Severe heartburn during pregnancy: what to know

Pregnancy hormones can relax the valve between the food pipe and stomach. As the uterus grows, pressure on the stomach can also push acidic contents upward. This may cause a burning feeling behind the breastbone, a sour taste, burping, or discomfort after meals and when lying down. Heartburn is a symptom, not a diagnosis; acid reflux is one possible explanation, while gastritis, a hiatus hernia, or a peptic ulcer can cause related upper-abdominal discomfort. A symptom does not by itself identify a specific condition.

Try smaller meals, eat slowly, and remain upright after eating. Avoid lying down soon after food, and notice whether rich, spicy, acidic, or caffeinated foods trigger symptoms. Elevating the upper body during sleep may help. Drink fluids regularly, but avoid forcing large amounts with meals if that worsens fullness. Do not start an over-the-counter antacid or acid-reducing medicine without checking that it is suitable in pregnancy; a clinician or pharmacist can advise on the product and timing. Keep a short record of meals, symptoms, and night-time episodes.

Contact your maternity team or clinician promptly if symptoms are severe, frequent, worsening, or not settling with reasonable measures. Seek urgent help for chest pressure, trouble breathing, fainting, vomiting blood, black stools, severe upper-abdominal pain, repeated vomiting, or difficulty swallowing. Pregnancy-related concerns such as severe headache, visual changes, sudden swelling, or pain beneath the ribs also need urgent maternity assessment because they are not typical heartburn features.

Ask which pregnancy-safe treatment fits your symptoms, whether another cause should be checked, and what changes should prompt same-day contact. Mention any medicines, supplements, vomiting, swallowing difficulty, or pain that occurs with exertion.