Heartburn During Pregnancy

More than one-half of all pregnant women report symptoms of severe heartburn, particularly during their second and third trimesters. Heartburn, also called acid indigestion, is an irritation or burning sensation of the esophagus caused by stomach contents that reflux (comes back up) from the stomach.

Heartburn in pregnancy may occur because of changing hormone levels, which can affect the muscles of the digestive tract and how different foods are tolerated. Pregnancy hormones can cause the lower esophageal sphincter (the muscular valve between the stomach and esophagus) to relax, allowing stomach acids to splash back up into the esophagus. In addition, the enlarged uterus can crowd the abdomen, pushing stomach acids upward.

Prevention and Treatment of Heartburn During Pregnancy

To reduce heartburn during pregnancy without hurting your baby, you should try the following:

• Eat several small meals each day instead of three large ones.
• Eat slowly.
• Avoid fried, spicy or rich foods, or any foods that seem to cause relaxation of the lower esophageal sphincter and increase the risk of heartburn.
• Drink less while eating. Drinking large amounts while eating may increase the risk of acid reflux and heartburn.
• Don't lie down directly after eating.
• Keep the head of your bed higher than the foot of your bed. Or place pillows under your shoulders to help prevent stomach acids from rising into your chest.
• Ask your doctor about using medications such as Tums or Maalox, which are generally safe to use during pregnancy. You may find that liquid heartburn relievers are more effective in treating heartburn as they coat the esophagus.
• Wear lose-fitting clothing. Tight-fitting clothes can increase the pressure on your stomach and abdomen.

If your heartburn persists, see your doctor. He or she may prescribe medications that are safe to take during pregnancy. Heartburn usually disappears following childbirth.

Reviewed by the doctors at The Cleveland Clinic's Department of Obstetrics and Gynecology (2006).