The common causes and remedies of heartburn during pregnancy

During pregnancy, it’s normal to experience all sorts of aches and pains throughout the nine-month-and-a-bit stretch. As anyone who’s had to deal with heartburn during pregnancy will tell you, it’s one of the more memorable pregnancy symptoms … and not in a good way.

Indigestion and heartburn aren’t quite the same thing, although it’s easy to confuse the two. While people often use the terms interchangeably to describe the burning sensation in the chest that’s commonly associated with heartburn, indigestion isn’t related to stomach acid, while heartburn is. This article won’t cover indigestion, but we’ll focus on heartburn. 

Heartburn is a symptom of both acid reflux and gastroesophageal reflux disorder (GERD), the scientific name given to the chronic form of acid reflux. But what’s the difference between heartburn, acid reflux, and GERD? “A small amount of reflux (stomach contents including acid) is considered normal,” explains Dr. Sara Twogood, a board-certified obstetrician and gynecologist. “There are often no symptoms at all. Mild symptoms related to this physiologic reflux are referred to as heartburn. The symptoms are typically described as a burning sensation, usually after eating. We use the term ‘acid reflux’ because it is the stomach acids that cause the symptoms. 

“GERD is typically both heartburn and regurgitation (the feeling that stomach contents come back up to the esophagus or mouth). When reflux causes troublesome symptoms and/or complications, that can be called GERD as well. An endoscopy (camera down the esophagus) is needed to see how severe GERD is.”

Heartburn is a common issue for women and people who menstruate, particularly during pregnancy. As one Flo user joked, “If you don’t have antacids sitting on your bedside table, are you even really pregnant?”

Try not to feel too disheartened if you experience heartburn during pregnancy. We understand that it can be incredibly challenging, but remember that you’re not alone. There are also numerous treatments available, both in terms of lifestyle changes you can make and over-the-counter medications.

With that in mind, let’s take a closer look at heartburn during pregnancy. What are the causes, and what can you do about it if you’re experiencing symptoms? Do any home remedies — which run the gamut from noshing on ice cream to elevating your head — really work? We asked Dr. Sarina Schrager, family medicine doctor and professor at the University of Wisconsin School of Medicine and Public Health, to give us the lowdown on the causes and remedies for heartburn during pregnancy.

What does heartburn during pregnancy mean?

Heartburn during pregnancy is the uncomfortable sensation of burning in the chest or throat that many people experience at some point while pregnant. Dr. Schrager explains that the condition is caused “when acidic food contents in the stomach leak up into the esophagus [the hollow tube that takes food and drink from your throat down into your stomach].” 

Heartburn during pregnancy can be extremely unpleasant. And unfortunately, it’s also very common. In fact, research has shown that when it comes to gastrointestinal symptoms during pregnancy, heartburn is one of the most common, affecting anywhere between 17% and 45% of pregnant women.

Heartburn in pregnancy is so common that pregnancy has even been named as one of the risk factors for heartburn, while another study notes that GERD is reported in up to 80% of pregnancies. In addition, acid reflux is thought to occur in around 30% to 50% of pregnancies. 

Heartburn during pregnancy will present much like heartburn at any other time does, likely beginning with a sensation of burning behind the breastbone in the chest or throat, as well as an acidic taste in the mouth. 

Frustratingly, nighttime tends to be when the condition is at its most irritating, since symptoms are often exacerbated when lying down (or bending over) or after a big meal. 

What causes heartburn during pregnancy?

According to Dr. Schrager, there are two main reasons for the elevated rates of reflux in pregnancy that can lead to heartburn: hormonal changes and increased pressure on the stomach. 

“Higher levels of progesterone (a normal hormone that is increased when you are pregnant) relaxes the sphincter, which can allow food and acid to leak out of the stomach,” she explains. The sphincter is a muscle (shaped like a tight ring) that sits at the junction between the esophagus and the stomach and normally prevents food contents from leaking back into the esophagus. 

The other reason heartburn tends to strike in pregnancy is due to the uterus getting bigger. This puts pressure on the stomach, pushing it upward and making reflux more common. 

So, when does heartburn start during pregnancy? The bad news is that it can happen at any time, although it generally tends to get worse as pregnancy continues. One study found that the prevalence of heartburn increased from 22% in the first trimester to 39% in the second trimester, rising to as high as 72% in the third. “Progesterone is high the whole pregnancy, but later in the pregnancy (second and especially third trimesters), as the uterus gets bigger and bigger, reflux is more common,” explains Dr. Schrager.

This isn’t always the case, however. Some pregnant people experience heartburn during early pregnancy (first trimester), which then goes away. Others are lucky enough to never have any heartburn symptoms at all. “Heartburn is common in pregnancy but does not affect everyone,” Dr. Schrager adds.

She notes that some people are more susceptible to indigestion and heartburn during pregnancy, and it’s more likely to affect those “who had heartburn prior to pregnancy and those who are older.” She adds that increased weight gain is another factor that could make someone more susceptible to experiencing heartburn during pregnancy.

It’s also worth noting that heartburn isn’t just an issue for pregnant people. In fact, almost every person will experience heartburn at least once in their life, while a nationwide Cedars-Sinai study from 2019 found that acid reflux (which heartburn is a symptom of) affects as many as a third of US adults every single week. So if you are experiencing heartburn during pregnancy, you can rest assured that you’re not alone.

The good news is that since it tends to occur as a result of hormones, in a majority of cases, heartburn symptoms should disappear once you’ve delivered your baby. Unfortunately, up to 20% of pregnant women continue to experience heartburn symptoms after giving birth, but there are numerous treatment options available to help that we’ll touch upon later in this article.

Symptoms of heartburn during pregnancy: What does heartburn feel like during pregnancy?

You’re likely to know if you’re experiencing heartburn during pregnancy because the symptoms are frustratingly difficult to ignore. 

According to Dr. Schrager, heartburn causes “a burning sensation in the middle of the chest and sometimes a sour taste in the back of the throat. Occasionally, people will also have pain at the top of their abdomen.”

Flo’s community of users has been candid about their symptoms and the different ways heartburn during pregnancy made them feel throughout all three trimesters. They’ve also shared some of their favorite heartburn-during-pregnancy remedies. 

Below are some anonymous user comments describing what heartburn feels like during pregnancy.

• “I’m 11 weeks pregnant, and my heartburn is so bad it is now burning my throat.” 
• “I get heartburn badly at night if I eat too close before I go to bed.”
• Some users experience severe heartburn during pregnancy, with symptoms like vomiting. 
• “Have had heartburn from the get-go … It causes me to throw up at very unexpected times.” 
• “I’ve had severe heartburn/acid reflux so bad I went to the [emergency room] twice!”

But it’s not all bad news. Heartburn during pregnancy can also be nonexistent, relatively mild, and straightforward to manage, according to Flo app users, who have described some ways they’ve dealt with heartburn during pregnancy below.

• “I started getting heartburn in my third trimester. In the beginning it wasn’t that bad, so I could ignore it, but it gets worse every week … I notice that drinking water helps, and chewing gum makes it almost go away immediately.”
• “I had heartburn every day in my third trimester. The thing I did to help reduce it was to eat smaller portions more often; avoid highly acidic, greasy, and spicy foods; and take antacids.” 

Foods that cause heartburn during pregnancy

While heartburn in pregnancy is mainly caused by hormones and a growing uterus, there is also a link between consuming certain foods and drinks and heartburn symptoms. 

“Some women have indigestion related to foods that they eat, which could also mimic the symptoms of heartburn. These symptoms are pretty classic for reflux,” explains Dr. Schrager.

If you’re dealing with indigestion and heartburn during pregnancy, there are certain foods and drinks you might want to try avoiding, according to Dr. Schrager.

• Citrus (e.g., orange juice) and tomatoes, due to their high acid content
• Coffee, which is high in acid
• Soda and other carbonated beverages, which can cause bloating

The UK National Institute for Health and Care Excellence also recommends that those who are pregnant switch up what they eat. For example, you could try avoiding acidic foods, as above, and eating smaller meals to deal with heartburn in pregnancy. 

Spicy, greasy, and fatty foods can also make heartburn symptoms worse, so you might want to think twice before ordering the takeout your pregnancy cravings have you demanding.

Heartburn during pregnancy remedies: How to avoid and relieve indigestion

Whether you’re experiencing heartburn in the first trimester or later on, you’re probably wondering if there are any solutions or home remedies for heartburn during pregnancy.

As a first step, experts tend to recommend dietary changes that include eating smaller meals, eating dinner earlier in the evening, and avoiding the known trigger foods that we’ve discussed above. 

“Limiting acidic foods, soda, and caffeine will help with symptoms,” assures Dr. Schrager. “Also, eating small, frequent meals is recommended.”

Home remedies for heartburn during pregnancy

Although people love to tout their favorite natural remedies for heartburn during pregnancy (ginger tea, anyone?), other than eating smaller meals earlier in the day and avoiding those acidic trigger foods, there isn’t much that experts recommend when it comes to home remedies for heartburn during pregnancy. In some cases, these simple lifestyle changes can make a big difference, especially for those whose heartburn symptoms flare up at night. 

“In that case, we recommend that you stop eating at least three hours before lying down and elevate the head of your bed (with pillows or blocks under the mattress),” says Dr. Schrager. “By physically elevating yourself, you can decrease the risk that the acidic material will leak upward.”

It’s also worth noting that exercising shouldn’t affect heartburn in any way.

Foods that help with heartburn during pregnancy

There are lots of foods that are rumored to get rid of heartburn during pregnancy, but there is no evidence to support their efficacy (sorry, frantically searching online for “does ice cream help heartburn during pregnancy?” won’t help this time). 

Your best bet is to avoid those trigger foods known to exacerbate symptoms, as well as eating smaller meals throughout the day and finishing your evening meal earlier.

Drinks that help with heartburn during pregnancy

You might also be wondering whether there are any recommended drinks for pregnant women that could help to alleviate the symptoms of heartburn. If so, good news: The American Pregnancy Association recommends eating yogurt, drinking a glass of milk, or adding a tablespoon of honey into warm milk as natural remedies to ease heartburn during pregnancy.  This is thought to be because milk is rich in calcium and protein, which studies have shown can reduce the risk of heartburn and reflux. 

Dr. Schrager is in favor of milk too, noting that “some women find benefit from drinking a glass of milk (with the added benefit of getting calcium) or taking over-the-counter, calcium-containing antacids.”

Medicine for indigestion and heartburn during pregnancy

Medicine for heartburn during pregnancy is available over the counter. For short-term relief, you can try antacids, which work by neutralizing the acid in your stomach to help relieve heartburn.  

Dealing with persistent heartburn symptoms? Dr. Schrager adds that there are other options available for longer-lasting relief, including “some over-the-counter medications (like famotidine, an H2 blocker, or omeprazole, a proton pump inhibitor) that are safe in pregnancy, but it is recommended that you consult your clinician before taking any of those.”

When to see a health care provider

Heartburn symptoms can be difficult to manage, and it can be understandably distressing if lifestyle changes and over-the-counter medications aren’t alleviating your symptoms. If this is the case, you may want to see your health care provider, especially if the “pain is making it hard to sleep or is severe,” says Dr. Schrager.

Heartburn during pregnancy: The takeaway

While we wish we could tell you how to avoid heartburn entirely during pregnancy, it’s a common ailment that affects anywhere between 17% and 45% of pregnant people, so it’s likely that you might experience it during this time. But with heartburn affecting almost everyone at some point in their lives, there is some comfort to be found in knowing you aren’t alone. And remember that there are numerous treatment options available to help.

There’s no way of getting around the fact that heartburn in pregnancy can be incredibly uncomfortable, causing an unpleasant burning in the chest and throat and leaving an acid taste in the mouth. Those who have it badly may even throw up. If you are experiencing these symptoms, and you need to do some venting, Flo’s community is at your fingertips, ready to listen and offer advice.

Certain foods and drinks can worsen symptoms, and making other lifestyle changes, such as eating smaller meals more often, having dinner earlier in the day, and elevating your head when lying down, can also help. Over-the-counter medicines are available but shouldn’t be used until you’ve spoken to a doctor.