Lately, I’ve been feeling a terrible burning sensation in my chest after eating. Is it heartburn? Most likely. Many women experience heartburn for the first time during pregnancy, and although it is common and generally harmless, it can be quite uncomfortable.
What is heartburn?
Heartburn (also called acid indigestion or gastroesophageal reflux) is a burning sensation that often extends from the bottom of the sternum to the lower part of the throat and is caused by hormonal and physical changes in your body.
What happens during pregnancy?
During pregnancy, the placenta produces the hormone progesterone, which relaxes the smooth muscle of the uterus. This hormone also relaxes the valve that separates the esophagus from the stomach, allowing stomach acid to leak upward, which causes the unpleasant burning sensation of heartburn.
Progesterone also slows the wave-like contractions of the esophagus and intestines, making digestion slower. Later in pregnancy, the growing baby increases pressure on the stomach, pushing acids back into the esophagus.
Many women begin to feel heartburn and other gastrointestinal discomforts during the second half of pregnancy.
How to manage it?
- Avoid foods and drinks that cause discomfort, such as alcohol, caffeine, chocolate, and mint-containing products. Also, avoid acidic foods like citrus fruits and juices, tomatoes, mustard, and vinegar. Stay away from processed meats, fried foods, fatty foods, and spicy meals.
- Do not eat large meals. Instead, eat several small meals throughout the day. Take your time eating and chew well.
- Avoid drinking large amounts of fluids during meals. (It is important to drink 8–10 glasses of water daily during pregnancy, but drink them between meals.)
- Try chewing gum after eating. Gum stimulates saliva production, and saliva can help neutralize acid.
- Do not eat right before bedtime. Give yourself two to three hours to digest before lying down.
- Sleep with your upper body elevated. Raise the upper part of your body to keep stomach acids where they belong and to aid digestion.
- Wear loose, comfortable clothing. Avoid anything tight around the waist and abdomen.
- Bend at the knees instead of at the waist.
- Do not smoke. Besides the serious health problems it causes, smoking increases stomach acidity.
If these measures do not help, talk to your doctor about prescription heartburn medications that are safe to use during pregnancy.
When heartburn starts in pregnancy and how long it lasts
It can appear as early as the first trimester, but it becomes more frequent and more intense after week 20 and peaks in the third trimester. By the end of pregnancy, up to eight in ten pregnant women report it. It almost always subsides within a few days after delivery.
As for the well-known myth that heartburn means the baby will have a lot of hair: there is no cause-and-effect relationship. The same hormones that relax the esophageal sphincter simply appear to also be linked to fetal hair growth.
Natural remedies: what really helps
- Milk or yogurt: a small glass of milk or a little yogurt gives many women temporary relief.
- Almonds: a few raw almonds after a meal.
- Ginger: as a tea or fresh, it also helps with nausea.
- Sugar-free gum for half an hour after eating, not mint-flavored.
- Sleeping on your left side with your upper body raised by 15 to 20 centimeters.
Avoid baking soda. It contains a lot of sodium, promotes fluid retention and the relief it gives is short-lived. Also avoid herbs and “natural” products of unknown composition.
Which heartburn medications are safe in pregnancy
When dietary changes are not enough, there are medications that can be used safely. Your doctor will choose the right one.
- Antacids with calcium or magnesium, and alginates: first choice. They act locally and form a protective layer on top of the stomach contents.
- H2 blockers and proton pump inhibitors: for persistent symptoms, only on medical advice.
Do not take antacids at the same time as iron, because they reduce its absorption. Leave at least two hours in between.
Heartburn or something else? When to call your doctor
Simple heartburn is harmless for you and your baby. Contact your doctor, however, if:
- the pain is high in the abdomen, below the ribs, especially on the right, and does not go away with antacids,
- it comes with a severe headache, blurred vision or sudden swelling of the face and hands,
- you have difficulty swallowing, are losing weight or are vomiting blood,
- your stools are black.
In the second half of pregnancy, persistent pain in the upper abdomen can, rarely, be a sign of preeclampsia. Read more about high blood pressure in pregnancy and about abdominal pain in pregnancy.
Foods that trigger and foods that soothe heartburn
- Usually make it worse: fried and fatty foods, chocolate, coffee, carbonated drinks, citrus fruits and juices, tomatoes and sauces, spicy foods, vinegar, mint, raw onion and garlic.
- Usually well tolerated: oats, bananas, melon, boiled vegetables, rice, lean chicken and baked fish, yogurt, whole-grain bread.
Every woman has her own “culprits.” A short food diary for a few days will show you which foods bother you. More ideas in the guide to foods for pregnancy.
Heartburn in the first trimester: when it comes with nausea
Most women associate heartburn with late pregnancy, but quite a few get it in the first weeks. Progesterone rises sharply, the stomach empties more slowly and heartburn gets confused with nausea, one of the earliest pregnancy symptoms.
The distinction matters in practice. Nausea often improves with something in your stomach, while heartburn gets worse with large meals and lying down. In many women the two occur together and each makes the other worse: vomiting irritates the esophagus and reflux intensifies nausea. Small, dry snacks, such as crackers or rusks, help with both. If you are vomiting so often that you cannot keep even water down, contact your doctor the same day.
Which pregnant women are more likely to get heartburn
Any pregnant woman can get heartburn, but certain factors increase the likelihood and intensity:
- reflux or gastritis before pregnancy,
- heartburn in a previous pregnancy,
- a twin or multiple pregnancy, where the uterus grows larger,
- increased amniotic fluid, which is detected on obstetric ultrasound,
- large weight gain during pregnancy,
- smoking.
If you belong to any of these groups, start making changes to your diet and posture early, before symptoms appear.
A day without heartburn: a practical plan
General advice helps most when it becomes a daily routine. An example:
- Morning: a glass of room-temperature water and a light breakfast, such as oats with milk or yogurt and a banana. Coffee, if you drink it, after eating and not on an empty stomach.
- Midday: a moderate portion, for example grilled chicken with rice and boiled vegetables. Eat sitting down and slowly, and do not lie down right afterward.
- Afternoon: a small snack, such as a few almonds or a low-acid fruit, and a ten-minute walk.
- Evening: a light dinner at least two to three hours before bed. Avoid sauces, fried foods and chocolate desserts.
- Before bed: upper body raised and sleeping on your side. If your doctor has recommended an antacid for the night, this is the time to take it.
Antacids and other medications: watch for interactions
Antacids act locally, but they affect the absorption of other medications you take at the same time. Besides iron, this also applies to other products commonly prescribed in pregnancy:
- Thyroid hormone: its absorption is reduced when taken together with antacids or calcium. It needs a gap of several hours.
- Calcium supplements: many antacids already contain calcium. Tell your doctor so that you do not take more than you need.
- Certain antibiotics: are affected by the minerals in antacids.
- Low-dose aspirin: if it has been prescribed for you, take it after eating, because it can irritate the stomach. Do not stop it because of heartburn without talking to your doctor.
The right gap between medications depends on the product. Ask your doctor or pharmacist and make a simple dosing schedule.
Myths about heartburn in pregnancy
- “Milk cures heartburn.” A small glass gives temporary relief. A large amount of whole milk, however, stimulates acid secretion, and heartburn can come back stronger.
- “Lemon water alkalizes the stomach.” In practice, citrus fruits make symptoms worse in many women.
- “Antacids harm the baby.” The products recommended in pregnancy act locally in the stomach and are barely absorbed. They can be used safely after consulting your doctor.
- “If I follow a diet, it will go away completely.” Diet reduces symptoms, but in the third trimester pressure from the uterus plays a big role. If you need medication, you have not failed.
Heartburn after delivery and while breastfeeding
In most women, heartburn disappears within a few days after giving birth. If it continues for weeks, there may have been reflux before pregnancy, or it may have another cause, such as gastritis, and it needs to be evaluated. During breastfeeding, most antacids are considered compatible, but start any medication only after talking with your doctor.
How to describe your symptoms to your doctor
A clear description helps your doctor tell simple heartburn apart from other conditions. For a few days, note:
- when the heartburn starts and how long it lasts,
- whether it is linked to specific meals or to lying down,
- whether it wakes you at night or causes a cough and hoarseness,
- exactly where it hurts: behind the breastbone or high in the abdomen, below the ribs,
- what you have tried and whether it helped.
Pain below the right ribs that does not feel like burning always needs a blood pressure check and a medical evaluation.
Heartburn and exercise: which movements help and which make it worse
Movement helps digestion, but some exercises put pressure on the stomach and trigger heartburn. A few simple rules let you keep exercising without discomfort.
- A gentle ten- to fifteen-minute walk after eating speeds up stomach emptying.
- Wait one to two hours after a main meal before more intense exercise.
- Avoid exercises that involve bending forward or having your head lower than your stomach, as well as lying flat on your back on the floor right after eating.
- Swimming and prenatal yoga in standing or seated positions are usually well tolerated.
- Drink water in small sips while exercising, not large amounts in one go.
Frequently Asked Questions
Why do I have heartburn in pregnancy?
Progesterone relaxes the valve between the stomach and the esophagus and slows digestion. Later, the growing uterus presses on the stomach and pushes acid upward.
Does heartburn harm the baby?
No. It is unpleasant for the mother but does not affect the fetus.
What can I do about heartburn at night?
Eat your last meal two to three hours before lying down, raise the head of your bed and sleep on your left side. If that is not enough, ask your doctor about an antacid before bed.
Can I take antacids during pregnancy?
Antacids with calcium or magnesium and alginates are considered safe. Ask your doctor about the product and dose, and do not take them together with iron.
When does heartburn go away?
In most women it subsides within a few days after delivery, once hormone levels drop and the uterus stops pressing on the stomach.
Can heartburn cause a cough or hoarseness?
Yes. When acid rises high into the esophagus, especially at night, it can irritate the larynx and cause a dry cough, morning hoarseness or a feeling of a lump in the throat. Raising your head while sleeping and eating dinner earlier usually help. If the cough persists, tell your doctor.
Can I drink chamomile or other teas for heartburn?
A cup of chamomile or ginger tea is usually fine and can settle the stomach. Peppermint tea is best avoided, because it relaxes the stomach valve and makes reflux worse. Herbal blends of unknown composition are not recommended in pregnancy.
Are all antacids the same?
No. They differ in ingredients and side effects: some make constipation worse, others cause soft stools, and some contain a lot of sodium. That is why the product is chosen after consulting your doctor, based on your symptoms and the other medications you take.
How do I tell heartburn apart from pain that needs to be checked?
Heartburn is a burning feeling behind the breastbone that is linked to eating or lying down and improves with an antacid. Pain high in the abdomen or below the right ribs that does not go away, or that comes with a headache, blurred vision, swelling or vomiting, needs a medical evaluation the same day.
