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Experiencing breathing difficulty during pregnancy is a common concern among many expectant mothers. Studies have shown that about 75% of women who seldom felt out of breath before getting pregnant experienced breathlessness more frequently during pregnancy (1). The signs of breathlessness or respiratory distress during pregnancy are not something to be worried about. However, if you have any questions related to it, consult your doctor. Read on to know more about the signs of breathing difficulty in pregnancy, its causes, and treatment options. Understanding the causes and risk factors can help pregnant women prevent distress and anxiety.
Key Pointers
- Experiencing shortness of breath due to physical exertion is normal during pregnancy unless associated with medical conditions.
- Pregnancy-related dyspnea is caused due to the bodily and hormonal changes that occur to accommodate the growing fetus.
- Being physically active, breathing exercises, a balanced diet, and adequate rest, can help manage dyspnea during pregnancy.
- Pregnant women should also pay attention to their posture and sleeping positions.
- The incidence of dyspnea during pregnancy can be reduced by staying hydrated and by avoiding strenuous activities.
- However, breathlessness along with severe chest pain, fatigue, bluish skin, dizziness, or fever need immediate medical attention.
Is Shortness Of Breath During Pregnancy Normal?
It is common to experience shortness of breath, especially in the third trimester, and also early in the pregnancy. Some women may feel breathless right from the first trimester, while some others experience it in the final trimester (1).
If the breathlessness is due to some physical strain like climbing the stairs, then it is completely normal and harmless. But if you have certain medical conditions such as asthma, peripartum cardiomyopathy (a cardiac issue that might occur during pregnancy or immediately after delivery), pulmonary problems like embolism (blockage of an artery in the lungs), then shortness of breath could cause other health complications and might require medical supervision.
Does Shortness Of Breath Hurt Your Baby?
As long as you do not suffer from any other worrying symptoms, feeling short of breath is common and will not harm your baby as they get plenty of oxygen through the placenta. Your deep and efficient breathing will supply your fetus with oxygenated blood.
What Causes Shortness Of Breath In Pregnancy?
Breathing difficulties in pregnancy arise mainly due to the natural changes that the body undergoes to adapt itself for holding a baby.
This condition is also called Dyspnea or Dyspnoea (2). Here are a few trimester-wise bodily changes that could lead to breathlessness.
In The First Trimester
- The progesteroneiA female reproductive hormone that plays a vital role in menstruation, pregnancy, and breastfeeding hormone could be responsible for your breathlessness. This hormone makes your body absorb more oxygen into the bloodstream, thus increasing the lung capacity. Your body will, therefore, get overwhelmed to breathe out excess levels of carbon dioxide.
- Though your breathing rate is the same as before your conception, you might take breaths more deeply, and this could be the reason you will feel breathless (3).
- Also, in the early stages of pregnancy, the blood volume swells by about 50%, for which your heart has to work harder than before. This makes you breathe more even when you are resting.
In The Second Trimester
- The pregnancy hormones, as in the first trimester, allow your body to take more oxygen, thereby stimulating your brain to increase the number and depths of your breaths.
- The hormones also may cause swelling of the capillaries in the respiratory tract, making you feel like you are breathing hard.
In the Third Trimester
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- Your growing baby and expanding uterus pushes the diaphragm (the muscle that lies under the ribcage) up, restricting the amount of space for your lungs and making it hard for them to expand (4).
- It might, therefore, make you breathe faster as if you have just run a marathon. It is quite normal and completely harmless to you and your fetus.
- You may feel short of breath during the final trimester, especially when you are carrying the fetus high, or there is excess amniotic fluid (5).
Quick factYou may also go out of breath when you take stairs, carry heavy items, or have gained weight unusually during pregnancy.
Shortness of breath can also happen when you are carrying twins or multiples. You need to take as much rest as you can in such cases.
Sometimes, breathlessness can indicate underlying health conditions, such as:
- Anemia: If you are deficient in iron, you will have low red blood cell count (red blood cells carry oxygen from lungs to the rest of the body and return carbon dioxide from the body to lungs). In such cases, your body works harder to provide oxygen for you and your baby. Breathlessness could develop as one of the symptoms of anemic hypoxia (6). According to a survey conducted by the World Health Organization (WHO) in 2019, the global prevalence of anemia in pregnant women was reported to be 36.5%.
- Asthma can be another reason for breathlessness (7), and you should check with your doctor if your breathing problem is due to this condition or pregnancy hormones.
- If you have breathlessness along with heartburn, racing pulse, palpitations, or cold fingers and toes, it could indicate a serious lung or cardiac problem. You should immediately check with your doctor.
- Bronchospasm is another condition that may cause dyspnea. It occurs due to an infection, underlying condition, allergy, or an environmental factor that tightens the bronchi leading to oxygen deprivation or shortness of breath.
- Pulmonary hypertension is another condition where you feel shortness of breath due to high blood pressure in pulmonary arteries.
- Pulmonary edema can also cause dyspnea during movement or lying down due to fluid build up in the lungs from cardiogenic or non-cardiogenic causes, which may lead to lung congestion.
How To Ease Shortness Of Breath During Pregnancy?
It is not uncommon for pregnant women to experience shortness of breath. But how to relieve breathing difficulties during pregnancy? Here are some changes you can make in your lifestyle.
1. Practice good posture
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- A good posture might help in relieving shortness of breath (8). While sitting, keep your chest lifted and your shoulder placed back. This gives enough room for your lungs to expand.
- While sleeping, prop your body upwards using some pillows, to expand the space in your abdominal cavity, giving you relief.
- Also, if you are lying by the side, use an extra pillow to elevate your head.
- Avoid sleeping on your back if you are feeling short of breath or dizzy. Otherwise it is completely okay for you and your baby to sleep in the position you feel comfortable.
Research finds2. Change your position
If you feel breathless by being in the same position for long, shift your position to breathe easily
. You may stand up straight as it might relieve pressure on your diaphragm.
3. Slow down
It is advised to listen to your body’s signals and rest whenever you feel like relaxing. When you feel out of breath, try to relax. Just stop what you are doing and take a few deep breaths until you start feeling better. Take a break of about 20 minutes and then resume your activity.
4. Eat healthy food
Right from the moment you plan for pregnancy, try maintaining the ideal weight and fitness levels. If your breathlessness is due to anemia, then eating a healthy balanced diet might prevent breathlessness. Also, a proper diet promotes a healthy weight and eases your breathing.
- Include , such as red meat, dark berries, and green leaves, as breathlessness can be one of the symptoms of anemia caused by iron deficiency.
- Do not take foods containing excess sugars, fats, and salts.
- Increase vitamin C intake as it helps your body absorb iron. Also, beans are great sources of protein. However, consume them, especially the dark-hued ones, in moderation as they affect your body’s iron absorption.
5. Practice breathing exercises
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Pregnant or not, breathing exercises might help increase your lung capacity and enable more chest breathing (as abdominal breathing is difficult due to expanding uterus) (9). These exercises might help in reducing hyperventilationiRapid breathing due to panic, anxiety, or a medical problem during pregnancy (10).
You can try this breathing exercise during pregnancy:
- Inhale deeply while raising your arms upwards and sides.
- Then exhale while bringing back your arms down on sides.
- Raise your head while inhaling and lower while exhaling.
- Take a long breath into your chest, rather than your abdomen, by placing your hands on the rib cage.
- Push your ribs against the hands while you are inhaling deeply. Practice deep breathing so that you can switch to it whenever abdominal breathing becomes hard.
6. Exercise
Lack of fitness might increase your breathlessness.
So, try some light exercises, which would allow you to hold a conversation without going out of breath. Your baby should also get enough oxygen while you exercise.
- Exercises in early pregnancy can improve your breathing and control pulse rate (10). Confirm with your doctor before you start any exercise program.
- If you have not started any activities, it is the right time to start beginner yoga. The stretches in yoga offer room to breathe properly.
- Brisk walking and swimming may also increase your ability to breathe deeper and maintain your fitness levels.
- You can also try some pregnancy yoga and pilates that can help in breathing, provide comfort from pain, and can even prepare your body for childbirth.
These exercises will offer you enough stamina to deal with breathlessness symptoms effectively. However, listen to your body signals and do not overdo any exercise.
If the breathlessness is caused due to an underlying health condition, such as asthma or anemia, treating and managing the condition may help alleviate the breathing difficulties and other associated problems. For example, in the case of anemia, make sure to have regular prenatal checkups to monitor your iron levels and take iron supplements as directed by your physician.
Can You Prevent Breathlessness In Pregnancy?
It may or may not be possible to prevent breathlessness during pregnancy, as it is your body’s reaction to accommodate the growing fetus. However, with few precautions you might be able to reduce the intensity of breathlessness.
1. Stay Hydrated
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Breathlessness could be due to dehydration. Make sure you are drinking enough water and avoiding beverages like coffee, tea, soda, and alcohol. These drinks might increase your body’s weight and can worsen your shortness of breath by causing palpitations.
2. Avoid Strenuous Tasks
Do not exert yourself by carrying heavy objects or working late in the office. Try to take breaks from strenuous work.
When To Seek Doctor’s Help?
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It is common to feel breathless while you are pregnant. But, if you experience any other serious symptoms, you should immediately check with your doctor for remedies. Go to the doctor if you experience any of these symptoms:
- Severe breathlessness, along with rapid breathing, chest pain, or rapid heart rate (tachycardia).
- Severe pain in the chest while taking a deep breath.
- Bluish tinge on lips and fingertips.
- Giddiness soon after doing any activity.
- Breathing difficulty or wheezing while lying down or at night.
- A persistent cough, along with fever or coughing blood.
- A feeling that you are out of oxygen.
- Feeling tired due to anemia.
- Breathing problem as a result of asthma or pneumonia.
Beware:
- If you do not control asthma during pregnancy, the risks are quite higher for you and your fetus.
- Another serious complication called pulmonary embolism, a blood clot in the lungs, can occur, causing breathlessness (11). It requires immediate doctor’s attention.
How Long Will Shortness Of Breath Last?
If you are a first-time mother, your baby drops down to your pelvis around 36 weeks. This is the time when your breathing issues will go away. If you were pregnant before, your baby would not fall until the end of your pregnancy (12).
Frequently Asked Questions
1. When does shortness of breath start in pregnancy?
In the third trimester, around 31 to 34 weeks, women experience shallow breathing and fall short of breath. This happens because the uterus starts to press on the diaphragm around this time, making it hard for the lungs to expand completely. Consult your OB-GYN immediately if your breathlessness becomes severe or sudden (13) (4).
2. Why is it hard to breathe at night when pregnant?
Breathing at night becomes difficult during the later stages of pregnancy due to a phenomenon called sleep-disordered breathing (SDB). Frequent snoring, maternal age, and high pre-pregnancy BMI (>25 kp.m-2) indicate SDB in early pregnancy. Though there is no pregnancy-specific treatment for SDB, your doctor may reevaluate your condition after the sixth month if you have pre-existing SDB (14).
3. How common is it to experience shortness of breath during pregnancy?
Shortness of breath (SOB) is common during pregnancy, affecting roughly 60% to 70% of healthy pregnant women. It is regarded as a regular physiological response to changes in the body during pregnancy (15).
4. How does a pre-existing respiratory condition impact breathing difficulties during pregnancy?
Pre-existing respiratory diseases may worsen breathing issues during pregnancy, requiring further monitoring and management for the mother’s and baby’s well-being (16).
5. Are there any medications that can safely treat breathing difficulties during pregnancy?
Breathing difficulty during pregnancy, especially while doing activities such as climbing stairs, is common and doesn’t require treatment. Increased weight, expanding uterus, and hormonal changes are the factors that usually cause it. However, it may occur due to underlying medical conditions in some cases. So, if you are frequently worried about how to relieve breathing difficulties during pregnancy, it’s worth noting that moving to a position that helps you breathe easily and exercising from the start of the pregnancy could offer some relief. Further, staying hydrated and avoiding strenuous activities may help reduce the intensity of breathlessness. However, seek prompt medical guidance if breathlessness is accompanied by symptoms such as giddiness, rapid breathing, or chest pain during pregnancy.
Infographic: Ways To Deal With Shortness Of Breath In Pregnancy
Increased body weight and altered lung capacity may cause breathing difficulties in pregnant women, especially in the last trimester. Nevertheless, as the infographic below suggests, mild breathing issues may be handled with simple yet effective measures. So try these steps to alleviate shortness of breath during pregnancy to feel better. Illustration: Momjunction Design Team
Illustration: Shortness Of Breath During Pregnancy: Causes And Remedies
Image: Dall·E/MomJunction Design Team
Pregnancy can cause increased heart rate and shortness of breath after 20 weeks. Learn why this happens and how to manage it in this video.
References
1. CN Nelson- Piercy; Asthma in pregnancy; Respiratory diseases in pregnancy-1
2. Study Session 12 Minor Disorders of Pregnancy; Antenatal Care Module: 12. Minor Disorders of Pregnant; Open University
3. Antonella LoMauro, and Andrea Aliverti; Respiratory physiology of pregnancy; Breathe- The Respiratory Professionals Source For Continuing Medical Education.
4. Shortness of Breath In Pregnancy; HARVARD MEDICAL SCHOOL
5. Polyhydramnios (too much amniotic fluid); National Health Service
6. Noran M. Abu-Ouf, and Mohammed M. Jan; The impact of maternal iron deficiency and iron deficiency anemia on child’s health; Saudi Medical Journal
7. Bidad K, et al.; Frequency of asthma as the cause of dyspnea in pregnancy; NCBI
8. The Best Position for Sleep During Pregnancy; The National Sleep Foundation
9. Breathing problems and exercise; Better Health Channel; Victoria State Government
10. Raziyeh Haddadi, et al.; The Effect of Breathing Exercises on Breathing Pattern of Pregnant Women; Research Gate
11. Andrew Frederick Scarsbrook; Investigating suspected pulmonary embolism in pregnancy; The British Medical Journal
12. Pregnancy: Dropping (Lightening); Michigan Medicine
13. Your third trimester guide; UNICEF
14. Bilgay Izci Balserak; Sleep disordered breathing in pregnancy; National Library of Medicine (2015)
15. Goland, Sorel et al.; Shortness of Breath During Pregnancy: Could a Cardiac Factor Be Involved?; National Library of Medicine (2015).
16. Stone, Sophia, and Catherine Nelson-Piercy.; Respiratory disease in pregnancy; National Library of Medicine (2007).
17. Albuterol; National Library of Medicine
18. Smy, Laura et al.; Is it safe to use inhaled corticosteroids in pregnancy?; National Library of Medicine (2014).
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