GUIDE
Progesterone relaxes the valve between your stomach and esophagus, while your growing uterus pushes stomach contents upward — causing acid reflux.
Heartburn is one of the most common pregnancy complaints, affecting more than half of all pregnant people. It tends to worsen as pregnancy progresses but responds well to dietary changes and safe over-the-counter treatments.
Be prepared from day one
Pregnancy heartburn is a burning sensation that rises from the stomach into the chest and sometimes the throat. It can feel like a hot pressure behind the breastbone, often accompanied by a sour or bitter taste in the back of the mouth. Some people describe it as feeling like something is stuck in their chest.
Two things cause heartburn to be so common in pregnancy. First, progesterone — the hormone that keeps the uterus relaxed — also relaxes the lower esophageal sphincter, the muscular valve that normally keeps stomach acid from flowing back up. Second, as the uterus grows, it pushes the stomach upward and compresses it, physically forcing acid into the esophagus.
Heartburn affects an estimated 17 to 45 percent of people in the first trimester, rising to 50 to 80 percent by the third trimester. It is not harmful to your baby, but it can be genuinely miserable — especially at night when lying down removes gravity's help.
Some people notice mild heartburn as early as the first trimester, when progesterone levels start climbing. However, heartburn most commonly becomes a regular problem in the second trimester and peaks during the third trimester as the uterus reaches its largest size.
The third trimester is often the worst because the mechanical pressure from the uterus is greatest. By mid-pregnancy, many people are already noticing occasional reflux. By weeks 28 to 40, it may be a nightly occurrence.
The good news: pregnancy heartburn typically resolves quickly after delivery, once progesterone levels drop and the uterus is no longer compressing the stomach.
A combination of dietary changes, timing adjustments, and safe over-the-counter remedies can make a significant difference. Most providers recommend starting with lifestyle modifications before adding medication.
Large meals fill the stomach and increase pressure on the lower esophageal sphincter. Eating 5 to 6 smaller meals throughout the day keeps the stomach from becoming overly full and reduces the chance of acid washing back up into the esophagus.
Wait at least 2 to 3 hours after eating before lying down. Gravity helps keep stomach acid where it belongs. If nighttime heartburn is your biggest issue, elevate the head of your bed by 6 inches using blocks or a wedge pillow — stacking regular pillows is less effective.
Common heartburn triggers include spicy foods, citrus, tomato-based sauces, chocolate, caffeine, carbonated drinks, and fatty or fried foods. You do not have to eliminate all of these — pay attention to which ones bother you and reduce those specifically.
Tums are considered safe in pregnancy and are often the first OTC recommendation. They neutralize stomach acid quickly and provide supplemental calcium. Follow the dosing on the label and avoid exceeding the maximum daily dose, as too much calcium can cause constipation.
Tight waistbands and clothing that compresses the abdomen can worsen reflux by putting additional pressure on the stomach. Opt for maternity pants with stretchy waistbands and loose-fitting tops, especially after meals.
Chewing sugar-free gum for 30 minutes after eating increases saliva production. Saliva is naturally alkaline and helps neutralize acid in the esophagus. This simple habit can provide surprising relief, especially after lunch or dinner.
These symptoms can occasionally signal something that needs medical attention. When in doubt, call.
Pregnancy heartburn almost always resolves after delivery — most people notice dramatic improvement within days of giving birth. In the meantime, it is very manageable with the right combination of dietary changes and safe treatments.
If your heartburn is severe, do not suffer through it. Your provider has safe options including H2 blockers (like famotidine) and proton pump inhibitors that can make the last weeks of pregnancy much more comfortable.
You may also find our guides on pregnancy constipation and morning sickness helpful, as digestive symptoms often overlap during pregnancy. If you are also dealing with trouble sleeping because of reflux, check out our pregnancy insomnia guide for positioning tips that can help with both issues. For managing pregnancy cravings that may trigger reflux, and weight gain guidance to support your nutrition throughout pregnancy, we have guides on those as well.
This guide is for informational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider with any questions about your pregnancy.
