Heartburn & Acid Reflux
Heartburn affects up to 80% of pregnant women, particularly in the second and third trimesters. It occurs when stomach acid backs up into the esophagus.
What "Moderate" Means Here
A "moderate" rating means this symptom is common but is more likely to benefit from your provider’s input — either to confirm it’s within the normal range for you, to rule out an underlying cause, or to get a treatment recommendation beyond basic home remedies. It doesn’t necessarily mean something is wrong; many moderate symptoms are simply worth mentioning at your next appointment so your provider has full visibility into how your pregnancy is progressing. If it escalates in intensity or frequency, that’s a good reason to reach out sooner rather than waiting for your next scheduled visit. Providers generally appreciate patients flagging moderate symptoms proactively rather than waiting to see if they resolve, since the same symptom can mean different things depending on your individual health history, prior pregnancies, and how far along you are.
Timing During Pregnancy
This symptom is most often reported later in pregnancy. Third-trimester symptoms are frequently related to the growing uterus placing more pressure on nearby organs, joints, or blood vessels, or to the body preparing for labor. Because late-pregnancy symptoms can occasionally overlap with signs of labor or other conditions specific to the third trimester, it’s worth reviewing the "when to call your doctor" guidance below a bit more closely as your due date approaches. Many providers also schedule more frequent visits in the third trimester specifically so that new or worsening symptoms can be caught and addressed quickly.
Common Causes
- Progesterone relaxing the lower esophageal sphincter (the valve between stomach and esophagus)
- Growing uterus pushing stomach upward, reducing its capacity
- Slower digestion during pregnancy allowing more acid production
- Eating habits and food triggers
Remedies That May Help
Eat Smaller Meals
5-6 small meals instead of 3 large ones keeps the stomach from overfilling.
Stay Upright After Eating
Wait at least 2-3 hours after eating before lying down.
Elevate Your Head
Prop up the head of your bed 6 inches with blocks, or use extra pillows.
Avoid Trigger Foods
Common triggers: spicy foods, citrus, tomato, chocolate, fried foods, and carbonated drinks.
Antacids
Calcium-based antacids (Tums) are safe during pregnancy. Avoid antacids containing aluminum or sodium bicarbonate.
When to Call Your Doctor
- Heartburn so severe it prevents eating or sleeping
- Difficulty swallowing or pain when swallowing
- Vomiting blood or dark-colored vomit
- Unexplained weight loss alongside heartburn
Warning Signs That Always Warrant Immediate Care
Regardless of the specific symptom you’re looking up, general ACOG and CDC guidance is to seek immediate medical attention — call your provider’s urgent line, go to labor and delivery, or go to the ER — if you experience any of the following:
- Vaginal bleeding that is heavy, bright red, or accompanied by pain
- Severe or persistent abdominal or pelvic pain
- A severe headache that doesn’t improve with rest, water, or over-the-counter pain relief
- Sudden swelling of the face, hands, or feet, especially paired with a headache or vision changes
- Vision changes such as blurring, seeing spots, or temporary vision loss
- A noticeable decrease in your baby’s movement compared to their usual pattern
- Fever of 100.4°F (38°C) or higher
- Fluid leaking or gushing from the vagina
- Regular, painful contractions before 37 weeks
- Difficulty breathing, chest pain, or a rapid heartbeat
- Persistent vomiting that keeps you from keeping down fluids
- Severe itching, especially on the palms and soles, which can sometimes indicate a liver-related condition
This list reflects general warning signs recognized across pregnancy, not just for this specific symptom — when in doubt, it’s always appropriate to call your provider and describe what you’re experiencing rather than waiting to see if it resolves.
General Tips for Managing Pregnancy Symptoms
Alongside any symptom-specific remedies above, a handful of general habits tend to help with a wide range of pregnancy symptoms and are worth keeping in mind throughout your pregnancy:
- Stay consistently hydrated — many pregnancy symptoms, from headaches to fatigue to constipation, are worsened by even mild dehydration.
- Keep taking your prenatal vitamin as directed, since nutrient gaps (particularly iron, calcium, and vitamin D) can compound certain symptoms.
- Prioritize rest and sleep where you can, including resting on your side in later pregnancy, which supports circulation to the uterus.
- Stay gently active if your provider has cleared you for exercise — light movement like walking or prenatal yoga can ease many common complaints.
- Eat smaller, more frequent meals rather than three large ones, which can help with digestive symptoms and blood sugar swings.
- Keep a running list of questions between appointments so nothing gets forgotten when you do see your provider.
None of these general habits replace medical evaluation for a specific concerning symptom, but they’re a reasonable baseline to maintain throughout pregnancy regardless of what you’re experiencing.
Frequently Asked Questions
Does heartburn mean my baby will have lots of hair?
Surprisingly, a 2006 Johns Hopkins study did find a correlation! But heartburn is caused by hormones and anatomy, not baby's hair.
Is Pepcid (famotidine) safe during pregnancy?
Most doctors consider famotidine safe during pregnancy when antacids aren't sufficient. Always consult your provider before starting any medication.
Will heartburn go away after delivery?
For most women, yes — heartburn resolves within days to weeks after delivery as hormone levels normalize and the uterus shrinks.
How do I know if a pregnancy symptom needs medical attention?
As a general rule, contact your provider if a symptom is severe, sudden, rapidly worsening, or paired with other concerning symptoms like fever, vision changes, or reduced fetal movement — even if it doesn’t appear on a specific warning-signs list. You know your body best, and providers consistently say they’d rather field a call about something that turns out to be normal than have a patient wait through something that wasn’t.
Should I track this symptom before my next appointment?
It’s a good habit to jot down when a symptom started, how often it occurs, roughly how intense it feels, and anything that seems to make it better or worse. This kind of record is genuinely useful to your provider — it turns a vague "I’ve been having some discomfort" into something they can actually assess for patterns, and it can help you notice on your own whether a symptom is improving, staying steady, or getting worse over time.
Is it normal for pregnancy symptoms to come and go?
Yes — many pregnancy symptoms fluctuate day to day or even hour to hour, influenced by things like hydration, activity level, meal timing, and simple positional changes. Fluctuation on its own usually isn’t a red flag. What’s more worth flagging to your provider is a symptom that is steadily trending worse over days or weeks, or one that suddenly becomes much more intense than your usual pattern.