Heartburn and Pregnancy

Most likely. Many women experience heartburn for the first time during pregnancy — and though it's common and generally harmless, it can be quite uncomfortable.

Heartburn (also called acid indigestion or acid reflux) is a burning sensation that often extends from the bottom of the breastbone to the lower throat. It's caused by some of the hormonal and physical changes in your body.

During pregnancy, the placenta produces the hormone progesterone, which relaxes the smooth muscles of the uterus. This hormone also relaxes the valve that separates the esophagus from the stomach, allowing gastric acids to seep back up, which causes that unpleasant burning sensation.

Progesterone also slows down the wavelike contractions of your esophagus and intestines, making digestion sluggish. Later in pregnancy, your growing baby crowds your abdominal cavity, pushing the stomach acids back up into the esophagus.

Many women start experiencing heartburn and other gastrointestinal discomforts in the second half of pregnancy. Unfortunately, it usually comes and goes until your baby is born.

What to do About It :

Though you may not be able to eliminate heartburn entirely, you can take steps to minimize your discomfort:

• Avoid food and beverages that cause you gastrointestinal distress. The usual suspects are carbonated drinks; alcohol (which you should avoid anyway during pregnancy); caffeine; chocolate; acidic foods like citrus fruits and juices, tomatoes, mustard, and vinegar; processed meats; mint products; and spicy, highly seasoned, fried, or fatty foods.

• Don't eat big meals. Instead, eat several small meals throughout the day. Take your time eating and chew thoroughly.

• Avoid drinking large quantities of fluids during meals — you don't want to distend your stomach. (It's important to drink eight to ten glasses of water daily during pregnancy, but sip it between meals.)

• Try chewing gum after eating. Chewing gum stimulates your salivary glands, and saliva can help neutralize acid.

• Don't eat close to bedtime. Give yourself two to three hours to digest before you lie down.

• Sleep propped up with several pillows or a wedge. Elevating your upper body will help keep your stomach acids where they belong and will aid your digestion.

• Gain a sensible amount of weight, and stay within the guidelines your healthcare provider suggests.

• Wear loose, comfortable clothing. Avoid any tightness around your waist and tummy.

• Bend at the knees instead of at the waist.

• Don't smoke — in addition to contributing to a host of serious health problems, smoking boosts stomach acidity. (Ideally, smoking is a habit you should break before getting pregnant. If you're still smoking and are having trouble quitting, ask your caregiver for a referral to a smoking-cessation program.)

• An over-the-counter antacid that contains magnesium or calcium may ease discomfort, but check with your prenatal caregiver before taking one, because some brands contain aluminum or aspirin or are high in sodium.

If these measures don't help, talk to your caregiver about prescription heartburn medications that are safe during pregnancy.

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