Pregnancy is a beautiful journey, but it often comes with some uncomfortable side effects. One of the most common complaints among expecting mothers is acid reflux. Many women who have never experienced heartburn before suddenly find themselves dealing with a burning sensation in their chest, sour taste in their mouth, or even persistent coughing. Up to 80% of pregnant women experience reflux symptoms by the third trimester, with estimates ranging from 30% to 80% overall. While usually not dangerous, it can affect quality of life and sleep. This post will explore why acid reflux and GERD is so common during pregnancy, what symptoms to watch for, and practical ways to find relief.
In pregnancy, the body produces large amounts of progesterone (and estrogen), which relax smooth muscles—including the lower esophageal sphincter (LES). A relaxed LES allows stomach acid to flow back into the esophagus, causing heartburn. Hormonal changes can have an influence on reflux during pregnancy.
As the uterus expands, it pushes on the stomach, increasing pressure and making it easier for acid to escape into the esophagus.
You may experience a combination of the following:
Symptoms are often worse after large meals, lying down, or during the third trimester.
These methods are both safe and supported by medical guidance:
Split your food intake into five to six smaller meals instead of three large ones. This prevents your stomach from stretching too much and compressing the LES.
Everyone is different, so keep track of what seems to cause problems for you and adjust accordingly.
Gravity is your friend when it comes to preventing reflux. Try to stay upright for at least an hour after eating. Avoid lying down or reclining right after a meal.
If nighttime heartburn is an issue, try raising the head of your bed by about six to eight inches. You can do this by placing sturdy blocks under the bedposts or using a wedge pillow (wedge pillows are usually better). Propping up with regular pillows is less effective since it tends to bend your body at the waist, which can actually increase pressure on your stomach.
Tight garments can compress your abdomen and worsen reflux. Opt for loose, comfortable clothes.
Drinking during meals can increase stomach volume. Instead, drink throughout the day between meals.
Chewing sugar-free gum increases saliva production, which helps neutralize and wash away acid.
Chewable antacids like calcium carbonate (Tums) are typically considered safe during pregnancy. They have the added benefit of providing calcium, and they do not cross the placenta, making them a low-risk option. Avoid antacids containing sodium bicarbonate, as they can cause fluid overload or metabolic alkalosis.
Important: Antacids can interfere with iron or folic acid absorption. Take them separately and follow dosage instructions.
If antacids are not enough, an H2-blocker such as famotidine (Pepcid) can help. These medications reduce acid production and are considered safe when used under medical guidance during pregnancy.
PPIs like omeprazole (Prilosec) or lansoprazole (Prevacid) are also regarded as safe for short-term use during pregnancy. However, they are stronger and slower to take effect, so they are usually considered only after other options have failed.
Talk to your healthcare provider if you experience:
These symptoms may indicate a complication requiring medical evaluation.
For most women, acid reflux greatly improves after the baby is born. Hormone levels return to pre-pregnancy levels and abdominal pressure diminishes, allowing the LES to regain its usual tone
Acid reflux during pregnancy is common and usually manageable with safe strategies:
Always consult your healthcare provider before starting any new medication or if symptoms persist. Using these evidence-based methods, you can reduce discomfort and focus on enjoying this special time.
Note: This article is not medical advice. Please consult a medical professional if you believe you are being impacted by acid reflux or GERD.
