When does heartburn start during pregnancy?

There is no single week when heartburn begins for everyone. Hormonal changes early in pregnancy may relax the valve above the stomach. Later, the enlarging uterus can reduce room for the stomach, so reflux may become more troublesome after meals or when lying down. Some people notice symptoms early, while others first notice them later or not at all. Burning behind the chest, sour fluid in the throat and frequent burping fit the pattern of [Heartburn](/symptoms/heartburn/), but symptoms can have other explanations, including [Acid Reflux](/conditions/acid-reflux/).

Keep a simple record of when symptoms occur and what you ate beforehand. Try smaller meals, chew slowly and avoid lying flat soon after eating. If night symptoms occur, ask your maternity clinician about a comfortable way to raise your upper body. Avoid stopping prescribed medicines or starting over-the-counter products without advice. A pharmacist can help review pregnancy suitability, and your clinician may discuss [Acid Reflux Medication](/treatments/medical-management/acid-reflux-medication/) if lifestyle measures are not enough.

Ask for clinical advice if heartburn starts suddenly and is severe, keeps returning, prevents normal eating or affects sleep. Get urgent help for chest pressure with breathlessness, fainting, vomiting blood, black stools or trouble swallowing. During pregnancy, severe upper abdominal pain with headache, visual disturbance or sudden swelling should be assessed promptly rather than assumed to be reflux.

Does my symptom timing fit reflux? Which pregnancy-safe options can I use if it continues? Should another condition, such as [Hiatus Hernia](/conditions/hiatus-hernia/) or [Gastritis](/conditions/gastritis/), be considered?