รูปแบบการจัดการภาวะท้องผูกโดยไม่ใช้ยาในสตรีตั้งครรภ์ครรภ์แรก: การทบทวนวรรณกรรมแบบบูรณาการ

Satjaporn Thamawong; Thitaree Disapirom

Authors

Satjaporn Thamawong Department of Obstetrics Nursing and Midwifery, Boromarajonani College of Nursing, Chon Buri
Thitaree Disapirom Department of Obstetrics Nursing and Midwifery, Boromarajonani College of Nursing, Chon Buri

Keywords:

Integrative review, Management, Constipation, Pregnant women

Abstract

Constipation during pregnancy is a common condition that adversely affects maternal quality of life. It can be identified based on the presence of at least two of six clinical criteria, including fewer than three bowel movements per week, hard stools, and straining during defecation. The condition is multifactorial, involving physiological changes, health behaviors, and psychological factors. Although certain laxatives may be considered safe under professional supervision, most clinical guidelines recommend non-pharmacological approaches as the first-line management due to their safety for both mother and fetus. However, in the Thai context, care for constipation in pregnant women remains fragmented, lacks integration, and is not guided by a clear evidence-based model, leading to inconsistencies in nursing practice.

This integrative review aimed to synthesize empirical evidence on non-pharmacological management models for constipation in pregnant women from 2016 to 2025. A systematic search was conducted using PubMed/MEDLINE, CINAHL, BASE, ThaiJO, TDC, and Google Scholar. The quality of included studies was appraised using the Mixed Methods Appraisal Tool (MMAT), and data were analyzed using thematic analysis.

A total of five studies met the inclusion criteria, all of which employed quantitative designs. The findings identified four key components: 1) assessment and symptom monitoring, 2) education and self-regulation, 3) health behavior modification, and 4) safe complementary approaches. These components can be utilized as a framework for developing care for constipation in pregnant women, emphasizing non-pharmacological interventions as the first-line approach and integrating them into antenatal care services to enhance the quality of nursing care and improve maternal quality of life.

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