Heartburn and acid reflux during pregnancy

Heartburn and acid reflux are common during pregnancy. They usually occur during the second trimester, and the symptoms may intensify over time. Some women experience symptoms right from the first trimester.

What causes heartburn and acid reflux during pregnancy?

The hormones produced during pregnancy disrupt the digestive system. In addition to slowing the digestion process, they have a relaxing effect on the muscles that keep the stomach closed. At the same time, your growing baby is putting more and more pressure on your stomach. All of these factors can cause stomach fluids to rise up into the esophagus, causing heartburn and acid reflux.

How to relieve discomfort

There are a number of things you can do to help reduce the pressure of food inside your stomach, thus reducing heartburn and acid reflux.

• Make some changes to your eating habits:
  – Eat more frequently, but in smaller portions (5 to 6 meals a day)
  – Eat slowly and thoroughly chew your food
  – Drink between meals rather than while eating
  – Don’t eat or drink too much before bedtime
• Sit upright when you eat.
• After eating, wait 2 hours before taking a nap or going to bed. Avoid lying down for 30 minutes after a meal.
• Place an extra pillow or pillows under your head and shoulders when you lie down to keep your head at a 45-degree angle. You can also raise the head of your bed by about 15 cm (6 in.) by tucking pillows under your mattress.
• Wear clothes that fit loosely, especially around the waist.

What foods should pregnant women avoid to prevent heartburn and acid reflux?

The Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends that expectant mothers avoid the following foods if they’re experiencing heartburn:

• Fatty and fried foods
• Rich desserts (e.g., cheesecake)
• Spicy foods
• Onions and garlic
• Citrus fruits (e.g., oranges, grapefruit, lemons)
• Tomatoes
• Coffee and tea
• Chocolate
• Soft drinks

Make sure to eat protein-rich foods at every meal.

What to do about persistent heartburn and acid reflux

If the measures above don’t help, you can try antacids that contain calcium carbonate (e.g., Tums^®, Rolaids^®), aluminum and magnesium (Maalox^®), or alginic acid (Gaviscon^®). Consult a pharmacist or your doctor before taking them.

If you need to take an antacid, wait for about an hour after a meal. Since antacids are effective for about 2 hours, you can take a second dose 3 hours after the meal. However, avoid taking antacids with other medications, as they may decrease their effectiveness. If you take other medications and need to take an antacid, discuss it with a pharmacist or the doctor following your pregnancy.

When should you speak with an expert?

Consult your doctor or midwife in the following cases:

• Antacids provide only temporary relief, or you need to take them regularly for several days to feel better. You may be prescribed other medications.
• Your symptoms don’t improve, even when you take antacids.
• You’re also experiencing fever, nausea and vomiting, or severe headaches.

Things to keep in mind

• Pregnancy hormones and pressure on the stomach from the baby can cause heartburn and acid reflux.
• Changing certain eating habits can help prevent discomfort.
• Many antacids are safe to use during pregnancy.

Scientific review: Dr. Chantal Ouellet, physician Research and copywriting: The Naître et grandir team Updated: November 2020

Photo: iStock/skynesher