Heartburn and indigestion in pregnancy: why it happens and how to ease it

A burning feeling in your chest or throat is one of the most common pregnancy complaints. Here’s why it happens, what you can try, and when to mention it.

Why does pregnancy cause heartburn?

The NHS says indigestion and heartburn happen when stomach acid irritates your stomach lining or gullet. In pregnancy, hormonal changes, your growing baby pressing on your stomach, and the muscle between your stomach and gullet relaxing can all let acid rise. It’s more likely if you had indigestion before pregnancy, if you’ve been pregnant before, and in the later stages.

What can help

Eat smaller, more frequent meals instead of three large ones, and avoid eating within 3 hours of bedtime.
Sit upright when you eat and for a while afterwards.
Cut down on caffeine, and on rich, spicy or fatty food. See caffeine in pregnancy.
Prop your head and shoulders up in bed, and consider sleeping on your left side.
Stop smoking if you smoke (your midwife or the NHS Smokefree helpline can help), and avoid alcohol. The safest approach in pregnancy is not to drink at all.

Medicines

The NHS says antacids can neutralise stomach acid and some can be bought from a pharmacist. Tell the pharmacist you’re pregnant, because some antacids aren’t suitable. Don’t take antacids within 2 hours of folic acid or iron supplements, because they can stop your body absorbing them properly. Alginates, which are also available from pharmacies, can ease reflux by stopping acid rising up your gullet. Tell the pharmacist you’re pregnant. Your GP may suggest taking these before meals or bed if symptoms keep coming back. If antacids and alginates don’t help, a GP may prescribe another medicine to reduce stomach acid.

When to get help

See your midwife or GP if diet and lifestyle changes don’t help. The NHS also says to get advice if you have difficulty swallowing, a hoarse voice, a persistent cough, swollen glands on both sides of your neck, weight loss, or pain or swelling in your stomach.

Heartburn that doesn’t go away with heartburn medicines can sometimes be a sign of pre-eclampsia, especially with a severe headache, vision problems, pain below your ribs or sudden swelling. The NHS says to call your maternity unit or NHS 111 straight away if that happens. See headaches in pregnancy.

Questions people ask

When does heartburn start in pregnancy?

NCT says heartburn and acid reflux often start after the first trimester.

Is it safe to take antacids?

Some are, and some aren’t. The NHS says to tell the pharmacist you’re pregnant, and to ask which one is suitable.

Will it stop after the birth?

It often settles after the birth. If it doesn’t, speak to your GP.