Almost eight out of 10 pregnant women develop heartburn during their pregnancy. The heartburn may or may not accompany indigestion and acidity during pregnancy. Many women experience heartburn for the first time during pregnancy. It’s common and harmless, but it can be painful. Serious complications are rare, although it may be associated with severe nausea and vomiting, and the condition usually resolves soon after delivery.
In some studies [1], the prevalence of heartburn has been found to increase from 22% in the first trimester of pregnancy to 39% in the second trimester to between 60% and 72% in the third trimester.
Understanding heartburn
Heartburn is a burning sensation that often extends from the bottom of your breastbone up to your lower throat. It happens when acid from your stomach is brought up into your food pipe (oesophagus). The acid may flow back up (reflux) into your throat or mouth, leaving a sour and bitter taste.
What causes heartburn in pregnancy?
Hormonal and physical changes in your pregnant body during pregnancy can cause temporary symptoms such as heartburn and acidity (or even acid reflux.)
An increase in the hormone progesterone when you’re pregnant relaxes the smooth muscles of your womb (uterus). Experts believe this hormone also relaxes the valve that separates your food pipe from your stomach. This allows gastric acids to seep back up your food pipe, causing a burning sensation.
Progesterone also slows down the wave-like contractions of your stomach, making your digestion sluggish.
In later pregnancy, your growing baby pushes your intestines and stomach upwards. This slows digestion and forces acids up from your stomach into your gullet.
How common is heartburn during pregnancy and when will it stop?
Heartburn is very common when you’re pregnant, particularly in mid-pregnancy to late pregnancy. Many mums-to-be start getting heartburn and indigestion in the second half of pregnancy, although it’s not unheard of to get it before then.
About one-third of pregnant women experience heartburn as early as the first trimester, rising to two-thirds by the third trimester.
Try not to worry about coping with heartburn after your baby’s born. The symptoms will disappear once you give birth.
Self-help tips for heartburn in pregnancy
For Pregnancy Heartburn Relief
The main triggers for heartburn are eating, lying down and bending over. If you can work out which activities make your heartburn worse, you can try to avoid them.
Although you may not be able to eliminate heartburn entirely, some of the following may give you some pregnancy heartburn relief:
- Choose food and drink that’s easy to digest. That means skipping rich, high-fat or spicy dishes, chocolate, citrus fruits or juices, alcohol and coffee.
- Eat little and often. This leaves less time for acid to build up in your stomach, as food neutralises stomach acid.
- If you smoke, try to stop. Smoking relaxes the valve between your stomach and gullet, making acid reflux more likely to happen. Smoking is also harmful to your baby.
- Bending over or a slumping posture can make the symptoms worse. Try to sit up straight and stay upright for at least an hour after eating.
- If your heartburn is worse at night, try not to eat or drink anything but water in the three hours before you go to bed.
- Raise the head of your mattress by a few inches (around 10 cms) with some cushions or rolled-up towels. Or place a sturdy object, such as wood or concrete blocks, under the head end of the bed itself. Make sure the bed is steady and safe before you get in. Gravity will help keep your stomach acids where they should be and aid your digestion. Avoid propping yourself up with pillows as this can put undue pressure on your abdomen.
- Certain medicines for other conditions can make heartburn worse, for example antidepressants and non-steroidal anti-inflammatory drugs. Check with your doctor if you’re concerned about your medication.
If none of these treatments eases your symptoms, contact your doctor. (S)he may be able to suggest another course of action.
Could my heartburn be something else?
Possibly, but it depends on where the pain is and whether you have other symptoms:
Heartburn pain usually travels up behind your breastbone to your throat. If instead you have a sharp pain located in the top of your belly below your ribs, it could possibly be a sign of pre-eclampsia. If you’re at all unsure, contact your doctor.
Sometimes, the symptoms may indicate a liver problem related to your pregnancy or even a digestive problem unrelated to pregnancy, such as a peptic ulcer. If unresolved, it is best to talk to your doctor.
Medical References: [1] Heartburn in pregnancy; Juan C Vazquez, Specialist in Obstetrics and Gynecology and Assistant Professor in Obstetrics and Gynecology; Published online 2015 Sep 8; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4562453/