Coping With Heartburn During Pregnancy

Symptoms, causes, treatments, and complications

Heartburn is a common discomfort during pregnancy. Between 40 and 80 percent of women have symptoms of heartburn, indigestion, or acid reflux while they’re expecting. It can start anytime during pregnancy, but it’s more common in the second and third trimester as the baby grows.

Here’s what you need to know about the symptoms, causes, and complications of heartburn in pregnancy, along with tips for dealing with it.

how to prevent heartburn during pregnancy
Illustration by Brianna Gilmartin, Verywell

About Heartburn

It may burn, but it doesn’t have anything to do with your heart. Heartburn happens when food and acid from your stomach move back into your esophagus (the tube that goes from the back of your mouth to your stomach).

It doesn’t hurt when the acid is in your stomach because the cells that make up the stomach lining are meant to hold acid and the enzymes that break down food. But, the lining of the esophagus is more sensitive than the lining of the stomach. So, when what's in the stomach backs up into the esophagus, it causes irritation that feels like a burning sensation. And, even though it’s in your gastrointestinal (GI) tract, the spot of the burning feels like it’s near your heart, which gives it the name of "heartburn." It’s sometimes called acid reflux or indigestion, too.

Symptoms

Heartburn usually comes on after meals, and it’s often worse at night or when you’re lying down for a nap. When the acid flows back into the esophagus, it can go all the way up to the back of the throat and cause these symptoms: 

The symptoms of heartburn can go away in just a few minutes or last a few hours. Be sure to talk to your doctor about any symptoms you’re experiencing, so they can determine if it's heartburn. 

Causes

Many parts of the body go through changes during pregnancy, including your digestive tract. When you’re expecting a baby, your body makes more of the hormones progesterone and relaxin.

Progesterone causes the stomach to empty more slowly after you eat while relaxin calms or relaxes the smooth muscle in your body. The ring, or sphincter, around the bottom of the esophagus that keeps the food and stomach acid in your stomach is made up of smooth muscle.

Because of these hormones, the food stays in the stomach longer, and can more easily back up into the esophagus. Additionally, as the weeks go on and your belly gets bigger, your expanding uterus and growing baby begin to put pressure on your stomach. This pressure can push the contents of the stomach past the weakened sphincter and up into the esophagus, also leading to heartburn.

Of course, you can get heartburn during pregnancy for the same reasons you might get heartburn when you aren’t carrying a child. Other things that cause heartburn are: 

  • Overeating
  • Spicy foods
  • High-fat foods and processed meats
  • Citrus fruits and juices
  • Tomatoes
  • Chocolate, caffeine, and soda or other drinks with carbonation
  • Smoking
  • Alcohol
  • Obesity
  • Certain medications
  • Stress

Complications

Heartburn can cause discomfort and interfere with sleep, but it's usually not dangerous. Serious complications of heartburn during pregnancy are rare. However, heartburn can become a concern if there are other things going on along with it. Your doctor will look into your condition more carefully and monitor you and the baby more closely if: 

Tips for Coping

If you're suffering from heartburn, there are some things you can do to try to prevent it or to ease the discomfort once it starts. Here are some of the ways to cope with heartburn during pregnancy.

  • Watch the weight gain: Try to stay within the guidelines for weight gain that your doctor recommends. Excessive weight gain can put additional pressure on your stomach and make heartburn worse. 
  • Stay away from foods that cause discomfort: If you notice you have heartburn after eating fried, spicy, or gassy foods, avoid them as much as possible.
  • Eat smaller meals: Instead of having three large meals, try eating smaller portions more often. You can also pack healthy snacks or small healthy meals in your bag when you leave the house so you can keep up with eating throughout the day. 
  • Drink enough fluids: Have eight to ten 8-oz glasses of water or other healthy beverages each day, but limit caffeine and sugary drinks. 
  • Avoid restrictive clothing: Clothes that are tight around your waist can put pressure on your stomach. 
  • Do not lay down or go to bed immediately after eating: It’s more likely the food will back up if you lay down on a full stomach. Instead, sit up for a while to allow your body to digest. 
  • Use gravity to your advantage: Sleep on an incline with an extra pillow or a wedge to keep your head elevated and the food down.   
  • Bend down with your knees: Bending over at the waist can put pressure on your stomach and put your body in a position where the stomach contents can move up into the esophagus. If you bend at the knees and keep your body upright, you can help keep the food down.
  • Pay attention to your posture: Slouching and bending over puts pressure on your stomach, so try to sit up straight and walk with your shoulders back to give your stomach more room and keep your esophagus in an upright position.  
  • Reduce stress and get enough rest: Stress and fatigue can make heartburn worse. Try to rest when you can and use meditation, mild exercise, listening to music, or other techniques to help you relax your body.
  • Don’t smoke or drink alcohol: It’s not only bad for heartburn, but it’s also bad for you and your baby.
  • Try an alternative treatment: Studies show acupuncture may help to provide relief from heartburn during pregnancy.
  • Ask your doctor about taking a safe antacid: If you’re getting heartburn often and you’re very uncomfortable, talk to your doctor. She can recommend or prescribe something for you. You can even carry it in your purse, so you have it with you when you need it.

Medication During Pregnancy

When natural treatment options aren’t enough, you may need something more to deal with the heartburn. Talk to your doctor at your next prenatal visit or call the office if you can’t wait for relief. There are over-the-counter antacids and prescription medications that you may be able to take. Your health care provider can recommend or prescribe a safe medicine to treat heartburn or reflux depending on your symptoms. 

The go-to products to relieve heartburn during pregnancy are: 

Calcium Carbonate

Antacids containing calcium carbonate work immediately to neutralize acid on contact. Calcium antacids also give you extra calcium. The popular brands of calcium carbonate are:  

Magnesium Hydroxide and Aluminum Hydroxide

The combination of magnesium hydroxide and aluminum hydroxide work together to neutralize stomach acid and ease heartburn. This type of medication is considered safe during pregnancy and includes brands such as: 

Other types of medicines that treat heartburn include: 

H2 Blockers

H2 receptor antagonists block histamine in your body and cause your stomach to make less acid. The drugs in this category are considered safe to take during pregnancy. Your doctor can give you a prescription, or you can get them over-the-counter. If you choose to use an OTC medicine you should still talk to your doctor first. H2 blockers are: 

Proton Pump Inhibitors (PPI)

Proton pump inhibitors block the proton pumps in the stomach and stop them from making acid. They are considered low risk during pregnancy, however, long-term use of PPIs is not advised as they can lead to B vitamin deficiencies and calcium insufficiency in pregnancy. If you need a PPI, your doctor can advise you on which one to choose and the dose to take, or she can write you a prescription. The PPI’s you may be familiar with are:

Other

Carafate (sucralfate) is a prescription that coats the esophagus and the stomach to protect it from acid. It contains aluminum, but the GI tract does not absorb aluminum well, so it’s considered safe to use during pregnancy.

Antacids You Shouldn’t Take

You should always read the labels and ask your doctor before using OTC medicines, herbs, or home remedies while you’re pregnant. Even though it may seem like something should be safe, it isn’t always. Some conventional treatments for heartburn that you shouldn’t use during pregnancy are: 

A Word From Verywell

You probably won't be able to get through your entire pregnancy without a little heartburn. But, while it may be annoying, leave you with a bad taste in your mouth, or disrupt your sleep, it’s usually not harmful. You can try your best to prevent it, and then take steps to cope with it when it pops up. With the advice and assistance of your doctor, you'll get through it. You may even accept dealing with occasional indigestion or heartburn just to indulge in a meal you’ve been craving, and that’s OK, too. Then, once your baby is born, your belly shrinks back down, and your hormones return to the way they were before your pregnancy, the heartburn should go away.

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