What to know about bad heartburn while pregnant

Heartburn may feel like burning behind the breastbone, a sour taste, or fluid rising into the throat. It can be worse after meals, when bending over, or when lying down. The discomfort can be strong without meaning that the pregnancy itself is in danger.

Pregnancy hormones can relax the valve between the oesophagus and stomach. As the uterus grows, pressure inside the abdomen can also encourage stomach contents to travel back up. This is often called acid reflux; frequent reflux may be described as gastro-oesophageal reflux disease.

Large meals, eating close to bedtime, fatty or spicy foods, citrus, chocolate, caffeine, and fizzy drinks can aggravate symptoms for some people. Triggers vary, so a brief food-and-symptom note can help identify your pattern. Heartburn that starts suddenly with severe pain, vomiting, or difficulty swallowing should not simply be attributed to pregnancy.

Try smaller meals more often, eat slowly, and remain upright after eating. Avoid lying down soon after food, and raise the upper part of your body when resting if night-time symptoms are a problem. Choose loose clothing around the waist and reduce only the foods or drinks that clearly trigger your symptoms.

Do not start, stop, or borrow a medicine during pregnancy without checking with your obstetric clinician, midwife, or pharmacist. They can review your stage of pregnancy, other medicines, and medical history before recommending an antacid or another acid-reducing treatment. Tell them if symptoms continue despite lifestyle changes or regularly disturb sleep.

Seek urgent help for chest pressure or pain with breathlessness, sweating, faintness, or pain spreading to the arm, back, neck, or jaw. Get prompt medical assessment for vomiting blood, black stools, repeated vomiting, inability to keep fluids down, or food becoming stuck when you swallow.

Contact your maternity team promptly if the pain is severe or persistent, feels different from your usual heartburn, or comes with severe headache, vision changes, sudden swelling, or pain beneath the ribs. These symptoms need assessment rather than self-treatment. If you are unsure whether the sensation is heartburn or another type of pain, describe it to a clinician.

Ask which medicines are suitable at your stage of pregnancy, how often to use them, and whether they can be taken alongside your prenatal vitamins or iron. Mention any history of reflux, a hiatus hernia, gastritis, or an ulcer, and bring a list of prescribed and over-the-counter medicines.

You can also ask what symptoms should trigger same-day advice, whether another condition could explain the pain, and what follow-up is needed if the burning continues after delivery.