Which statement about managing heartburn (pyrosis) in pregnancy indicates a need for additional teaching?

• A. I should avoid carbonated beverages.
• B. I should drink more water with meals.
• C. I should eat smaller, more frequent meals.
• D. I should lie down a half hour after eating.

Answer: (D)

Heartburn in pregnancy often happens because progesterone relaxes the valve between the stomach and esophagus and the growing uterus pushes on the stomach, making reflux more likely. To reduce symptoms, the recommended approach focuses on staying upright after meals, avoiding triggers, and limiting stomach distension. Lying down a short time after eating allows stomach contents to move back up into the esophagus, worsening acid reflux. So telling someone to lie down half an hour after eating is not appropriate and indicates a need for more teaching; instead, they should remain upright for several hours after meals and elevate the head of the bed when sleeping to lessen reflux. The other statements fit typical guidance: avoiding carbonated beverages helps reduce gas and reflux; drinking water supports hydration and digestion; eating smaller, more frequent meals reduces gastric volume and pressure.