancy.
in constipation during pregnancy.
Be familiar with the nursing management in constipation during
Be familiar with the nursing management in constipation during
pregnancy.
pregnancy.
Have resources to health educations & home management in
Have resources to health educations & home management in
constipation during pregnancy.
constipation during pregnancy.
Be knowledgeable in Islamic Perspectives of care in pregnancy
Be knowledgeable in Islamic Perspectives of care in pregnancy
mother.
mother.

Definition of
Constipation
Constipation is A condition in which you typically
have:

Fewer than three (3) bowel movements a week

Bowel movements with stools that are hard, dry,

and small, making them painful or difficult to pass

(National institute of diabetes and digestive and kidney diseases)

Constipation is normal during

pregnancy

The consumption of iron-containing

prenatal vitamins, hormonal changes
and the pressure of the uterus on the
rectum can aggravate constipation.

It also caused by hormonal changes

that decrease the rhythmic muscular
movements of the gut (peristalsis),
which push food along the intestines.

It can be improved by a high fluid

intake, eating high-fibre foods and
getting plenty of exercise.

Anatomy

Physiology

Process of defecation:
a. propulsion of stool through the colon to the rectum
b. the recognition of stool within the rectum
c. the conscious act of defecation.

The colon terminates in rectum, which, in turn, passes through the levator ani muscles and
becomes the anal canal.

Two groups of muscles encircle the anal canal:

the internal anal sphincter (involuntary control)

the external anal sphincter (voluntary control)

In 3-4 hours after ingestion, food enters the cecum; after several more hours, it reaches the
rectum.

When the rectal wall is distended by stool, reflex contraction of the rectum occurs, the internal
anal sphincters relax.

Fecal material is pushed into the anal canal.

At this point, the stretch receptors of the anoderm recognize the stool.

A decision is made on whether to expel the stool by relaxing the external anal sphincter,
squatting, and increasing intra-abdominal pressure with the Valsalva manoeuvre OR to
postpone defecation by contracting the external anal sphincter and the gluteal muscle.

Mechanism
Baby puts
An

pressure on the rectum.

increased blood supply means the

mother need a lot more fluid, so she
can easily get dehydrated.

Cont..
Increasing of progesterone
Slows down the intestine muscles
The food to move slowly through the
system
Feel gassy and bloated

Causes
High level

of progesterone

Uterus become bigger

High Iron

intake

Changes of the GI System during

pregnancy

Oral Cavity:a. Increased saliva & saliva become more

acidic which promotes tooth decay.
b. Gums- more sensitive, smell easily &
bleed.

Morning sickness may presentCharacterised by vomiting & poor appetite.

Complications
Fecal

impaction

Irreversible

distention of the colon

(known as megacolon)

Hemorrhoids
Fissures.

Treatment

Eat high fiber diet

Drink a lot of fluids

Exercise routinely

Reduce or eliminate iron supplements

Over the counter medication (Metamucil)

Take Probiotics supplement

Treatment cont.

Laxative pills are NOT recommended for the

treatment of constipation during pregnancy
because they might stimulate uterine
contractions and cause dehydration.

Mineral oils should NOT be used during

pregnancy because they reduce nutrient
absorption.

Diagnosis 1 : Constipation related to low fiber diet as evidence by

hard stool and painful defecation
Goal
Gain soft stool and no
pain while defecation

Nursing
Intervention
-Identify factors that
may cause
or contribute to
constipation.
-Encourage increased
fluid intake, unless
contraindicated.

-Advice pt to have a
high fiber diet.
-provide information
about the constipation

Rationale

Evaluation

-Assessing causative
factors is an essential
first step in teaching
and planning for
improved bowel
elimination.
-Sufficient fluid intake
is necessary for the
bowel to absorb sufficient amounts of
liquid to promote
proper stool
consistency.
-Fiber absorbs water,
this can soften the
stool
and speeds up
passage through the
intestines
-information given can
awaken the pt about
the dangerousness of
having constipation

Has soft stool and no

pain while defecation

Diagnosis 2 : Immobility related to pregnancy as evidence by

patient complaint
Goal

Nursing
Intervention

patient can have

a simple exercise
and helps in
bowel
elimination

-Assess general
condition of patient
whether she has
any pain felt on the
body
-Explain the
importance of
having exercise
-Encourage pt to
ask questions
about exercise and
constipation as
they are related
each other
-Teach simple
exercise for
pregnant women

Rationale
-Simple exercise
can be done
without having
any pain
-Pt can know the
advantages of
exercise
-To solve any
doubts in pts mind
so that she have
clear view on
exercise and
constipation
-The exercise can
be practiced by the
pregnant women

Evaluation
pt can perform
exercise very
well and have
smooth bowel
elimination

HEALTH EDUCATION
Nutrition
Eat three meals each day. Do not skip meals.
Gradually increase the amount of high-fiber foods in the diet.
Choose more whole grain breads, cereals and rice.
Select more raw fruits and vegetables -- eat the peel, if
appropriate.
Read food labels and look for the "dietary fiber" content of
foods. Good sources have 2 grams of fiber or more.
Drink six to eight glasses of water each day.
Limit highly refined and processed foods.

Exercise and Sleep

Exercise regularly. Try to do weight-bearing exercise, such as
walking, three or more times each week.
Go to sleep at a regular time each night. Make sure to get enough
sleep.

Stress

Try to limit stress and avoid things that can induce stress in life.
Go for a short walk whenever you feel anxiety or stress increasing.

Conclusion

Constipation is something that can be

avoided.

Mothers should acquire knowledge on

management of constipation.

Seeking information from health care

provider is vital in order to avoid or/and
manage constipation

Islamic Perspectives in
Complication During Pregnancy

Rasulullah (S.A.W) said: "A woman from her pregnancy

till the time of weaning her child is like one protecting
the boundaries of the Islamic state. If she passes away
during this period she attains the reward of martyrdom
(shaheed)."

Dates enrich the breast milk with all the elements

needed to make the child healthy and resistant to
disease. Modern Science has proved that dates are a part
of a healthy diet. They contain sugar, fat and proteins as
well as important vitamins. They are also rich in
natural fibres. Medical research has proven that they
are effective in preventing stomach cancer.

References
American Pregnancy Association. (2015). Constipation During Pregnancy:
Causes, Prevention And Treatment. Retrieved from
http://americanpregnancy.org/pregnancy-health/constipation-during- pregnancy/
Moulana Moosa ibn Ahmad Olgar (n.d). Pregnancy. Upbringing of Children.
Retrieved from
http://www.beautifulislam.net/family/pregnancy.htm
National Institute of Diabetes and Digestive and Kidney Diseases. (2014).
Definition and Facts for Constipation. Retrieved from
http://www.niddk.nih.gov/health-information/health-topics/digestivediseases/constipation/Pages/definition-facts.aspx
Trottier M., Erebara A., and Bozzo P., (2014). Lifestyle and Complementary
Medicine for Common Gastrointestinal Disorders in Pregnancy. The Journal of
The College of family Physicians of Canada. 8:97-99. Retrieved from
http://www.cfp.ca/content/58/8/836.full