- Diane Sanfilippo | New York Times bestselling author of "Practical Paleo" and "The 21-Day Sugar Detox" | Home of the Balanced Bites Podcast - http://balancedbites.com -

Troubleshooting Your Digestive Issues: Tips for Common Digestive Issues in Pregnancy (part 4)


Hey everyone! This week’s installment of the Troubleshooting your Digestive Issues series is written by a paleo Registered Midwife, Meghanne Reburn. I figured it’s best to leave this topic to her, since she’s an expert – enjoy!  – Diane 


Pregnancy can be an all around awesome time a woman’s life. I always find it magical to watch the body change, as it grows a new little person. Unfortunately, some of the hormonal adaptations during pregnancy can wreak havoc on your digestive system, causing a plethora of annoying discomforts.

In this post, I’ll explore three of the most common gastrointestinal problems women experience during pregnancy and offer some natural paleo-friendly solutions to these annoying problems.



Yup, I’m going to start by talking about poop! It’s a common problem, with around 40% of women experiencing constipation at some point during their pregnancy. Pregnancy related constipation occurs because your body produces more of the hormone progesterone. Progesterone’s main job during pregnancy is to act as a smooth muscle relaxant.

From an evolutionary perspective, having extra progesterone when growing a baby is a really good thing. Ensuring that the muscular uterus is chilled-out by the mellowing effects of progesterone helps your body maintain the pregnancy and prevent you from going into premature labour.

Now, back to your poop…

Your bowel normally moves stool and waste products along through a process known as peristalsis. This is when the muscles that line the bowel contract and relax in a rippling, wave-like motion. The pregnancy mediated increase in progesterone makes it more difficult for the bowel muscles to contract, thus making it harder to move stool along. Contrary to what your mom may have told you, pregnancy related constipation isn’t caused by lack of dietary fiber. In fact, increasing your fiber intake with bulk causing substances, such as, flax seeds or psyillium may actually make the problem worse!

Here are a few suggestions that may help get things moving:


Heartburn is another common discomfort is also caused by our friend, progesterone. This time progesterone’s muscle “chillaxing” effects work on your esophageal sphincter, the muscle at the top of your stomach that holds your stomach acid in place. When this muscle relaxes, the acid that is naturally present in your stomach can be forced up and into your esophagus, causing painful heartburn.

It’s important to understand that you’re not over producing acid in your stomach, you’re just having a hard time keeping it in the right place! Most women seem to complain of heartburn during the second and third trimesters as your growing baby is displacing your stomach upwards and literally squeezing acid up and into the ‘discomfort zone’.

I generally don’t encourage the use of antacids or acid reducing medications or supplements. Reducing your stomach acid will only do you a digestive disservice by causing sub-optimal digestion and reduced nutrient assimilation.

Instead, try these simple suggestions:

Nausea and Food Aversions

Up to 90% of women experience some form of food aversion, nausea or vomiting during their pregnancy. Only 1:5000 will experience nausea and vomiting that becomes a clinical health risk, but for the vast majority of women, nausea and food aversions are limited to the first trimester and are manageable with easy adaptations.

By far the most common food aversion women experience is aversion to proteins. From an evolutionary perspective, this makes perfect sense. In fact, evolutionary biologist, Margie Profet, proposes that nausea during pregnancy evolved as a protection against toxins and other dangerous substances that could harm the developing embryo [1].  In ancestral times, meats aka proteins had greatest chance of harboring bacteria and parasites. In addition to protein aversion, my clients have also noted food aversions to spicy and smoked foods, which is an interesting observation, as the flavors in these foods can easily mask the taste and smell of meat turned bad. The body is so SMART!

I hear from women all the time who have been following a Paleo diet, rich in quality protein sources. Most of them find this new aversion to protein troubling and worry about possible malnutrition during this period. My first word of advice is don’t worry! Simply focus your attention on food QUALITY rather than stress about calorie levels or macronutrient percentages.  You only need 200 extra calories during pregnancy, which is a far cry from the common belief that you are ‘eating for two’. It’s really about 1.1. Your body is smart and produces certain hormones that actually make it easier to acquire and store nutrients from your foods during pregnancy.  Your baby will get what it needs to grow, and your hunger will return in a few weeks so just chill and do your best.

Nausea tends to be exacerbated when our blood sugars get low. During pregnancy your blood sugars tend to run on the high side in order to ensure a good supply of energy to your growing baby, so nausea can also be seen as a signal that your baby needs more fuel. It’s important to not let yourself get too hungry and when you do eat, choose something lower on the glycemic index with lots of nutrient dense fats.

Here are some foods that seem to be better tolerated during the first trimester:

Give these tips a try, do your best by sticking to a clean Paleo diet and remember to RELAX! So much of how our gut’s function has to do with how we manage stress! A little bit of chill time can go a long way.


Parts in this Series:

Part 1: Signs & Symptoms of Digestive Upset

Part 2: How to Improve Overall Digestion Function

Part 3: Specific Recommendations for Constipation & Diarrhea

Part 4: Tips for Common Digestive Issues in Pregnancy



[1] Profet, Margie (1992). “Pregnancy Sickness as Adaptation: A Deterrent to Maternal Ingestion of Teratogens”. In Barkow, Jerome; Cosmides; Tooby, Leda. The Adapted Mind: Evolutionary Psychology and the Generation of Culture. Oxford University Press.


About the author:

headshot_MeghanneRMeghanne Reburn is a practicing Registered Midwife with a BScH (Hons) in Midwifery and a special interest in Paleo/Primal nutrition and lifestyle. Meghanne has delivered hundreds of babies both at home and in hospital and has additional training in both naturopathic and homeopathic medicine. She takes an evolutionary approach to her practice, believing that when properly cared for, the body has innate wisdom to care for and heal itself.

Meghanne spent her formative years living and working amongst the Canadian Rocky Mountains and is an avid backcountry skier, climber and trail runner. In 2010, friends introduced her to the Paleo diet. With a history of gluten intolerance, going Paleo was an easy transition. After giving up all processed ‘gluten free goodies’ and grains she noticed almost instant improvements to her health, athletic performance and overall wellbeing.  Meghanne became a member of the Weston. A. Price Foundation and took it upon herself to learn how the Paleo diet could help optimize fertility and support women during pregnancy and breastfeeding.

Meghanne has a new blog called CaveGirl Plus One, where she writes about Paleo friendly pregnancy topics and plans to offer private nutrition and lifestyle counseling focused around woman in their childbearing years.