Heartburn, often described as a burning sensation in the chest or throat, is a common experience during pregnancy. It is a form of indigestion resulting from stomach acid flowing back into the esophagus. While not related to the heart, this discomfort affects a significant number of pregnant individuals, with estimates suggesting anywhere from 30% to 80% experience it.
Heartburn in Late Pregnancy
Many pregnant individuals notice an increase in heartburn symptoms as they approach their due date. This leads some to wonder if worsening heartburn signals the imminent onset of labor. While heartburn often becomes more pronounced in late pregnancy, there is no direct scientific evidence or physiological mechanism that establishes increased heartburn as a reliable predictor of labor.
Some anecdotal reports suggest that heartburn might temporarily lessen if the baby “drops” lower into the pelvis, potentially relieving some pressure on the stomach. However, this “lightening” can occur weeks before labor, and the relationship between heartburn and labor onset remains largely coincidental rather than causal.
Understanding the Causes
The physiological changes during pregnancy contribute to the prevalence and intensity of heartburn. One primary factor is the increase in progesterone, a hormone that causes muscles to relax throughout the body. This relaxation includes the lower esophageal sphincter (LES), a muscular valve between the esophagus and the stomach, which normally prevents stomach acid from flowing back up. When the LES relaxes, stomach acid can more easily reflux into the esophagus, causing the burning sensation.
Another contributing factor is the growing uterus, which expands in late pregnancy. This physical expansion places increased pressure on the stomach and other abdominal organs. The added pressure can push stomach contents and acid upwards into the esophagus, exacerbating heartburn symptoms. Additionally, pregnancy hormones can slow down the entire digestive process, meaning food remains in the stomach for longer periods, further increasing the likelihood of acid reflux.
Relief Strategies
Managing heartburn discomfort during late pregnancy involves dietary and lifestyle adjustments. Eating smaller, more frequent meals throughout the day instead of three large ones can help reduce the amount of food in the stomach, lessening pressure. It is also helpful to eat slowly and chew food thoroughly. Avoiding trigger foods such as spicy, fatty, or fried items, as well as citrus fruits, chocolate, and carbonated beverages, can also provide relief.
Lifestyle modifications also help reduce heartburn. Remaining upright for at least an hour after eating, and ideally two to three hours before lying down, helps gravity keep stomach acid in its place. Elevating the head of the bed by several inches can prevent nighttime reflux. Over-the-counter antacids containing calcium carbonate are generally safe during pregnancy, but it is advisable to consult a healthcare provider before taking any medication.
Important Considerations
While heartburn during pregnancy is typically a benign discomfort, there are situations where medical consultation is recommended. If heartburn is severe, persistent, or not relieved by home remedies and over-the-counter antacids, seeking professional advice is important. Symptoms such as difficulty swallowing, significant unintended weight loss, or vomiting blood warrant immediate medical attention.
Heartburn-like symptoms, particularly pain below the ribs, can sometimes resemble or mask more serious conditions like preeclampsia. Therefore, it is important to communicate any concerning or unusual symptoms to a healthcare provider. Regular antenatal appointments allow for monitoring of overall health and early detection of any potential complications.