stomach in pregnancy

Overview

Many people have stomach and digestive problems during pregnancy. These include nausea, heartburn, indigestion, bloating, and constipation. The changes happen because pregnancy hormones relax the muscles of the digestive system, which slows things down. Later, the growing baby can also press on the stomach and intestines.

Very common. Almost every pregnancy involves at least one digestive symptom, most often nausea or heartburn.

Pregnant people of all ages. Nausea and vomiting are most common in the first 12 weeks, while heartburn and constipation often appear later, especially in the third trimester.

Symptoms

Common symptoms

• Nausea and vomiting (often called morning sickness, but it can happen at any time)
• Heartburn or acid reflux (burning feeling in the chest or throat)
• Indigestion or feeling full quickly
• Bloating with gas or burping
• Constipation (hard, infrequent stools) and haemorrhoids
• Food aversions and a metallic taste in the mouth

Symptoms in children

• Not applicable — this topic relates to pregnant people, not children.

Symptoms in older adults

• Not applicable — these symptoms occur in pregnancy regardless of age. Older pregnant people may have additional risk factors, but the symptoms and care are the same.

Causes

Main causes

• Rising pregnancy hormones, including hCG and progesterone, relax the muscles in the stomach and intestines, slowing digestion
• The hormone progesterone also relaxes the valve between the stomach and the oesophagus, allowing acid to flow up into the throat
• As the baby grows, the expanding womb pushes on the stomach, which can make heartburn and indigestion worse
• Pressure on the intestines can slow bowel movements, leading to constipation

Risk factors

• Having twins or triplets
• A history of severe nausea in a previous pregnancy
• A personal or family history of motion sickness or migraine
• Pre-pregnancy obesity or a history of acid reflux

When to see a doctor

See a doctor urgently if:

• If you suspect you are dehydrated (dark urine, very dry mouth, or dizziness)
• If you have severe pain or pain with fever
• If you cannot keep food or liquid down for more than 12 hours
• If you have bleeding from the back passage or blood in vomit

Book a routine appointment if:

• Talk to your midwife or GP early if nausea or heartburn makes it hard to do normal activities
• Ask for advice before taking any over-the-counter medicine
• Bring up any stomach discomfort at your prenatal appointments

Diagnosis

Your doctor or midwife will talk with you about your symptoms and how they change through the day. In most cases, this is enough. They may check your blood pressure, pulse, and weight. If needed, they can do a quick urine test or send blood for testing.

Tests that may be done

• Urine test to check for ketones (a sign of dehydration)
• Blood test to check for electrolyte imbalances
• Ultrasound if there is a concern about the baby or to check for multiple pregnancy

What to expect at your appointment

You will be advised on diet and lifestyle changes. If symptoms are severe, your doctor can suggest safe treatment options. Many people feel much better quickly.

Treatment

Treatment focuses on relieving symptoms by changing how and what you eat, staying hydrated, and resting. If lifestyle changes are not enough, there are medications that are safe to use in pregnancy, but you should only take them after checking with your doctor or pharmacist.

Self-care at home

• Eat small, frequent meals instead of three large meals
• Avoid spicy, fatty, or very acidic foods if they trigger symptoms
• Take a short walk after meals to help with digestion
• Sleep with extra pillows to keep your head up
• Try ginger or peppermint if you feel nauseous — but check with your midwife first

Medical treatments

Your doctor or midwife may recommend an antacid or an acid-reducing medicine that is considered safe in pregnancy. Never take any medicine without first asking a pharmacist or doctor, because some over-the-counter products are not suitable during pregnancy. Where symptoms are severe, with uncontrollable vomiting, you may need to spend time in hospital so that fluids and nutrients can be given through an IV directly to your vein.

Living with this condition

With a few simple changes, most people can manage their stomach symptoms well and continue normal activities. Keep a small food diary to notice which foods or situations make you feel worse.

Lifestyle tips

• Eat slowly and chew well
• Sit upright for an hour after eating
• Wear comfortable, loose clothing around your waist
• Take a rest after meals and keep up gentle movement like walking
• Drink fluids between meals rather than during meals

Diet and exercise

A varied, balanced diet is ideal. For constipation, add foods high in fibre such as vegetables, fruits, wholegrains, and drink plenty of water. Gentle exercise such as walking or prenatal yoga can help keep the digestive system moving.

Mental health and emotional wellbeing

It is completely normal to feel tired, frustrated, or worried if you live with nausea or heartburn every day. These symptoms can interfere with sleep, work, and enjoyment of your pregnancy. If you notice low mood, anxiety, or hopelessness, talk to your health visitor or GP — help is available.

Prevention

Not always, but some problems can be reduced. You can lower your chances of heartburn and constipation by eating regular small meals, staying active, and avoiding foods that have bothered you before.

Complications

If left untreated

• Severe dehydration from persistent vomiting
• Weight loss or poor weight gain during pregnancy
• Inflammation of the food pipe from long-standing acid reflux
• Rarely, severe nausea and vomiting (hyperemesis gravidarum) can become serious if not treated

Long-term outlook

For the vast majority of people, digestive symptoms are uncomfortable but temporary, and they get better once the baby is born. With simple support, you can take control of your symptoms and focus on the positive side of your pregnancy.

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