Acid reflux: an early sign of pregnancy?

Heartburn and acid reflux are very common in pregnancy, so it’s natural to wonder whether they could be an early sign. They can happen at any point, but on their own they’re not a reliable clue that you’re pregnant.

What heartburn and reflux feel like

Heartburn is a burning feeling in the middle of your chest. With acid reflux you may also get an unpleasant sour taste in your mouth, from stomach acid coming back up. Symptoms are often worse after eating, when lying down and when bending over.

In pregnancy, the NHS says indigestion can also make you feel full, heavy or bloated, burp a lot, feel or be sick, or bring food back up. Symptoms usually come on soon after eating or drinking.

Why pregnancy can cause reflux

The NHS gives three reasons it’s more likely in pregnancy:

hormonal changes
the muscles between your stomach and gullet relaxing, so stomach acid can come back up
later on, your growing baby pressing on your stomach

You’re more likely to get it if you had indigestion before you were pregnant, you’ve been pregnant before, or you’re in the later stages of pregnancy. It can happen at any point, but it’s more common from 12 weeks onwards.

Is it an early sign?

Not usually. Heartburn isn’t on the NHS list of early pregnancy signs, and it has lots of everyday causes, including:

coffee, tomatoes, alcohol, chocolate, and fatty or spicy food
smoking, being overweight, and stress and anxiety
some medicines, such as anti-inflammatory painkillers like ibuprofen
hormone changes

Often there’s no obvious cause at all. So a bout of heartburn before your period is due is more likely to be down to one of these than to pregnancy.

Signs that tell you more

If your periods are regular, a missed period is often one of the first signs of pregnancy. Other early signs the NHS lists include feeling or being sick, larger and tender breasts, feeling extremely tired, needing to pee more often, a metallic taste, being sensitive to certain smells, and cravings or going off foods you usually enjoy. Most start around 4 to 6 weeks of pregnancy, counted from the first day of your last period, so around the time your period is due or a little after. See how early can you tell you’re pregnant?

Easing heartburn if you might be pregnant

Eat little and often. Small meals more often, rather than 3 large ones. You’re more likely to get indigestion when you’re very full.
Leave a gap before bed. Try not to eat in the 3 hours before you go to bed.
Sit up straight when you eat and just after eating.
Cut down on caffeine, and on rich, spicy or fatty foods.
Don’t drink alcohol or smoke. Both can cause indigestion, and it’s safest not to drink at all in pregnancy.
Raise the head end of your bed by about 10 to 20cm, so your chest and head are above your waist. Don’t use extra pillows instead, as they can increase pressure on your belly and make symptoms worse. Sleeping on your left side can also help.

Medicines for heartburn

If changes to what and when you eat aren’t enough, a pharmacist can suggest an antacid, which neutralises stomach acid, or an alginate, which stops acid coming back up your gullet. Tell the pharmacist you’re pregnant or might be, as some antacids aren’t suitable in pregnancy. You may only need to take them when symptoms start.

Don’t take antacids within 2 hours of folic acid or iron supplements, as they can stop them being absorbed. If you’re trying to get pregnant, you should already be taking folic acid, so space them out.

If antacids and alginates don’t help, your GP may prescribe another medicine. Don’t stop a medicine you’ve been prescribed without talking to your GP first, and speak to your GP if you take medicine for another condition, such as antidepressants.

When to see a GP or midwife

See your GP, or your midwife if you’re pregnant, if you need help managing your symptoms or changes to your diet and lifestyle aren’t working. Also see them if you have:

difficulty swallowing
a hoarse voice
a cough that doesn’t get better or keeps coming back
swollen glands on each side of your neck
weight loss
pain or swelling in your stomach

If your symptoms are getting worse, contact your GP or call NHS 111.

Chest pain: when to call 999

Heartburn usually comes on after eating, often with a sour taste or bringing food up. But chest pain can have other causes, and a heart attack can feel like burning or indigestion. Call 999 if:

you get sudden pain or discomfort in your chest that doesn’t go away. It can feel like squeezing or pressure inside your chest, burning or indigestion
the pain spreads to your left or right arm, or your neck, jaw, stomach or back
you have chest pain and you feel sweaty, sick, light-headed or short of breath

If you’re pregnant and you suddenly feel breathless, are out of breath when lying down, or are breathless with chest pain or dizziness, get checked straight away. Contact your GP or early pregnancy unit, or call NHS 111. Call 999 if you have any of the chest pain symptoms above.

See a GP if you have chest pain that comes and goes, or goes away quickly but you’re still worried.

When to test

If you could be pregnant, a test will tell you far more than any symptom.

Some early tests can be used from 5 days before your period is due (the packet may say ‘6 days before your missed period’), but they won’t pick up every pregnancy that early. Testing from the day your period is due is more reliable, though a negative can still be wrong if there isn’t enough hCG yet. If your period doesn’t come, test again a few days later.

If you don’t know when your period is due, test at least 21 days after you last had unprotected sex.

Questions people ask

Can heartburn be a sign of pregnancy before a missed period?

It’s possible to get heartburn at any point in pregnancy, but it isn’t one of the recognised early signs and it has lots of other causes. The NHS says it’s more common from 12 weeks onwards. If you might be pregnant, a test is the way to find out.

When does pregnancy heartburn usually start?

It can start at any point, but it’s more common from 12 weeks and in the later stages of pregnancy, when your baby is pressing on your stomach.

What can I take for heartburn if I might be pregnant?

Ask a pharmacist. They can suggest an antacid or alginate that’s suitable in pregnancy. Tell them you might be pregnant, and take it at least 2 hours apart from folic acid or iron.

Does sleeping position help with reflux?

It can. Raising the head end of your bed by about 10 to 20cm helps stop acid coming up while you sleep. The NHS advises against using extra pillows instead, and says sleeping on your left side can help in pregnancy.

When to get help

Mild cramps that ease with rest are usually nothing to worry about. But if you’re pregnant, or think you could be, get urgent advice from your maternity unit, an early pregnancy unit or NHS 111 if you have:

any bleeding or spotting, even if it’s light
tummy pain that’s severe, on one side, or hasn’t eased after resting for 30 to 60 minutes
pain in the tip of your shoulder

Call 999 if you have bleeding along with severe tummy pain, pain in your shoulder, or feeling sick, faint or dizzy, or if the bleeding is heavy (soaking a pad soon after putting it on). Also call 999 if you have sudden, sharp and intense tummy pain and you feel very dizzy or faint, feel sick or look very pale. These can be signs of an ectopic pregnancy or a miscarriage that need treating straight away.