General Pregnancy Articles

Article / Updated 09-29-2022

More and more women are expressing interest in nontraditional or alternative birthing methods, and more and more possibilities are becoming available. Certainly, the following options aren’t for everyone, but knowing what’s possible can be helpful. Delivering without anesthesia Natural childbirth usually refers to giving birth without any medications or anesthesia. (It’s probably not the best terminology, because using pain medication doesn’t make the birthing process unnatural.) The theory behind natural birth is that childbirth is an inherently healthy and natural process, and that women’s bodies are made to handle childbirth without the need for medications. Natural childbirth allows women to have a great deal of control over the childbirth process and their own bodies. It emphasizes having the woman choose which positions are comfortable, how mobile she wants to be, and which techniques she wants to use to be as comfortable as possible. Natural childbirth can be practiced in a hospital setting, birthing center, or even at home. Some practitioners aren’t comfortable with every aspect of natural childbirth because they don’t want to be limited in doing what they feel is medically necessary and important. Discuss with your practitioner what he feels comfortable with, so your delivery can be as great an experience as possible. Giving birth at home Home births are still relatively uncommon in the United States, with fewer than 1 percent of women choosing to deliver at home. This rate is similar to other industrialized countries, except that England has a rate of about 2.4 percent, and the Netherlands about 23 percent! Although the American College of Obstetricians and Gynecologists, in agreement with the American Academy of Pediatrics, believe that hospitals and birthing centers are the safest setting for births, they respect the right of women to make medically informed decisions about where they want to deliver. For some women, a home birth provides an ideal environment to deliver their baby. Common reasons for choosing a home birth are the desire for a low-intervention birth; a desire for control over the birth process; a desire to give birth in a familiar and comfortable environment, surrounded by family and friends; living in a rural area with lack of access to a hospital; and economic, cultural, or religious issues. Typically, a midwife usually attends a home birth, and an obstetrician is on call in case problems arise. Home births are certainly more appropriate for women who are at very low risk for complications. Although some studies demonstrate that home births are associated with greater risks for both the mother and baby, others show that home births are at least as safe as hospital births for healthy, low-risk women. The American College of Obstetricians and Gynecologists recently published the minimum criteria for planning a home birth, which include informed consent, a singleton pregnancy with the fetus’s head down, no medical or obstetrical conditions, no contraindications to vaginal birth, and the prenatal care, labor, birth, and postpartum care administered by a licensed obstetrical caregiver. The backup hospital should also be within 15 minutes of the home. In addition, and of prime importance, is that women completely understand that while the absolute risk of home births is low, it is still associated with a two- to threefold increase in neonatal death when compared with planned hospital births. Using a doula A doula may be a friend, relative, or trained companion who is there to provide nonmedical continuous support during labor and delivery. Doulas often meet with prospective moms before delivery so they get to know each other. During labor, they provide both emotional support and physical support — helping to get moms into comfortable positions, massaging their back or legs, getting water or ice chips, and so forth. Some studies have shown that labors attended with doulas may actually be shorter in length, although there is no effect on cesarean delivery rates. Women who used doulas also seemed to have a slightly better overall birth experience and were more likely to rate their labor and delivery as “very good.” Some women choose doulas because they may not have someone there (like a partner or friend) who can be of emotional support. Others may be at a hospital without one-on-one nursing care and want the additional help. Others just like having a helping hand, and others believe it will enhance the birthing experience. Immersing yourself in a water birth Water births refer to spending much of labor immersed in water, with the option of even delivering the baby in the water. Water births usually take place in a birthing center with the help of a midwife, although some hospitals may provide birthing pools or baths. The water temperature is kept about the same as the body temperature, and the woman’s temperature should be monitored throughout labor. A recent review of randomized trials found a somewhat lower rate of anesthesia when water immersion was used in the first stage of labor. Interesting, prolonged immersion for more than two hours may actually slow down labor by decreasing the production of oxytocin. Although some professionals in the medical community feel that a water birth is a safe procedure, others have more serious concerns about its safety for both the patient and newborn. Water immersion during the second stage is not well studied. There have been a few cases reported of water aspiration and snapped umbilical cords, difficulty regulating body temperature, and infections in the newborn.

Article / Updated 06-01-2022

Infertility has long been a silent struggle for some people trying to start a family. But this June, Infertility Awareness Month seeks to help those suffering learn more about conception and become more vocal about their journey. The prevalence of infertility Infertility is usually defined as not being able to get pregnant after one year of trying. It also refers to women who are able to become pregnant, but struggle to carry their pregnancy to term. Six million women are diagnosed with fertility troubles each year in the U.S., which equates to roughly 10 percent of women ages 15 to 44. Moreover, around 1 in 8 couples deal with infertility on their way to becoming a family. It’s a common problem, but it’s often kept quiet, as many couples feel shame, fear, or judgment around the issue. Overall, Western culture is becoming more open to discussing infertility. Maybe you’ve seen it addressed on TV shows like This is Us, Parenthood, or Friends. Maybe you’ve heard about the infertility journeys of celebrities like Kim Kardashian, Emma Thompson, and Gabrielle Union. Or, maybe you saw a friend post “I am 1 in 8” on social media. Though it’s not as taboo as it once was, it still can be difficult to know how to discuss such a personal issue. Infertility Awareness Month is meant to help others see the wide reach of this disease and to give those struggling with it a way to start conversations with friends, family, and other loved ones. Not just a woman's issue Though people tend to think of infertility as a woman’s struggle, its causes are split equally between women and men. A third of infertility cases are caused by female reproductive issues, another third by male reproductive issues, and the remaining third by a combination of male and female or unknown issues. Male infertility issues tend to be a bit more straightforward; they’re usually caused by low sperm production, slow sperm movement, or variant sperm shape. Female infertility problems, on the other hand, can be very complex. Because many different organs and systems need to work together to produce a viable pregnancy, just one irregularity may prevent fertility. Checking out the organs Doctors will often check a woman’s uterus and fallopian tubes first to see if any tumors, polyps, or scars are present. The fallopian tubes can also be damaged in some way. The roles they play in fertilization are vital: Think of them not only as the intersection where the sperm and egg have their “meet-cute,” but also the romantic bistro where the relationship incubates and, finally, the minivan that carries the fertilized egg to its new home: 1000 Uterus Place. Unfortunately, fallopian tubes can swell, dilate, or even burst. If there’s anything wrong with them, it’s likely the woman will need to look into in-vitro fertilization (IVF) to get pregnant. Parsing PCOS Another common cause of infertility in females is polycystic ovary syndrome (PCOS). It’s unknown what causes this mysterious syndrome, but it’s quite prevalent, affecting 1 in 10 women of childbearing age. PCOS can manifest in myriad ways. Women with PCOS may experience irregular periods, excessive hair growth on their face, chest, or thighs, or male-pattern baldness on their head. Often, women with PCOS will develop multiple cysts on their ovaries (sometimes referred to as a pearl necklace — because of the appearance of the “chain” of circular cysts on ultrasounds). However, the presence of cysts isn’t necessary for a PCOS diagnosis. Doctors may also measure hormone levels, such as insulin, androgens, and progesterone. Since PCOS interferes with ovulation (that interference is what can cause irregular periods), women with PCOS may have trouble growing the follicles that produce an egg to full maturity, and thus, have issues becoming pregnant. Thankfully, there are fertility medications that can aid ovulation, such as Clomid and Letrozole. If all else fails, IVF is another option for women with PCOS. 'Outside' fertilization (aka in vitro) You’ve probably heard of in vitro fertilization (IVF) before, but what does it actually mean? In vitro is a Latin term that literally translates to "in glass." This refers to a glass test tube or petri dish where a doctor or scientist observes or performs an experiment. In contrast, in vivo is a Latin term that translates to "in the living." So, when something happens in vitro, it happens outside of a living organism. But to get to that “outside” fertilization, a lot of stuff needs to happen inside first. An IVF treatment cycle involves different courses of drugs and hormones meant to stimulate egg production and egg maturation. If the drugs work as planned, an egg collection and sperm collection are scheduled, and an embryologist will put the egg together with the sperm (this is the in vitro part). If this is successful, the egg fertilizes, and an embryo begins to form. A few days later, this embryo is placed in the uterus, and a pregnancy test is performed after a few weeks to see if the implantation worked. Sadly, it often takes many cycles of treatment for IVF to be successful, and each procedure can be very expensive, time-consuming, and stressful. However, there are things people wanting to start a family can do to help. Explore this IVF cheat sheet to discover ways to improve chances at IVF success, learn common abbreviations and procedure names, and view ways to keep high spirits on this journey. Infertility support Whether those struggling with infertility are in and out of doctors’ offices, calculating an ovulation window, or trying to discreetly inject themselves with hormones in public, it’s easy to feel alone when undergoing infertility treatments. But there are organizations that exist to help women and families on this journey: RESOLVE: The National Infertility Association exists to help all people on a family-building journey find knowledge, community, advocacy, and eventually, resolution. In addition to providing important facts about infertility, RESOLVE also helps connect people with medical professionals and support groups. Fertility Out Loud helps people struggling with infertility to understand cryptic insurance policies, learn how to reply to insensitive comments (like “Your clock is ticking! Better hurry up!”), and connect and share stories on social media platforms. Rescripted is an online community for those trying to conceive (TTC) founded by two women who underwent their own IVF journeys. Aside from articles and support stories, this site also has videos on how to perform common hormonal injections and a digital pharmacy where users can search for inexpensive fertility medications. For general information about how to assess fertility and nurture pregnancy, check out Getting Pregnant for Dummies.

Article / Updated 05-11-2022

Women’s infertility issues can be very complex because so many different systems can be at fault. Is the problem uterine, tubal, hormonal, age-related, or ovarian? Any one of these problems can cause enough trouble to prevent you from becoming and staying pregnant. A healthy uterus Maybe you had an HSG to evaluate your fallopian tubes and uterus, or maybe you had a hysteroscopic surgery for an even closer look into the uterus. Looking at the uterus is an integral part of any fertility workup because the uterus nourishes and holds a baby for nine months. Finding fibroids in the uterus Fibroids, or benign tumors, are commonly found inside or on the outside of the uterus. They’re extremely common, with 40 percent of women between the ages of 35 and 55 having at least one. Fibroids are even more common in African-American women, with 50 percent having at least one. Fibroids can cause bowel or bladder problems, very heavy bleeding, or pain. Fibroids can be either inside or outside the uterine cavity; their location determines whether they cause a problem with your ability to get or stay pregnant. Fibroids completely outside the uterus, such as pedunculated fibroids, which are attached to the uterus by a stem, don’t usually cause a problem with fertility. Submucosal fibroids grow through the lining of uterine wall and can cause a miscarriage. Fibroids can be surgically removed through a process called a myomectomy. A small fibroid inside the uterus can usually be removed by hysteroscopy, a procedure in which a thin telescope is inserted into the uterus through the vagina. This is outpatient surgery and is relatively atraumatic. In contrast, large intramural fibroids require an abdominal incision and a hospital stay. You generally need to deliver by cesarean section after an abdominal myomectomy. Removing polyps in uterus Polyps are small fleshy benign growths found on the surface of the endometrium. Very small polyps usually cause no problem with getting pregnant, but larger polyps or multiple polyps can interfere with conception. Polyps can cause irregular bleeding; they can be diagnosed via sonohysterogram or hysteroscopy and can be scraped off the endometrium. Polyp removal is called polypectomy. Clearing out the fallopian tubes Most women have two fallopian tubes, one on each side of the uterus, next to the ovaries. Because these tubes are the transport path from the ovary to the uterus, a problem with one or both tubes can have a big impact on your baby-making ability. How fallopian tubes should work and what can go wrong Fallopian tubes are not just tubes. If they were, then repair would be much simpler and far more successful. Tubes actually have jobs to do: specifically, to transport and culture. The tube is where the sperm and eggs meet, and fertilization takes place. So, the tube must allow sperm to migrate through the uterus and into the tube. The tube also must pick the oocyte from the surface of the ovary when it is ovulated and move it nearer the uterus. Finally, once the fertilized egg, now called an embryo, has developed for two to three days, the tube must move the embryo into the uterus. The inside of the tube is lined with cells that have hair-like projections that move in a wave-like fashion to transport the embryo. (Think beach ball at a football game moving around the crowd.) Infections can damage these hair-like projections and decrease or destroy the tube’s ability to perform the transport function. This is a microscopic function and therefore cannot be diagnosed. Also, the tube acts as an incubator for the early development of the embryo. The environment in the tube, designed specifically for the embryo, is unlike anywhere else in the body. This function also cannot be seen or diagnosed. Sometimes a tube is surgically removed after an ectopic pregnancy, a pregnancy that starts to grow in the tube rather than in the uterus. If this pregnancy is found early enough, it may be possible to dissolve the pregnancy with a chemotherapy agent called methotrexate. However, if the fetus grows large enough undetected in the tube, the tube can burst, causing life-threatening bleeding. The only way to stop the bleeding is to remove the tube. You can get pregnant with only one tube but having one ectopic pregnancy leaves you at a higher risk to have another. Frequently, when a tube is removed, the surgeon will look at the other tube and find that it looks okay. For a person with an ectopic and one remaining tube, the pregnancy rate is estimated to be about 70 percent, of which 10 percent are another ectopic. So why don’t the other 30 percent conceive? Probably because the tube may appear normal and be open, but damage on the interior of the tube has caused it to malfunction and not be able to perform the job it needs to do. When women become pregnant after an ectopic has been removed, they usually do so within the first year. Beyond that pregnancies can occur but they are rare, and the couple may want to pursue IVF. Damaged tubes Women who have only the left ovary and the right fallopian tube can get pregnant because the egg can “float” to the remaining tube. Of course, this also applies to women who have the left tube and the right ovary. (One study estimated that the egg gets picked up by the opposite tube about 30 percent of the time.) Sometimes fallopian tubes are seen to be enlarged on ultrasound or during an HSG. If the tubes are very swollen and dye doesn’t flow through them, you may have a hydrosalpinx, the medical term for a tube filled with fluid. If both tubes are dilated, the condition is known as hydrosalpinges. A hydrosalpinx interferes with pregnancy in two ways: The egg cannot be picked up by the dilated tube, whose fimbriae (the end) is blocked by scarring. The tube has an environment that damages the development of the embryo. The treatment for a hydrosalpinx is surgical. In mild cases, the end of the tube can be opened and the ends peeled back like a flower. Surgical repair of damaged tubes has a low chance of success primarily because surgical repair does not address the damage on the interior of the tube. However, in severe cases, the tube will not work even if it is opened. In these cases, the tube or tubes must be removed, and you need to have IVF. This diagnosis is a hard thing for many women to accept because it definitely ends any chance that they’ll be able to get pregnant on their own. However, well-done studies have demonstrated that pregnancy rates are lower for women with bilateral hydrosalpinges. Having one hydrosalpinx and one open tube still reduces the chance for a successful IVF cycle. The reason why the hydrosalpinx reduces the pregnancy rate is unknown, but theories propose that the fluid in the tube can leak into the uterus prevent implantation. In very rare cases, women can be born without any fallopian tubes; often the tubes are missing as part of a syndrome in which the external sex organs look normal, but the vagina, uterus, and fallopian tubes are missing. Of course, if you’ve had two ectopic pregnancies, you may have had both tubes surgically removed also. Sometimes fallopian tubes look fine on an X-ray but may be surrounded by adhesions (scarring) that prevent them from picking up the egg. Endometriosis, tissue growths found anywhere in the pelvis, can grow in or around the fallopian tubes and is a common cause of adhesions around tubes. Normal tubes can’t be visualized by ultrasound. Because the fallopian tubes play such a large role in getting pregnant, you’ll probably need intervention, such as IVF, to get pregnant if a problem is discovered with them. Removal or absence of the tubes, or a blockage that can’t be removed, makes IVF inevitable if you’re trying to get pregnant. Addressing scar tissue For doctors who perform surgeries in this area, it's typical to see scar tissue, or adhesions (as shown), in your reproductive system. Many women having a second or third cesarean section delivery or other surgery had scar tissue throughout the pelvis that needed to be cut away before the delivery team could get to the uterus. Adhesions form when blood and plasma from trauma, such as surgery (like an appendectomy, tubal removal of an ectopic pregnancy or fibroid), form fibrin deposits, which are threadlike strands that can bind one organ to another. They can be removed, but surgery to correct adhesions may result in — you guessed it — more adhesions. The amount of scarring depends upon the surgical procedure done but can occasionally be extensive. Adhesions can cause pelvic pain; cesarean sections can cause adhesions, but they tend to be anterior (or in front of) the uterus, and thus may cause difficulty during a subsequent C-section. However, C-sections don’t usually cause problems with tubes (which tend to be behind the uterus), and thus don’t usually cause infertility. Your chances of getting pregnant after adhesion removal are highest in the first six months after surgery, before extensive adhesions form again. Some adhesions can’t be removed without damaging the tubes or ovaries, and you may need IVF to get pregnant. Since the advent of IVF, surgical repair for pelvic adhesions is uncommon. If you have adhesions in the uterus itself, you may be diagnosed with Asherman’s syndrome, also called uterine synechiae. Asherman’s can follow a dilation and curettage (D&C), an abortion, or a uterine infection. It can be diagnosed during an HSG but is best diagnosed with a hysteroscopy, where the inside of the uterus can be visualized. Asherman’s is also suspected if you have scant or no menstrual flow or recurrent miscarriages following uterine trauma. There are varying amounts of scarring in Asherman’s syndrome. Some people have very few adhesions, and these are filmy and easy to remove. That person has a very good chance to conceive. If the mild to moderate adhesions are removed surgically, you have a good chance, probably 75 percent or better, of becoming pregnant and carrying to term. Severe adhesions may destroy nearly all the normal uterine lining, and pregnancy may not be possible. Less frequently, a person will have extensive intrauterine scarring and that person will have a very poor chance for achieving a pregnancy. A gestational surrogate may be needed in these cases.

Article / Updated 05-11-2022

If a couple tries to conceive but can’t seem to do it, one of the first things that doctors look for is a problem with the man’s sperm. Sperm compose about 5 to 10 percent of semen, and are the only part of the semen that can cause pregnancy. If a man is infertile, there is a problem with his sperm — often a low sperm count or low motility. Sometimes, male infertility can be treated. Just because testicles look normal doesn’t mean that they are fully functioning. The most common problems of male infertility are: Low sperm count, which means that the man isn’t producing enough sperm Low motility, where the sperm he is producing lack sufficient ability to swim to the egg The basis for the problems may be abnormal sperm production, which can be difficult to treat, or that the testicles are too warm. Heat is known to decrease sperm count, so the solution could be as simple as changing the style of underwear from tighty-whities (briefs) to boxers. Another cause can be a blockage somewhere along the line, which may be corrected through surgery. Interestingly enough, most semen analysis is done by gynecologists, specialists in the female reproductive system. A gynecologist is usually the first person a woman consults when she has problems getting pregnant. Commonly, the gynecologist asks that the man’s sperm be analyzed. If the tests reveal a problem with the sperm, the man is sent to a urologist for further evaluation.

Cheat Sheet / Updated 05-06-2022

Getting pregnant can be a complex and lengthy process for those diagnosed with infertility. Getting through the fertility treatment may seem difficult. Following are a few of our cheat lists to not only help you decipher fertility testing but also help you understand fertility treatment a little better.

Cheat Sheet / Updated 04-25-2022

If you’ve been trying unsuccessfully to have a baby for some time, you may wonder whether IVF can help fulfill your baby dream. To begin with, you need to undergo some tests to establish the cause of your infertility. If IVF is an alternative for you and you decide to try treatment, your best bet for coping with the inevitable ups and downs is to be well-prepared: The more you know about the physical, technical, emotional and financial aspects of infertility and IVF, the better you’ll fare on your IVF journey and beyond, when hopefully, you’ll have a baby to love and care for.

Cheat Sheet / Updated 03-23-2022

Becoming a dad is both an exhilarating and a terrifying experience. Planning ahead and being prepared are the best ways to handle what’s coming up in the next nine months and beyond. Doing what you can ahead of time, such baby-proofing your house and packing your hospital bag, will save precious time later on and help you feel like you’re in control (at least a little bit). After the baby arrives, all bets are off as far as feeling in control, but you can still be prepared to take an active role in caring for your newborn and supporting your partner during the postpartum period.

Cheat Sheet / Updated 09-13-2021

Once you find out you’re pregnant, follow a recommended schedule of prenatal visits and review the tests you can expect for each doctor’s visit. Learning a few medical abbreviations used by your doctors and hospital staff will help you keep up with what's going on all the way through your delivery. Keeping tabs on your baby’s growth is exciting, especially when you have a helpful growth chart to follow. Keep a bag packed towards the end of your pregnancy and have important phone numbers handy ahead of time.

Article / Updated 09-03-2021

If you want to feel great during pregnancy, radiate good health, wake up refreshed and energetic and stay that way all day long (well, most days, anyway), avoid major health problems, and provide all the nutrients your baby needs, you must regularly eat well. Here are five tricks that will set you on the right path during your pregnancy: Fill up on the good stuff. When you need a snack, grab an apple or banana, not a cookie or box of crackers. Eat before heading out for errands and bring healthy snacks with you in your purse. When you’ve had a bad day and think that the pint of your favorite comfort food or memory food is the only way to solve your problems, first make a big stir-fry with lean chicken (or pick up a container at your local Chinese takeout restaurant), drink a large bottle of water, and then — if you’re still hungry and stressed — put a scoop or two of ice cream in a small dish and see how that feels. Don’t completely deny yourself anything tasty. A doughnut once a week doesn’t compromise your health, but a doughnut every day, combined with other unhealthy eating habits, quickly has negative effects on your health. Turn off or otherwise ignore all food-related advertisements. The companies advertising food don’t care about you; they care about profits. Whether you struggle with illness or general feelings of blah is completely irrelevant to them, as long as you keep buying those foods. Take charge of your eating by eliminating the influence of commercials on your healthy lifestyle. This goes double for the many unhealthy recipes found in the food section of your local newspaper, many home and garden magazines, and gourmet food publications. Look for publications that cater to healthy eating, especially those that provide recipes that are low in fat and include fresh vegetables. Immediately look for the one or two healthy choices upon entering any restaurant, party, or other social gathering. If you’re not doing the serving or bringing a dish with you (as is the case at a restaurant or wedding), search for the veggie plate, a big salad, a lean meat option without any sauces, or a legume or whole-grain food. Serve or bring healthy foods, and limit the number and size of treats. If you’re serving the meal, offer an enticing array of brightly colored vegetables, legumes, whole grains, and lean meat, and then offer small slices of a delicious fruit pie with a spoonful of low-fat frozen yogurt. Your guests will be amazed at how colorful and delicious a nutritious meal can be and will be clamoring for recipes. If you’re at a potluck gathering, such as an office party or baby shower, bring one or two healthy dishes that you know you’ll eat, and quickly evaluate what other healthy foods are available at the gathering. All that said, if you’re unable to keep food down during any part of your pregnancy, find foods that you can tolerate and, until you’re able to keep down other foods, don’t worry about whether what you’re eating is healthy. Sometimes, pregnancy causes you to reject even the healthiest foods, so make gaining weight normally your number-one priority, with healthy eating number two on that list.

Article / Updated 09-03-2021

Heartburn is common during pregnancy and can happen at any time throughout your 40 weeks, although it often gets worse in the second and third trimesters. Heartburn has two causes, and both are related to the sphincter muscle that connects the esophagus to your stomach. The progesterone your body produces relaxes that sphincter muscle, and your growing uterus presses on it. The result is that gastric acids, liquids, and food from the stomach travel back up your esophagus, leaving you uncomfortable. Heartburn typically worsens as your belly grows and puts more pressure on your stomach, causing the sphincter muscle to allow acid back into the esophagus. You can lessen the symptoms of heartburn by trying the following tips: Stop eating two to three hours before lying down for bedtime or a nap. The less you have in your stomach, the less likely you are to experience acid reflux. Sleep propped up to avoid lying flat. When you elevate your upper body, gravity helps keep your stomach acids down. (If you’re past your first trimester, you shouldn’t lie flat, anyway; lying flat can cut off circulation to your baby and your legs. Lie on your left side for optimal circulation.) Practice good posture when sitting. When you slouch, you put more pressure on your esophagus, which can lead to heartburn. Avoid big meals. Eat small portions so that you don’t overfill the stomach and cause extra food to come back up the esophagus. Sip liquids with meals instead of drinking large amounts. Because you want to avoid having large amounts in your stomach at one time, drink small amounts at meals and stay hydrated by spreading your liquids out between meals. Avoid greasy or fatty foods. High-fat foods, specifically fried foods, tend to trigger heartburn because they don’t stimulate digestion but do take longer to digest (they just sit in your stomach). Skip spicy and acidic foods. Acidic foods, like tomatoes, citrus, and peppers, can be problematic for many women. Onions and garlic are also on some women’s problem-foods list. Avoid caffeinated and carbonated beverages. These drinks have been known to cause acid reflux. Sorry to say, but chocolate can also irritate the esophagus, so you may want to avoid it, too. Take an antacid when you’re uncomfortable. Talk to your doctor about which one to choose or about a safe prescription medication if over-the-counter antacids don’t work for you.