Shortness of Breath During Pregnancy: When Should I Worry?

It can feel harder to catch your breath while expecting. Find out what causes shortness of breath during pregnancy, how to feel better, and whether you need to worry.

Many women feel breathless during pregnancy—and not only from the excitement of creating a new life. This strange symptom is actually normal as your uterus expands upwards and your body adapts to hormonal changes. In rare cases, though, breathing difficulties may signal a serious complication like pneumonia or blood clots. Read on to learn more about shortness of breath during pregnancy.

What Causes Pregnancy Breathing Difficulties?

Shortness of breath in early pregnancy is caused by increased levels of progesterone. In the first trimester, it can be difficult to breathe as your body adjusts to new hormonal levels. This symptom might go away after a few weeks, then make a resurgence during the second or third trimester.

As your baby grows larger inside your abdomen, other organs are squeezed and pushed aside. Your lungs might not have enough room to expand with a full breath—and your diaphragm can't offer much help because it’s also compressed, says Laura Riley, M.D., medical director of labor and delivery at Massachusetts General Hospital, in Boston. (This doesn't cause any permanent damage; after your baby is born, your organs will slip right back into their pre-pregnancy position.)

Luckily most women get relief from this breathlessness before childbirth. When your baby's head drops into your birth canal—about 2 or 3 weeks before delivery—you'll have more room for your diaphragm and breathe more easily.

How to Overcome Shortness of Breath During Pregnancy

First of all, don't worry too much about your shortness of breath during pregnancy. Although you may feel as if you're getting less air, high levels of progesterone help you take deeper breaths and get more oxygen into your blood. And because your blood volume is higher during pregnancy, more oxygen passes back and forth across the placenta as you inhale and exhale, says Dr. Riley.

You can relieve symptoms by giving yourself and your lungs as much breathing room as possible. Stand up straight, sit up tall, and sleep propped up on pillows to expand the space in your abdominal cavity. When you feel breathless, slow down—rushing makes your heart and lungs work harder. You can also consciously breathe in a way that raises your rib cage; check that your ribs push out against your hands as you inhale deeply.

When to Worry about Shortness of Breath During Pregnancy

If you experience shortness of breath that's sudden, severe, or associated with chest pain or a faster pulse, get medical help immediately. A blood clot could have settled in your lungs, says Dr. Riley. This situation (called a pulmonary embolism) is a rare but dangerous occurrence among pregnant women, especially those with blood clots in their legs.

Be aware, too, that breathing problems can be caused by pneumonia. Usually accompanied by fever, chest pain, and cough, pneumonia is the third-leading cause of death among pregnant women, says Dr. Riley. Pneumonia can be viral or bacterial— and with either one, potential complications can include respiratory failure, premature delivery, or infections that can harm your unborn baby.

You can also seek medical advice if you have asthma that worsens during pregnancy. Many asthma medicines are considered safe while expecting. Doctors usually prefer to prescribe inhaled medications because they have a more localized effect and work well; if you discover that your chest feels tight, however, tell your doctor.

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