Congrats, you’re experiencing the miracle of life, creating a human and growing your family — that’s a beautiful thing. But let’s be honest, pregnancy can be a real shock to a woman’s system, and it comes with a lot of feelings. While many of those are to be expected, one can be particularly surprising — the burning sensation and discomfort in your chest. Surprise! You have heartburn.

Heartburn is a symptom of acid reflux. You feel it when stomach acid moves back up into the esophagus — unlike your stomach, your esophagus isn’t designed to handle that acid, so it leaves you with a burning sensation. (Nope, heartburn has nothing to do with your heart.)

There’s an old wives’ tale that women who experience heartburn during pregnancy are having a girl. But these days, there’s no gender discrimination — acid reflux is a condition that affects 80% of pregnant women. So rest assured, it’s normal and even expected to experience reflux, and it’s not dangerous for your baby. Nonetheless, we know it can be scary and uncomfortable, especially if you’ve never had it before.

When someone experiences acid reflux symptoms more than twice a week, they may be diagnosed with the chronic condition gastroesophageal reflux disease (GERD). And for many pregnant women, that’s highly likely. But the good news is, there are ways to manage it.

What causes heartburn during pregnancy

Several factors cause heartburn during pregnancy. Even before that bump starts showing, your hormones start changing. Progesterone, a key pregnancy hormone, relaxes muscles — including the lower esophageal sphincter (LES), the valve that sits between the esophagus and the stomach. When that valve is open, it’s more likely that stomach acids will move into the esophagus.

Then, as the baby grows in the second and third trimester, it places growing pressure on the stomach, making acid reflux more likely. And throughout your whole pregnancy, those progesterone-relaxed muscles slow down your digestion, so the fetus can absorb all the nutrition, which leaves you more at risk for discomfort in your digestive system. Luckily, many women experience a reprieve from GERD and reflux symptoms post-baby.

What does heartburn feel like when you're pregnant?

The burning sensation of heartburn in one’s upper body makes acid reflux a very uncomfortable condition for pregnant women. But there are more symptoms than just heartburn — some common symptoms of acid reflux include:

• asthma and/or shortness of breath
• difficulty swallowing and/or sore throat
• dry cough
• dyspepsia or indigestion (recurring pain or discomfort in the upper part of your abdomen)
• heartburn in your chest area, though severe cases can also generate back pain, felt between the shoulder blades
• nausea
• regurgitation, burping or vomiting
• sour or bitter taste at the back of your mouth

Is heartburn dangerous during pregnancy?

While heartburn and acid reflux aren’t necessarily dangerous, there are potential side effects and things to be aware of with GERD, especially if it becomes a long-term condition. However, it's important to understand what reflux treatments are safe during pregnancy, because your body processes things a little differently than usual for those nine months.

What are safe heartburn medications to take?

There are several ways to treat symptoms and mitigate the effects of acid reflux when you’re expecting, including over-the-counter (OTC) medications and prescription drugs.

• Calcium carbonate antacids neutralize stomach acid (you've probably heard of Gaviscon®, Tums®, etc.). The key here is looking for calcium carbonate antacids because the other types have ingredients that are not necessarily safe for pregnant women.
• H2 blockers, which block histamine so your stomach produces less acid.
• Proton pump inhibitors (PPIs), which reduce how much acid your stomach produces. They’re not as fast-acting as an H2 blocker, but they last longer. (You might know them by their brand names: Prilosec®, Prevacid®, Nexium®.)

What's not safe to take?

Early in your pregnancy, you can take magnesium, like Maalox, to help neutralize the acid. But in the third trimester, magnesium can interfere with labor contractions, so it's recommended you avoid magnesium-based treatments late in the pregnancy.

In addition, because you’ll want to avoid aspirin during your pregnancy, stay away from Alka Seltzer (though they do make aspirin-free varieties now).

What safe lifestyle changes you can make?

There are also lifestyle changes you can make to reduce your acid reflux during pregnancy.

• Avoid large meals — eating a few smaller meals throughout the day is recommended, especially since progesterone slows your digestion.
• Reduce your intake of fatty foods, spicy foods, as well as citrus fruits, which tend to instigate acid reflux.
• Stop eating 2-3 hours before bed, and use a pillow or wedge to prop yourself up — gravity will help keep acid reflux at bay. If you have to sleep on a side, choose the left side, which is known to be better for reducing acid reflux.
• Chew sugarless gum after meals — it’ll activate saliva, which helps neutralize stomach acids.
• While you can’t do anything to alleviate the pressure of your growing baby on your belly, it can help to wear loose-fitting clothes, as pressure on your stomach increases the risk of acid reflux.

A major pregnancy lifehack is herbal peppermint tea — it’s cooling and helps to ease digestion and any stomach issues you may experience. However, peppermint tea relaxes the muscles of the uterus, which is known to increase the risk of miscarriage. And while peppermint tea hasn’t been connected with miscarriages in any scientific study, it’s recommended that women with a history of miscarriages avoid drinking the tea. Regardless, be sure to talk to your doctor about how much is safe to consume, and what the best course of action is for you.

If you’re looking for something a bit more Eastern, some women experience abatement of symptoms with acupuncture, muscle relaxation therapies, and yoga.

When should I talk to my doctor?

We know this is a lot of information. Now that you know the symptoms and risk factors of heartburn and pregnancy, we recommend speaking with your doctor, who can recommend a treatment plan that works for your body at various stages throughout your pregnancy.

Above all, rest assured that what you’re going through is normal and manageable — and that soon you’ll have an adorable bundle of joy who’ll bring you bliss that far outweighs the discomfort of acid reflux during pregnancy.

The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.