Heartburn in the third trimester

As pregnancy advances, hormonal effects can relax the muscle between the stomach and food pipe, while the growing uterus can increase pressure around the stomach. Acid may then travel upward, causing burning, sour fluid, burping, or discomfort after meals and at night. Reflux is a common explanation, but gastritis, a hiatus hernia, or a peptic ulcer can cause similar symptoms. Heartburn does not by itself show that the baby is unwell.

Eat smaller portions more often, stay upright after meals, and avoid lying down soon after eating. Raise your upper body for sleep if your maternity team considers that comfortable and safe. Reduce foods and drinks that trigger your symptoms, and avoid tight pressure around the abdomen. Ask your maternity clinician or pharmacist before using any remedy; acid reflux medication should be chosen for your pregnancy and other medicines.

Contact your maternity team if symptoms are intense, persistent, or not relieved by recommended measures, or if you have difficulty swallowing, repeated vomiting, dehydration, black stools, or upper-abdominal pain. Seek urgent assessment for severe headache, vision changes, sudden swelling, or pain beneath the ribs, as well as chest pressure, breathlessness, fainting, sweating, or pain spreading to the arm, back, neck, or jaw.

Ask which treatment is suitable at your stage of pregnancy, whether another cause needs checking, and how to distinguish reflux from symptoms needing urgent review. Mention reduced eating or drinking, sleep disruption, and every medicine or supplement.