Acid reflux at night during pregnancy

By trimester

Weeks 1–13

1st trimester

Reflux symptoms show up in about a quarter of first-trimester pregnancies, often starting near the end of it as progesterone rises. Meal timing is the easiest first adjustment.

Weeks 14–27

2nd trimester

Symptoms climb to roughly a third of pregnancies now. A wedge or extra pillows under your head and upper back is worth setting up before things get harder in the third trimester.

Weeks 28–birth

3rd trimester

This is the peak, with reflux symptoms in over half of third-trimester pregnancies, and the growing uterus adds upward pressure. If lifestyle changes and antacids are not holding, ask about the next step.

What does the evidence show for acid reflux at night?

• Reflux symptoms affect about 41% of pregnancies overall, climbing from 26% in the first trimester to 33% in the second and 56% in the third, and they frequently disrupt sleep, appetite, and daily comfort. 1
• Eating meals at least 3 hours before you lie down or go to bed may improve reflux symptoms. 2
• Elevating your head during sleep with a foam wedge or extra pillows under your head and upper back, raising your head 6 to 8 inches off the bed, is a standard measure. 3
• Being pregnant is listed among the factors that affect the lower esophageal sphincter and lead to reflux, and you should see a doctor if symptoms do not improve with over-the-counter medicines or lifestyle changes. 4
• Progesterone relaxes smooth muscle and delays gastric emptying, and reflux is reported by 40% to 85% of pregnant women, usually starting at the end of the first trimester. 5

When should I call my provider about acid reflux at night?

Call your provider the same day for chest pain, pain or difficulty swallowing, or vomiting that will not stop. Vomit that looks like coffee grounds or contains blood, or stool that is black and tarry, both need prompt evaluation rather than another dose of antacid. Unexplained weight loss alongside reflux is also worth reporting rather than waiting for your next routine visit. Whatever the pattern, any symptom that feels beyond your usual range is a reason to call: obstetric teams expect these questions and would rather hear early than late.