Colace vs Miralax during pregnancy

How do the options compare?

Options are compared on ACOG or MotherToBaby endorsement, size and quality of pregnancy-specific studies, dosing predictability, time-to-effect, and side-effect profile: the same axes an obstetric clinician would use.

• Docusate softens stool by helping water and fats penetrate it, but the effect is slow: stool softening typically occurs 12 to 72 hours after starting it, and multiple systematic reviews have found little measurable benefit once constipation has already started. 1
• The current MiraLAX Drug Facts label describes an adult dose of 17 grams in 4 to 8 ounces of beverage once daily, a usual bowel movement within 1 to 3 days, and no more than seven days of self-directed use. The label directs pregnant users to a health professional. 2
• The American Academy of Family Physicians considers polyethylene glycol the drug of choice for chronic constipation in pregnant women, since its minimal systemic absorption makes severe fetal effects unlikely even though pregnancy-specific research is limited. 3
• At recommended doses, docusate sodium is unlikely to raise the chance of birth defects, preterm delivery, or low birth weight above the background rate, though a case report linked maternal overuse to low magnesium in a newborn. 4
• Osmotic laxatives like polyethylene glycol are not well absorbed by the intestine, so very little of the medication is expected to reach the pregnancy. 5

Which option makes sense?

A comparison can include options that should be avoided or considered only in specific circumstances. Please consult your healthcare provider about the findings and cautions that apply to you.

Disclosure: Pregnancy Smart makes supplements that overlap with some options above. This comparison describes the evidence, not our own product; where our formulation is relevant it is named.