Why You Get Heartburn During Pregnancy—And 12 Ways to Soothe It

Heartburn during pregnancy will plague most moms-to-be at some point because progesterone, the hormone that relaxes muscles in pregnancy, also relaxes the stomach valve that keeps acid out of the esophagus. In addition, the growing uterus crowds the stomach, forcing acid into the esophagus.

But there are safe, effective ways to stop it. "Pregnant women really don't need to suffer with heartburn anymore," says Adrienne Einarson, RN, assistant director of clinical services at Motherisk, a Toronto-based program that investigates the effects of prenatal exposures on maternal and fetal health. Here, experts recommend 12 different ways to (safely!) soothe heartburn during pregnancy.

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If you're suffering from morning sickness, eating just a little at a time is probably no problem for you. But if your appetite is healthy, be sure to avoid eating so much that you feel full.

Just as it does when you're not pregnant, an overly stuffed stomach can contribute to heartburn. Instead of three square meals a day, try five or six smaller ones.

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Bolting down your food can also lead to heartburn and indigestion. Try to relax and enjoy your meals, which will also help you avoid overeating.

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Rather than drinking a big glass of milk with dinner, you may be better off just sipping liquids during meals. Try to get most of your fluid intake by drinking beverages between, rather than during, meals.

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After a meal, take a leisurely walk, do a little housework, sit down and read a book—just don't lie down, and don't do anything that requires you to bend over. Both of these activities can help wash acid back up into your esophagus.

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Having a hearty meal and then heading to bed is a recipe for heartburn, warns Joel Richter, MD, director of the division of gastroenterology and nutrition and the esophageal diseases center at the University of South Florida, in Tampa, who has studied heartburn during pregnancy. He recommends trying not to eat for at least three hours before you go to sleep. You should also try to avoid liquids starting a few hours before bedtime.

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Many people with acid reflux swear by their "bedges," wedge-shaped pillows that gently slant your upper body upwards to keep stomach acid where it belongs.

• And there's no need for buying a pricey special product, Dr. Richter says. "You can get these at places like Bed, Bath and Beyond for about $25," he says. We like the Boppy Pregnancy Wedge ($16; amazon.com).
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Fat, caffeine, chocolate, citrus—pregnant women with heartburn have been advised to avoid all of the above at one time or another. But what causes reflux in one woman might not be a trigger for another.

Rather than tell his pregnant patients to avoid a specific food, Dr. Richter says he advises them to stay away from foods that specifically aggravate them. Everybody's different, Dr. Richter says. Some pregnant women can chow down on spicy Mexican food or a plate of spaghetti and meatballs with no ill effects.

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Wearing tight clothing is only going to put more pressure on your already crammed abdomen, and could possibly worsen acid reflux.

Opt for the loose-fitting maternity wear, especially if you're trying to stamp out heartburn. We love the gorgeous maternity clothes from HATCH (they're designed to flatter both before, during, and after pregnancy), or Isabel Maternity by Ingrid & Isabel for a more affordable option.

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Some women find that ginger—ginger ale or ginger candies, such as Chimes Ginger Chews, for example—can help ease an upset tummy.

This spice can also combat nausea and vomiting, which often go hand-in-hand with heartburn.

Although there's not much scientific evidence for ginger as a remedy for pregnancy woes, Einarson says, it is safe to consume when you are pregnant.

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If lifestyle changes don't cut it, over-the-counter antacids may quell your heartburn symptoms.

Antacids containing calcium or magnesium should be safe to take during pregnancy. In fact, the extra calcium in antacids like Tums is good for mom and baby.

But avoid antacids that contain aluminum because it can cause constipation and be toxic at high doses. Steer clear of sodium bicarbonate (baking soda) as well—it can cause swelling.

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If an antacid isn't working, it may be time to consider stronger medications.

Your first option will likely be an H2 blocker like Tagamet or Zantac. These drugs suppress stomach-acid production. All four H2 inhibitors on the market are now available without a prescription and considered to be safe during pregnancy. But talk to your doctor before taking them.

"They really work," says Einarson. "You only have to take one or two a day."

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If other medications don't help, there are also proton pump inhibitors (PPIs), such as Prevacid. These have a more powerful acid-suppressing effect than H2 blockers, and most are available over the counter.

Although PPIs are, in general, safe for pregnant women, animal studies have raised concerns that omeprazole (Prilosec) could harm a developing fetus, Dr. Richter says. "My recommendation to patients would be to avoid that one because there are about five or six out there on the market, with the H2 blockers," he says. "All of them look to be safe during pregnancy."

Be sure to discuss any medications with your doctor.

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