<s>[INST] im 18 weeks pregnant, and i have just started passing bowel movements about 4 days ago, from where ive been really constipated. So i went and thought i had to pass a bm and it was very little but when i wiped i had blood all over the toilet paper? im scared [/INST] Hello, and I hope I can help you today.Constipation is very common during pregnancy. It is caused both by the hormones of pregnancy and some of the ingredients and prenatal vitamins.When your stool is very hard, occasionally it can cause some bleeding around the anus if a particularly large stool is passed. In addition, hemorrhoids, which are common cause of rectal bleeding, can develop during pregnancy. These are not harmful and can be diagnosed by an examination by your obstetrician.I suggest that you make sure that you drink lots of water and I recommend that you buy a stool softener or other mild laxative as these are safe to use during pregnancy. Applying petroleum jelly or hydrocortisone cream using toilet tissue after a bowel movement can help lubricate the area to help stool to pass.If you continue to bleed every time you pass stool or the bleeding becomes heavy (like seeing blood in the toilet when you have a bowel movement) it may need further investigation.Otherwise, I would take a stool softener or laxative and discuss your situation with your obstetrician at your next appointment.I hope I was able to adequately answer your question and that my advice was helpful.Best wishes for the rest of the pregnancy, Dr. Brown </s>