acid reflux in pregnancy

Overview

Acid reflux happens when stomach acid flows back up into the food pipe (the oesophagus). This can cause a burning feeling in the chest or throat, often called heartburn. During pregnancy, hormone changes and pressure from the growing baby can make it more likely.

Yes. Many pregnant people experience acid reflux at some point. It is especially common after the first trimester, when the growing uterus begins to press on the stomach.

Acid reflux can affect anyone during pregnancy. You may be more likely to get it if you have had heartburn before becoming pregnant, are in the later stages of pregnancy, or are pregnant with more than one baby.

Symptoms

Common symptoms

• A burning feeling in the chest or throat, sometimes called heartburn
• A sour, bitter, or acidic taste in the mouth
• Feeling overly full or bloated after meals
• Belching or burping more than usual
• Nausea or an upset stomach
• A cough or a hoarse voice, especially at night

Symptoms in children

• Not applicable — this article is about acid reflux in pregnancy.

Symptoms in older adults

• Not applicable — this article is about acid reflux in pregnancy.

Causes

Main causes

• Pregnancy hormones, especially progesterone, relax the valve at the bottom of the food pipe, so stomach acid can flow backwards.
• As the baby grows, the uterus pushes upward on the stomach, which can force acid into the food pipe.
• During pregnancy, digestion slows down, so food and acid stay in the stomach for longer.

Risk factors

• Being in your second or third trimester
• Having acid reflux or heartburn before pregnancy
• Carrying twins, triplets, or more
• Being overweight before or during pregnancy
• Eating large meals, or lying down right after eating
• Drinking caffeinated or fizzy drinks, or eating spicy or fatty foods

When to see a doctor

See a doctor urgently if:

• If you have emergency symptoms listed above, call your local emergency number now.
• If you have severe vomiting or cannot keep fluids down, seek same-day medical care.

Book a routine appointment if:

• If your heartburn is frequent and does not get better with diet and lifestyle changes
• If it disturbs your sleep or makes everyday activities difficult
• If you are worried about any symptom and want to check it with your midwife or doctor

Diagnosis

Your doctor or midwife will usually diagnose acid reflux by listening to your symptoms and asking about your medical history. In most cases, no tests are needed during pregnancy.

Tests that may be done

• Usually there are no tests — the symptoms are clear enough to diagnose.
• If symptoms are severe or unusual, your doctor might recommend a small tube test (called pH monitoring) or an endoscopy to look inside your food pipe. These are rarely needed in pregnancy.
• Sometimes you may be checked for other conditions that can cause similar symptoms.

What to expect at your appointment

Your doctor or midwife will ask questions about when your symptoms happen, what makes them better or worse, and whether they affect your eating or sleep. You can then talk together about safe ways to manage your reflux.

Treatment

Treatment for acid reflux in pregnancy focuses on relieving your symptoms safely for you and your baby. Lifestyle changes — like how you eat, sleep, and move — are usually the first step. If these are not enough, your doctor, midwife, or pharmacist can recommend safe remedies and medicines.

Self-care at home

• Eat smaller, more frequent meals instead of three large ones.
• Avoid foods that often trigger reflux, such as spicy, fatty, or very acidic foods.
• Wait at least 1 to 2 hours after eating before lying down.
• Keep your head and upper chest raised while sleeping, using extra pillows or raising the head of your bed.
• Stay upright after meals — gentle sitting or walking is better than slouching.
• Wear loose, comfortable clothing around your waist.
• Sip water throughout the day rather than drinking large amounts at once.

Medical treatments

Some medicines that help neutralise stomach acid or reduce the amount of acid your stomach makes are used during pregnancy. However, no one should start any medicine during pregnancy without first checking with a doctor, midwife, or pharmacist. They will explain which option is safest for you and your baby, and how long to use it.

When is surgery considered?

Surgery for acid reflux is not normally needed during pregnancy. It is only considered in extremely rare situations, and would not be planned during pregnancy unless there is a serious reason.

Living with this condition

Acid reflux during pregnancy can be uncomfortable, but it is often manageable. Pay attention to what triggers your symptoms and adjust your meals, posture, and sleep habits accordingly. Remember that for most people, these symptoms are temporary and improve greatly after the baby arrives.

Lifestyle tips

• Sleep with your head raised or on a slight incline.
• Chew your food slowly and eat mindfully.
• Take gentle walks after meals to help with digestion.
• Try to manage stress — being anxious or tense can make reflux feel worse.
• Talk with your midwife or doctor before making any major changes to your routine.

Diet and exercise

A diet that is lower in fat and spice, and includes smaller portions, can help reduce reflux. Gentle exercise such as walking or prenatal yoga after eating may support digestion. Always check with your healthcare provider before starting a new exercise routine during pregnancy.

Mental health and emotional wellbeing

Dealing with daily heartburn can be tiring and frustrating, especially if it disrupts your sleep or makes you feel uncomfortable. It is natural to feel that way. Be kind to yourself and share your feelings with your partner, family, or a healthcare professional.

Prevention

You cannot always prevent acid reflux in pregnancy because hormones and the growing baby naturally affect your body. But you can reduce many symptoms by eating smaller meals, avoiding known trigger foods, staying upright after eating, and sleeping with your head raised.

Complications

If left untreated

• Severe acid reflux that is not managed may cause inflammation of the food pipe, known as oesophagitis.
• It can make eating and sleeping difficult, which may affect your energy and overall wellbeing.
• In very rare cases, long-term reflux could lead to bleeding or narrowing of the food pipe, but this is extremely uncommon in pregnancy.

Long-term outlook

The outlook is excellent. For most people, acid reflux in pregnancy eases quickly after giving birth. While you are pregnant, your healthcare team can help you find safe and effective ways to stay comfortable. You do not have to suffer in silence — support is available.

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