Heartburn and Constipation Are Disturbing My Sleep in Late Pregnancy

Pregnancy brings numerous physical and emotional changes, particularly in the later stages. One common concern for expectant mothers is the combination of increased appetite with uncomfortable symptoms such as heartburn and constipation, especially when these issues disturb much-needed sleep. It’s not unusual for pregnant women to find themselves caught between needing more nutrients and dealing with digestive discomfort. This article will explore the causes of these symptoms, offer solutions, and discuss how maintaining a healthy, balanced diet and incorporating antenatal care can help manage these discomforts, allowing for a more restful pregnancy.

Understanding the Causes of Heartburn and Constipation in Late Pregnancy

Why Does Heartburn Happen During Pregnancy?

Heartburn, also known as acid reflux or gastroesophageal reflux disease (GERD), is a common complaint during pregnancy, especially in the third trimester. It is characterised by a burning sensation in the chest or throat due to stomach acid rising into the oesophagus.

Heartburn becomes more prevalent in late pregnancy due to two main factors:

Hormonal Changes: During pregnancy, the hormone progesterone helps relax the muscles in the body. While this is crucial for supporting the pregnancy, it also relaxes the lower oesophageal sphincter (the muscle between the stomach and oesophagus), allowing stomach acid to escape into the oesophagus more easily, leading to heartburn [1].

Growing Uterus: As your baby grows and your uterus expands, it puts pressure on the stomach, which can push stomach acid upwards, exacerbating acid reflux. The expanding uterus can also cause the stomach to empty more slowly, increasing the likelihood of heartburn.

What Causes Constipation During Pregnancy?

Constipation is another common issue in pregnancy, particularly during the third trimester. It is defined as having fewer than three bowel movements a week or experiencing difficulty in passing stool. Like heartburn, constipation is often caused by a combination of hormonal and physical changes in the body.

Hormonal Impact: Progesterone, the pregnancy hormone, is also responsible for slowing down bowel movements by relaxing the muscles of the intestines. This results in slower digestion and the absorption of water from the stool, leading to harder, drier stools that are more difficult to pass [2].

Increased Pressure on the Intestines: As the uterus expands, it compresses the intestines and rectum, slowing the passage of waste through the digestive tract. This pressure makes it more difficult to pass stool, contributing to constipation.

Iron Supplements: Many pregnant women are advised to take antenatal vitamins, including iron supplements, as part of their prenatal care. However, iron can have a constipating effect, further exacerbating the issue for some women [3].

Why Can’t I Stop Eating?

As uncomfortable as heartburn and constipation can be, many expectant mothers find themselves hungrier than ever in late pregnancy. This increased appetite is perfectly normal and is your body’s way of ensuring that both you and your baby receive the necessary nutrients for growth and development. However, balancing this need for increased food intake with the discomfort caused by digestive issues can be challenging.

How Heartburn and Constipation Affect Sleep

Heartburn and constipation not only cause discomfort during the day but can also disturb your sleep, leading to restless nights. Heartburn tends to worsen when lying down, as stomach acid can more easily move into the oesophagus when the body is horizontal. Similarly, constipation may cause bloating, gas, and abdominal discomfort that makes it difficult to find a comfortable sleeping position.

For many pregnant women, these digestive issues make it harder to fall asleep and stay asleep, which can leave them feeling fatigued during the day. Sleep is crucial for both maternal and foetal health, so finding ways to manage these symptoms is essential.

Managing Heartburn and Constipation in Late Pregnancy

While heartburn and constipation are common during pregnancy, there are several strategies you can employ to manage these symptoms and improve your quality of sleep.

1. Eat Smaller, More Frequent Meals

One of the most effective ways to manage heartburn and constipation is to adjust your eating habits. Instead of eating large meals that can overwhelm the digestive system and increase the likelihood of acid reflux, try eating smaller, more frequent meals throughout the day. This approach helps prevent your stomach from becoming too full, reducing pressure on the oesophagus and minimising acid reflux.

Eating smaller meals also supports better digestion, helping to prevent constipation. Focus on eating fibre-rich foods such as fruits, vegetables, and whole grains, which can promote regular bowel movements.

2. Stay Hydrated

Proper hydration is essential for preventing constipation. Drinking plenty of water throughout the day helps keep stools soft and easier to pass. However, it’s important to avoid drinking large amounts of liquid during meals, as this can contribute to heartburn by increasing the volume of stomach contents.

Aim to drink water between meals rather than with them, and try to sip water slowly to avoid overloading your digestive system. Keeping a water bottle with you throughout the day can help remind you to stay hydrated.

3. Incorporate Antenatal Yoga

Incorporating gentle physical activity, such as antenatal yoga, into your daily routine can help manage both heartburn and constipation. Antenatal yoga is specifically designed for pregnant women and focuses on gentle stretches, relaxation techniques, and mindful breathing. It helps improve digestion by stimulating the muscles in the abdomen, promoting healthy bowel movements, and reducing bloating [4].

In addition, prenatal yoga has been shown to reduce stress and anxiety, which can contribute to better digestion and improved sleep. It’s a great way to stay active and relieve physical discomfort while preparing your body for labour.

4. Sleep Position Matters

Your sleeping position can have a significant impact on your comfort, particularly when dealing with heartburn. Experts recommend sleeping on your left side, as this position helps prevent stomach acid from rising into the oesophagus. Sleeping on the left side also promotes better digestion and circulation to the placenta.

Additionally, propping yourself up with pillows to elevate your upper body can help prevent acid reflux during the night. Many pregnant women find that using a wedge pillow or extra cushions can provide relief from heartburn symptoms while allowing them to sleep more comfortably.

5. Consider Antenatal Massage

Antenatal massage, or prenatal massage, can be a helpful tool for managing discomfort during pregnancy, including digestive issues such as constipation. Gentle massage of the abdomen can help stimulate bowel movements, relieve bloating, and ease tension in the muscles.

A 2010 study found that prenatal massage can also improve sleep quality by promoting relaxation and reducing stress hormones [5]. By easing physical discomfort and promoting a sense of calm, antenatal massage can help you get the rest you need, even if digestive issues are keeping you awake.

6. Use Relaxation Techniques Before Bed

If digestive discomfort is preventing you from falling asleep, incorporating relaxation techniques into your bedtime routine can help prepare your body for rest. Deep breathing, progressive muscle relaxation, and visualisation exercises can reduce stress and tension, making it easier to fall asleep despite heartburn or constipation.

Creating a calm environment in your bedroom can also support better sleep. Dimming the lights, playing soft music, and avoiding electronic screens before bed can help signal to your body that it’s time to wind down.

7. Manage Your Diet to Reduce Heartburn and Constipation

Certain foods can exacerbate heartburn and constipation, so managing your diet is key to reducing symptoms. Avoiding foods that trigger acid reflux, such as spicy foods, fried foods, citrus fruits, and caffeine, can help prevent heartburn.

For constipation, focus on increasing your intake of fibre-rich foods such as fruits, vegetables, whole grains, and legumes. These foods promote healthy digestion and help prevent constipation by adding bulk to the stool. It’s also important to avoid processed foods, which are often low in fibre and can contribute to constipation.

8. Antenatal Vitamins and Supplements

Iron supplements are commonly prescribed during pregnancy to support your baby’s development, but they can contribute to constipation. If iron supplements are causing discomfort, talk to your healthcare provider about alternative forms of iron that may be easier on your digestive system, such as slow-release or liquid iron supplements [6].

Some women also find that taking magnesium supplements can help alleviate constipation, as magnesium promotes muscle relaxation and supports healthy bowel movements. However, always consult your healthcare provider before making any changes to your supplement routine.

9. When to Seek Medical Advice

While heartburn and constipation are common in pregnancy, it’s important to seek medical advice if these symptoms become severe or if they’re accompanied by other concerning signs. If you’re experiencing persistent or severe heartburn that doesn’t respond to lifestyle changes, your healthcare provider may recommend safe over-the-counter medications such as antacids.

In some cases, constipation may lead to more serious complications such as haemorrhoids or faecal impaction, so it’s important to consult your healthcare provider if you’re struggling with severe constipation that doesn’t improve with dietary changes.

Regular antenatal checkups are an important part of managing your health during pregnancy. Your midwife or healthcare provider can help monitor your symptoms and offer personalised advice to ensure that both you and your baby are healthy.

The Importance of Antenatal Care

Antenatal care plays a vital role in supporting your health and well-being throughout pregnancy. Regular antenatal appointments allow your healthcare provider to monitor your baby’s growth, check for any potential complications, and provide guidance on managing common pregnancy symptoms such as heartburn and constipation.

In addition to attending antenatal appointments, consider taking antenatal education classes to learn more about pregnancy health and preparation for childbirth. Many classes offer practical tips for managing common pregnancy discomforts and provide a supportive environment where you can connect with other expectant parents.

Conclusion

Heartburn and constipation are common issues in

late pregnancy, but with the right strategies, you can manage these symptoms and improve your sleep quality. Eating smaller meals, staying hydrated, practising antenatal yoga, and making adjustments to your sleeping position can all help alleviate digestive discomfort. Additionally, consider incorporating relaxation techniques and antenatal massage to promote better sleep and overall well-being.

Remember, it’s important to listen to your body and seek medical advice if your symptoms become severe or unmanageable. Regular antenatal checkups and prenatal care are key to ensuring a healthy pregnancy and supporting both you and your baby through this exciting time.

References:

NHS. Heartburn in Pregnancy.

Mayo Clinic. Constipation During Pregnancy.

BabyCentre UK. Iron Supplements and Constipation in Pregnancy.

American Pregnancy Association. Prenatal Yoga.

Field, T. Prenatal Massage Therapy Reduces Stress and Improves Sleep.

Cleveland Clinic. Iron Supplements and Constipation.