Extreme Heartburn While Pregnant: What to Know

Heartburn is a burning feeling behind the breastbone that may rise towards the throat. It can occur after meals, when bending over, or when lying down, and may come with a sour taste or fluid coming back into the mouth.

During pregnancy, hormones can relax the muscle between the food pipe and stomach. As the uterus grows, pressure on the stomach can also encourage stomach contents to move upwards. These changes may make reflux more frequent or more uncomfortable, especially later in pregnancy.

Severe symptoms can also occur with acid reflux or, less commonly, another digestive problem such as gastritis, a hiatus hernia, or a peptic ulcer. Heartburn-like chest discomfort can sometimes have a cause outside the digestive system, so describe the sensation clearly to a clinician.

Try smaller meals, eat slowly, and remain upright after eating. Avoid lying down soon after a meal, and notice whether spicy, fatty, acidic, or caffeinated foods make symptoms worse. Raising the head of the bed may help symptoms that disturb sleep; use a safe arrangement that keeps your body supported rather than adding loose items under the mattress.

Speak with your obstetric clinician, midwife, or pharmacist before taking an antacid or other medicine. They can recommend an option appropriate for pregnancy and check for interactions with supplements or prescribed medicines. Do not stop a prescribed medicine without advice.

Arrange medical advice if heartburn is persistent, repeatedly wakes you, makes eating difficult, or does not improve with simple measures. A clinician may review your symptoms, medicines, and pregnancy history and decide whether further assessment is needed.

Seek urgent care for chest pressure or pain with breathlessness, faintness, sweating, or pain spreading to the arm, jaw, or back. Get prompt assessment for vomiting blood, black stools, trouble swallowing, severe abdominal pain, repeated vomiting, or symptoms with a severe headache, vision changes, sudden swelling, or pain under the ribs.

You could ask: Could another condition be causing these symptoms? Which food and drink changes are most useful for me? Which heartburn medicines are suitable during my pregnancy? Should I change the timing of any iron, vitamin, or other medicine? What symptoms mean I should contact the maternity unit urgently?