A: Constipation is another one of nature’s unfortunate gifts to women during pregnancy. Progesterone levels increase during pregnancy, slowing down the function of your gastrointestinal tract. Changes in your diet, in addition to stress, lack of exercise and even prenatal vitamins may also contribute to the problem. If you are having hard and painful bowel movements, you may be helped by the following recommendations.

1. Drink adequate fluids—at least 8 cups of water daily in addition to other beverages you enjoy. Include a glass of water before going to sleep.

2. Eat high-fiber foods such as whole grains, fresh fruits and vegetables, dried fruits, beans and prune juice. Eat at least 3 tablespoons of bran a day.

3. Many women have success eating oatmeal with supplemental oat bran every morning. Purchase the oat bran separately and add this to your cereal while cooking.

4. Stool softeners and bulking agents are fine, but many common laxatives are not recommended in pregnancy. For stool softeners to work, you must be drinking plenty of fluid.

5. Exercise regularly, such as walking or swimming for 30 minutes a day.

6. Iron supplements, or prenatal vitamins containing iron can contribute to constipation. Some iron and prenatal supplements also contain a stool softener, and may be helpful. Discuss your options with your health care provider.