Heartburn during pregnancy and what to do about it

One of the most common pregnancy symptoms is heartburn.¹ Also referred to as acid reflux, gastroesophageal reflux disease or indigestion, heartburn affects up to 75 percent of all soon-to-be birthing parents.²

Heartburn often feels like a burning sensation in the chest, explains Maggie Tetrokalashvili, MD, FACOG, FACS, chairperson of the department of obstetrics and gynecology at NYC Health + Hospitals/South Brooklyn Health.³  This feeling may be accompanied by regurgitation or a sour taste.⁴ “Some of the acid or food goes from the stomach to the mouth, which is very uncomfortable,” she says.⁵

Here’s the good news: You can do plenty of things to find relief. Read on to learn more about the causes of heartburn, some ways to avoid it and when to see a health care provider.

In this article:

• What causes heartburn during pregnancy?
• Lifestyle changes for heartburn relief support
• OTC products for heartburn relief support
• Other products for heartburn relief support
• When should you contact a health care provider?

What causes heartburn during pregnancy?

A muscle called the lower esophageal sphincter, located at the end of your esophagus, helps close the esophagus when it’s not in use.⁶ If it doesn’t clamp down properly, food and acid from the stomach can leak back into the esophagus or mouth. That irritation is what you feel as heartburn.⁷

During pregnancy, shifting hormones can cause the process to go a little haywire. One cause can be the increase in progesterone,^8,9 a hormone made by the ovaries and the placenta. This can cause the esophageal sphincter to relax as well as slow down digestion.^10,11

“Food stays in the stomach longer,” says Mascha Davis, MPH, RDN, registered dietician, nutritionist and author of Eat Your Vitamins.¹² “This can increase the likelihood of stomach acid refluxing into the esophagus.”

Your expanding belly also has an effect. “As the baby grows, the uterus exerts more pressure on the stomach,” says Davis. “This can push stomach contents, including stomach acid, up.”¹³ Acid reflux typically peaks in the third trimester as the uterus gets larger. The reflux goes away after the baby is born.^14,15

Lifestyle changes for heartburn relief support

“There is no good way to prevent reflux in pregnancy,” says Denise Tukenmez, MD, interim department chair of obstetrics, midwifery and gynecology at Alameda Health System in California.¹⁶ Luckily, however, “there are many ways to treat reflux and help pregnant women feel better,” she says.

A first line of defense is often lifestyle changes:

• Avoid certain foods and drinks. Sometimes the stomach wants what it wants during pregnancy. But do your best to avoid citrus, fatty foods and spicy meals, notes Dr. Tetrokalashvili.¹⁷ Carbonated beverages and caffeine can also make reflux worse.¹⁸
• Raise your head in bed. Along the same lines, propping your head and neck up with a pillow can help keep stomach contents moving in the right direction. “Raising the head of your bed six to eight inches can also be helpful,” Dr. Tukenmez advises.¹⁹
• Sleep on your left side. “The left lateral position helps the uterus to move away from the intestines and opens up the digestive system,” says Dr. Tetrokalashvili.²⁰
• Stay upright after eating. “It is recommended to wait at least three hours after eating before lying down to prevent stomach acid from flowing back into the esophagus easily,” says Davis.²¹
• Try small, frequent meals. Since pregnancy slows digestion down, eating large meals can open the door to reflux.²²

OTC products for heartburn relief support

When lifestyle changes aren’t doing the trick, over-the-counter (OTC) medications can help.²³ Keep in mind that it’s always a good idea to check with a health care provider before taking any new OTC drugs, especially during pregnancy.

One of the options you might discuss with your health care provider is the use of antacids. Antacids are medications that work by helping to neutralize stomach acid.²⁴ “Generally, we advise taking the calcium carbonate–containing antacids,” says Dr. Tetrokalashvili.²⁵

CVS Health^® extra-strength antacid tablets, CVS Health ultra-strength antacid soft chews and TUMS antacid extra-strength chewable tablets all have this active ingredient.

Other products for heartburn relief support

Some people may be looking for relief support without taking medications. One good investment may be a sturdy wedge-shaped pillow. Elevating the head has been shown to reduce symptoms of acid reflux.²⁶

You might consider Avana bed wedge acid reflux memory foam pillow or Skil-Care anti-reflux wedge.

Calcium found in low- or nonfat yogurt or skim milk may help ease symptoms of heartburn. Research shows ginger may also help speed up digestion and improve nausea and vomiting, both of which are related to heartburn.^27,28 But you should avoid ginger in high doses. Check with your health care provider about these and other options.

When should you contact a health care provider?

If you’re experiencing heartburn during pregnancy, don’t wait to bring it up with your doctor, midwife or health care provider. Chest pain, heart conditions, preeclampsia (a high blood-pressure disorder experienced during pregnancy) and other serious conditions require immediate medical intervention. These symptoms are often mistaken for heartburn.^29,30 “Seeking the attention of a physician is always the right thing to do, even with mild symptoms,” advises Dr. Tetrokalashvili.