Dealing with the many discomforts of pregnancy is common, and constipation is near the top of the list. So, what is the best stool softener during pregnancy? The best choice depends on your health and symptoms. In general, docusate sodium (Colace) and bulk-forming laxatives like psyllium (Metamucil) or polycarbophil (FiberCon) are often suggested because they have good safety records. These options either soften stool or add fiber to make stool easier to pass, without stimulating the bowels strongly. Always talk with your healthcare provider before starting any medicine, even over-the-counter products, during pregnancy.
Constipation during pregnancy-fewer than three bowel movements a week-affects up to 38% of pregnant women. Causes include hormone changes that slow digestion, a growing uterus pressing on the bowels, and iron supplements, which can make constipation worse. While uncomfortable, this usually does not harm you or your baby. Many safe, effective choices exist, from daily habits to certain over-the-counter medicines.
Are stool softeners safe during pregnancy?
Medication safety is a top concern during pregnancy. For stool softeners, most doctors agree they are usually safe. They work mostly in the gut and are barely absorbed into the bloodstream, so very little reaches the baby.
Still, “safe” does not mean “use without guidance.” Always speak with your provider. Even with over-the-counter options, a doctor or midwife can help you pick what fits your health needs and stage of pregnancy.
General safety profile of stool softeners
Stool softeners with docusate sodium or docusate calcium pull water into the stool so it’s softer and easier to pass. This is why they are often chosen in pregnancy. Unlike stimulant laxatives, they do not trigger bowel contractions. Also, very little of the active ingredient gets into your bloodstream, so exposure to the baby is low.
Research on docusate use in the first trimester has not shown a higher risk of birth defects. This supports its use for mild constipation or prevention, especially for those taking iron.
Stool softener categories: FDA pregnancy ratings
The FDA no longer uses letter grades for pregnancy, but the risk profile still matters. Docusate is generally considered low risk due to minimal absorption. Bulk-forming laxatives (fiber supplements) are also usually safe because they are not absorbed at all. They work inside the gut to bulk or soften stool.
Other options, like osmotic laxatives (polyethylene glycol/Miralax or magnesium hydroxide/Milk of Magnesia), are also generally fine for occasional use with your provider’s okay. Medicines that act locally in the gut and are barely absorbed are usually preferred during pregnancy.
When to consult your healthcare provider
Even if a product is sold without a prescription, talk with your provider before using it. This includes over-the-counter medicines, herbal products, and big diet changes. Your doctor or midwife can look at your medical history, current medicines, and symptom severity to guide you.
This is especially important in the first trimester, when the baby’s organs are forming. Also, seek help if diet and lifestyle steps (more fiber, fluids, and activity) aren’t working, or if you have strong pain or bleeding. Your healthcare team can check for other causes and keep you and your baby safe.
Which stool softeners are considered the best during pregnancy?
Choosing the “best” option is about safety, gentle action, and what works for you. Many providers suggest docusate sodium and bulk-forming laxatives first. Polyethylene glycol (Miralax) is also a common choice for more stubborn constipation. The aim is relief without extra risk for you or your baby.
Knowing how each product works helps you talk with your provider and pick the right plan for your situation.
Docusate sodium: Efficacy and safety overview
Docusate sodium (Colace) is often recommended in pregnancy because it is gentle and has a strong safety record. It lets more water and fat mix with stool, making it softer. It does not make the intestines contract, which helps reduce straining.
Docusate is barely absorbed, so little reaches the baby. It usually works within 12 to 72 hours. It is a good option for mild constipation or prevention, including if iron is causing the issue.
Polyethylene glycol (Miralax): Is it recommended?
Polyethylene glycol (PEG 3350, Miralax) is an osmotic laxative that pulls water into the colon to soften stool and help it pass more often. It is typically used when constipation is more persistent.
The American College of Obstetricians and Gynecologists (ACOG) says PEG is safe during pregnancy. It has minimal absorption and usually works within 24 to 72 hours. Use it for tougher cases and with your provider’s guidance.
Bulk-forming laxatives: When to use them
Bulk-forming laxatives are often the first choice, even before stool softeners. Examples include psyllium (Metamucil, Konsyl) and polycarbophil (FiberCon, Equalactin). They soak up water to form a bulky, soft stool and help you go regularly, much like dietary fiber.
The main advantage is safety: they are not absorbed. They work only in the gut. They’re good for prevention and mild constipation but need enough water to work well and can take 2 to 3 days to show full effect. Gas, bloating, or cramping can occur. If you use them, drink plenty of fluids.
Comparison: Colace vs. Miralax for pregnant women
Both Colace (docusate) and Miralax (PEG) are generally safe in pregnancy, but they work differently.
| Feature | Colace (docusate) | Miralax (PEG 3350) |
|---|---|---|
| Type | Stool softener | Osmotic laxative |
| Main action | Moistens and softens stool | Draws water into the colon to increase bowel movements |
| Best use | Prevention or mild, occasional constipation; reduces straining | More stubborn constipation when softeners aren’t enough |
| Onset | 12-72 hours | 24-72 hours |
| Absorption | Minimal | Minimal |
| Use length | Short-term daily use is often fine | Occasional use with provider guidance |
Bottom line: Colace is helpful to prevent constipation or manage mild symptoms. Miralax is better for active treatment when you need more help. Do not combine them or use either long-term without checking with your provider.
Which stool softeners and laxatives should be avoided in pregnancy?
Some products are not a good idea in pregnancy because of how they work or the risk they carry. Avoid options that may trigger uterine contractions, cause big shifts in electrolytes, or have unknown effects on the baby. When unsure, check with your provider first.
Risks of stimulant laxatives (senna, bisacodyl)
Stimulant laxatives like senna (Senokot) and bisacodyl (Dulcolax) make the bowel contract. In pregnancy, they are used carefully and usually avoided unless a doctor recommends them. The worry is that they could trigger uterine contractions, especially at high doses or with long use.
They can also cause cramping, dehydration, and low potassium or sodium. While occasional use has not clearly been tied to birth defects, most providers prefer gentler options. If used at all, they should be short term and supervised.
Why castor oil and mineral oil are not recommended
Two products to skip during pregnancy are castor oil and mineral oil.
Castor oil is a strong stimulant laxative and can trigger uterine contractions. It has been used to start labor, so it should not be used for constipation in pregnancy.
Mineral oil can block the absorption of vitamins A, D, E, and K, which are important for you and your baby. There is also a small risk of aspiration if inhaled by mistake, and it has been linked to bleeding problems in newborns. Avoid both of these during pregnancy.
Potential side effects and risks to the baby
Any product that causes severe dehydration or big electrolyte changes in the mother can affect the baby. While docusate and bulk-forming laxatives have low absorption, allergies or sensitivities can still happen.
Stronger laxatives that are absorbed or that change bowel function a lot could, in theory, pose risks, especially in the first trimester when organs form. Watch your symptoms and call your provider if anything feels wrong. The goal is safe relief without new problems.
How to safely use stool softeners while pregnant
After you and your provider decide a stool softener is right for you, safe use matters. Pick the right product, follow the dose, watch for side effects, and know when to ask for help. Aim for the lowest dose that works for the shortest time needed to protect you and your baby.
Even though many options are sold over the counter, pregnancy calls for extra care. Your doctor or midwife is the best source for advice.
Recommended dosages and duration of use
Follow dosing directions and timing closely. For docusate sodium (Colace), adults often use 50 to 300 mg per day, split into one to three doses. Start low and increase only if needed with your provider’s input. It may take 12 to 72 hours to work.
For bulk-forming laxatives like psyllium (Metamucil) or polycarbophil (FiberCon), follow the label. These are often powders mixed with water. Be sure to drink plenty of fluids during the day to avoid blockages or worse constipation. They can take a few days to show full benefit. For polyethylene glycol (Miralax), the common dose is 17 grams in a drink once daily. Follow the package or your provider’s instructions, and avoid long-term use unless your provider approves it.
Recognizing side effects or allergic reactions
Even safe medicines can cause side effects. Common mild effects include gas, bloating, or mild cramps. These often fade with time.
Serious symptoms need quick care. Signs of allergy include hives, rash, itching, swelling of the face, tongue, or throat, severe dizziness, or trouble breathing. If these occur, stop the product and get emergency help. Call your doctor if you have strong or lasting belly pain, rectal bleeding, or if your constipation gets worse or does not improve after several days.
When to seek medical advice
Call your healthcare provider if:
- Constipation does not improve after several days of use.
- You have strong belly pain, cramping, or heavy bloating.
- You see blood in your stool or have rectal bleeding.
- You develop diarrhea or big changes in bowel habits.
- You think you are having an allergic reaction or other worrisome side effects.
- You’re unsure about continuing a product or symptoms return after stopping it.
Your healthcare team can adjust your plan, check for other causes, and keep your approach safe and effective during pregnancy. Reach out with any concerns.
Frequently asked questions about stool softeners in pregnancy
Pregnancy brings many questions, especially about medicines. Here are clear answers to common questions on stool softeners in pregnancy. Always follow your provider’s advice for your situation.
Knowing these basics can help you make good choices with your healthcare provider.
Can stool softeners harm my baby?
For commonly used options like docusate sodium, the answer is reassuring: harm is unlikely. Docusate works in the gut and is barely absorbed, so very little reaches the fetus.
Bulk-forming laxatives are not absorbed at all, making them very safe choices. No medicine is 100% risk-free, but evidence and long experience support these options during pregnancy when used as directed and with medical guidance. Avoid stimulant laxatives and mineral oil, which carry more risk.
How quickly do stool softeners work?
They are not instant. Docusate often takes 12 to 72 hours. Bulk-forming laxatives usually take 2 to 3 days to reach full effect. Miralax tends to work within 24 to 72 hours. These products are better for ongoing management or prevention, not urgent relief. For faster help, ask your provider about other steps.
Do I need a prescription for pregnancy-safe stool softeners?
Many pregnancy-safe options are sold over the counter: docusate sodium (Colace), psyllium (Metamucil), polycarbophil (FiberCon), polyethylene glycol (Miralax), and magnesium hydroxide (Milk of Magnesia).
Even so, speak with your provider before you start. They can confirm the right product and dose for you, check for interactions with your other medicines or supplements, and look for other causes of constipation so your care is complete and safe.
Key takeaways for choosing the best stool softener during pregnancy
Handling medicines during pregnancy takes care and teamwork with your provider. There is no single best choice for everyone. Pick safe, gentle options and keep both your comfort and your baby’s safety in mind.
Start with daily habits: drink enough water, eat fiber-rich foods (fruits, vegetables, whole grains), and stay active as your provider allows. These simple steps can reduce or even remove the need for medicine.
If you still need help, options with low absorption are usually preferred. Docusate and bulk-forming laxatives are common first picks. For tougher cases, polyethylene glycol (Miralax) is often used. These work mainly in the gut with very little reaching the baby.
Avoid stimulant laxatives, castor oil, and mineral oil during pregnancy because of risks like uterine contractions, poor vitamin absorption, or electrolyte problems. Knowing what to skip helps you choose safer options.
In the end, the best choice is the one your provider recommends for your needs. They will weigh benefits and risks based on your history and pregnancy. With clear information and support from your care team, you can find safe, effective relief from constipation during pregnancy.