Heartburn during pregnancy

Pregnancy is a major physical upheaval that can come with certain unpleasant side effects. Among them: heartburn! Very common in pregnant women, it’s not very pleasant. What causes it? How can you relieve it?

Heartburn during pregnancy: we’ll tell you everything.

What is heartburn, and why is it so common during pregnancy?

Heartburn is also known as acid reflux or gastroesophageal reflux (GERD). GERD is the backflow of part of the stomach’s contents into the esophagus. Heartburn can range from mild discomfort to pain that makes daily life very unpleasant. This pain can sometimes be felt behind the breastbone. For some women, reflux can even affect sleep (insomnia, trouble falling asleep…).

GERD symptoms include:

• A burning sensation or pain in the upper abdominal (epigastric) area.
• Acid reflux occurring without nausea or retching, usually after meals.
• Digestive discomfort, such as hiccups or repeated burping.

In pregnant women, the origin of this phenomenon is both mechanical and hormonal:

• The size of the uterus, which increases in proportion to your baby’s growth, plays a role in the onset of heartburn. The more the uterus expands, the more it puts pressure on your stomach.
• Progesterone, the “relaxation” hormone whose production gradually increases during pregnancy, makes the lower esophageal sphincter (the muscle that closes the top of the stomach) less toned. And if it is less toned, it will have trouble acting as an anti-reflux valve. Stomach acid then ends up rising into the esophagus and irritating the lining, creating a burning sensation (called pyrosis).

In addition to progesterone, other hormones (such as relaxin) can disrupt the digestive system. Digestion slows down and stomach acid lingers in the stomach, which contributes to the burning sensation.

Want to learn more? Feel free to download the May app, where you’ll find plenty of resources to support and guide you throughout your pregnancy.

When does heartburn appear? Is it more common at certain stages of pregnancy?

As with many pregnancy symptoms, its onset and intensity vary and can be very different from one woman to another.

Heartburn generally appears during the second trimester of pregnancy, but for some women it may begin as early as the first trimester, or not appear at all (which is what we wish for you). Still, note that more than half of pregnant women may be affected, especially during the last months of pregnancy.

In late pregnancy, the uterus reaches its maximum size and compresses the stomach more. The baby’s position, often higher in the abdomen, increases this pressure. The result: acid reflux becomes more frequent and more intense, especially when lying down.

How can you adjust your diet if you have heartburn during pregnancy?

Did you know? To relieve heartburn, the first step is to pay attention to your diet. Whether it’s the choice of foods or the way you eat them, here are a few tips to try to reduce acid reflux.

Heartburn: foods to avoid

Certain foods can promote GERD during pregnancy. By limiting their consumption, you can also reduce heartburn. Here are a few examples:

• very rich or spicy dishes, which are difficult to digest,
• simple sugars,
• certain dairy products, such as full-fat cheeses,
• coffee (which contains caffeine) because it promotes relaxation of the sphincter,
• citrus fruits,
• very sugary carbonated beverages (i.e., sodas),
• alcohol (which should not be consumed at all during pregnancy).

Heartburn: foods to choose

If there are foods to avoid, there are also foods that are great for reducing heartburn. Here are a few:

• blanched almonds,
• pineapple (fresh or juice at room temperature),
• apples,
• legumes or high-fiber foods,
• starches, preferably with a low glycemic index (flour, semi-whole/whole pasta and rice),
• fresh parsley,
• boiled potatoes,
• raw carrots,
• fish,
• lean meats (chicken),
• eggs,
• ginger,
• cinnamon,
• a yogurt or a glass of milk at the end of the meal.

Heartburn: splitting up meals

In addition to these ingredients to limit or favor, some eating habits can also help prevent heartburn:

• Eat smaller amounts (avoid heavy meals), even if that means splitting up your meals—in other words, eating more often but less each time—eat slowly (chew well), and save your glass of water for after the meal.
• Try not to lie down right after eating. Stay upright for at least 1 hour (a post-meal walk is a great idea!).
• In the morning, on an empty stomach, drink the juice of half a lemon diluted in a little sparkling water, or in a little warm or hot water if you prefer.
• During the day, drink sparkling waters or waters high in bicarbonates, preferably outside of meals.
• Avoid drinking a large amount of liquid all at once (especially in the evening).

How can you effectively treat heartburn during pregnancy?

If, despite dietary changes, your heartburn continues, you can turn to other natural remedies. When nothing works, your midwife or doctor can also prescribe certain medications. In all cases, starting a treatment should be discussed during a visit with the healthcare professional following your pregnancy.

Heartburn: natural treatments

As we’ve seen, heartburn treatment starts first with lifestyle and dietary measures. That said, certain natural remedies can calm acid reflux. We’re thinking in particular of herbal teas (licorice, ginger…) used for their anti-inflammatory properties, or marshmallow root, since it forms a protective barrier on mucous membranes that limits irritation.

You can also:

• Place a warm heating pad on your stomach.
• Elevate your head while sleeping by adding extra pillows in your bed.
• Do physical activity (prenatal yoga) or relaxation activities (acupuncture or sophrology).
• Certain essential oils can also be considered, provided you get medical advice beforehand, as some are contraindicated during pregnancy.

Heartburn: approved medications

If your heartburn persists despite lifestyle and dietary measures, taking certain medications may be considered to help calm it. When treatment is necessary, your doctor may prescribe one of the following: antacids such as Gaviscon (a stomach-coating agent that relieves heartburn), or PPIs (proton pump inhibitors) such as esomeprazole or omeprazole.

Be careful not to self-medicate, and consult your doctor, OB-GYN, or midwife for more information and the correct dosage!

Can heartburn be dangerous for the baby?

Heartburn is not and cannot be dangerous for your baby. It also reflects the progression of your pregnancy. In the vast majority of cases, heartburn is a benign symptom. It becomes concerning when it is accompanied by other symptoms, but it cannot be considered dangerous in and of itself.

Who should you see, and when, in case of persistent reflux?

When lifestyle and dietary measures and antacids fail to relieve you, or only provide temporary relief, we encourage you to consult your healthcare professional, as a new medication treatment may be prescribed to improve your GERD.

See your midwife or doctor if your heartburn is accompanied by fever, nausea, regurgitation or headaches in order to get a diagnosis!

Heartburn is a benign but unpleasant gastric issue during pregnancy. Although it often ends up easing after a few habit changes, it’s important to consult a doctor or midwife as soon as it becomes too uncomfortable for you.

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Photo credit: voronaman111 | micens | kjekol | LightFieldStudios

This text was translated from French by an artificial intelligence. The information, advice, and sources it contains comply with French standards and may therefore not apply to your situation. Make sure to complement this reading by visiting the May US/UK app and consulting the healthcare professionals who are supporting you.