How Pregnancy Can Cause or Worsen GERD?

Feeling that burning sensation in your chest when you’re pregnant? You’re not alone. Many mums-to-be experience heartburn, acid reflux, or full-blown GERD (Gastroesophageal Reflux Disease) at some point during pregnancy. But what exactly causes it, and why does it seem worse when you’re carrying a baby?

Let’s break it down — simply, clearly, and with a touch of real-life understanding.


What Is GERD, and Why Is It Common in Pregnancy?

Before we go further, let’s get the basics right. GERD is a condition where stomach acid frequently flows back into the oesophagus, irritating its lining. In non-medical terms? It’s that awful burning feeling in your chest or throat after eating — and it can feel like your food is staging a comeback tour.

Now, pregnancy adds its own twist. While occasional heartburn can happen to anyone, pregnancy makes you more vulnerable to GERD due to a combination of hormones and physical changes. You might have been fine pre-pregnancy — but by your second or third trimester, reflux suddenly becomes your unwanted roommate.


How Pregnancy Hormones Contribute to GERD

Let’s talk hormones — especially progesterone. Often dubbed the “relaxing hormone,” progesterone helps your body support the pregnancy by softening muscles. Sounds good, right? Except it also relaxes the lower oesophageal sphincter (LES) — the muscular ring that keeps stomach contents where they belong.

When the LES weakens, acid creeps upward, especially after meals or when you lie down. Think of it like a loose valve — instead of sealing off your stomach, it lets acid leak back up into your oesophagus. Not fun.

This hormonal impact is most noticeable in the second and third trimesters, when progesterone levels peak.


Physical Changes in Late Pregnancy That Worsen Reflux

As your baby grows, so does your belly — and with that growth comes extra pressure inside your abdomen.

By the time you’re in the later stages of pregnancy, your expanding uterus starts pushing your stomach upward, squashing it against your diaphragm. The result? Even more acid gets forced up into the oesophagus, especially after eating or when lying down.

Imagine stuffing a suitcase that’s already full — something’s bound to spill over.

No wonder many women say: “I never had reflux until the last few months!”


Common Triggers of GERD in Pregnant Women

Every pregnancy is unique, but some triggers seem to affect nearly everyone. Have you noticed symptoms after these?

  • Eating large meals (or eating too close to bedtime)
  • Spicy or acidic foods like tomato sauces, citrus fruits, or chilli
  • Fatty or fried foods
  • Chocolate and caffeine (sad but true)
  • Carbonated drinks and mint

Even tight clothing, poor posture, or lying flat after a meal can make things worse.

Sometimes, GERD isn’t just about what you eat — it’s how, when, and even where you eat.


GERD Symptoms During Pregnancy: What to Watch For

Wondering if what you’re feeling is “normal heartburn” or something more?

Here are common GERD symptoms to watch out for during pregnancy:

  • A burning feeling in the chest or upper stomach
  • Sour or bitter taste in the mouth (regurgitation)
  • Feeling like food is stuck in your throat
  • Coughing at night or when lying down
  • Hoarseness in the morning

If you’re reaching for antacids several times a day or waking up in discomfort, it’s more than just the occasional reflux.


When Should You Be Concerned?

Pregnancy GERD can be frustrating, but it’s usually not dangerous. Still, it’s important to know when it’s time to check in with your doctor:

  • Are you unable to eat properly due to reflux?
  • Do you wake up choking or coughing frequently?
  • Are you taking antacids daily but still suffering?

In rare cases, untreated GERD can lead to oesophagitis — inflammation of the oesophagus — or disrupted sleep and nutrition.

If you’re unsure whether your symptoms are “normal,” err on the safe side and get checked.


Safe GERD Treatments During Pregnancy

The good news? Many treatments are safe and effective during pregnancy. But it always helps to start with natural approaches first, before jumping into medications.

Here’s what’s commonly recommended:

  • Antacids like calcium carbonate (e.g. Tums) are considered safe — but avoid those with aluminium or high sodium content
  • H2 blockers like ranitidine were used, but have been withdrawn in many countries — famotidine may be an alternative
  • Proton Pump Inhibitors (PPIs) like omeprazole or lansoprazole — often reserved for severe symptoms and prescribed only after consulting your doctor

And remember — not all medications are pregnancy-safe, so don’t self-medicate.


Practical Tips to Manage GERD Naturally During Pregnancy

Simple habits can make a big difference. Here are practical, everyday changes that often help:

  • 🍽️ Eat small, frequent meals rather than three large ones
  • 🛏️ Avoid eating within 2-3 hours before lying down or sleeping
  • 🛌 Sleep with your head slightly elevated using a wedge pillow
  • 🚶‍♀️ Take a gentle walk after meals — movement helps digestion
  • 🧥 Wear loose-fitting clothes that don’t press on your belly
  • 💧 Drink fluids between meals, not during, to avoid overfilling your stomach

These aren’t miracle cures — but for many pregnant women, they reduce the frequency and severity of reflux episodes significantly.


Lifestyle Habits That Can Help

Apart from food and sleep habits, a few lifestyle choices may offer relief too:

  • Maintain a healthy weight gain — excess weight increases pressure on your stomach
  • Avoid smoking — which is unsafe in pregnancy anyway, and weakens the LES
  • Practice stress management — anxiety can increase digestive symptoms
  • Sit upright after meals — and resist the urge to nap on the couch!

Even adding light prenatal yoga or breathing exercises can reduce bloating and aid digestion.


When to See Your Doctor

If GERD is messing with your sleep, appetite, or general comfort — don’t suffer in silence.

Call your doctor if:

  • You feel burning pain most days of the week
  • You experience weight loss, vomiting, or severe chest discomfort
  • Lifestyle changes and antacids aren’t helping
  • You’re unsure which medications are safe

Your healthcare provider can guide you to safe, pregnancy-appropriate relief, ensuring you’re comfortable and your baby stays healthy.


References

  1. “Pregnancy and GERD: Managing Heartburn During Pregnancy”, Cleveland Clinic, 2021. https://my.clevelandclinic.org/health/diseases/9684-gerd-in-pregnancy
  2. “GERD and Pregnancy: What You Need to Know”, Healthline, 2020. https://www.healthline.com/health/gerd/pregnancy
  3. “Heartburn During Pregnancy”, American Pregnancy Association, 2022. https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/heartburn-during-pregnancy/
  4. “Gastroesophageal Reflux Disease (GERD)”, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), 2023. https://www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults
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