shortness of breath in pregnancy

Overview

Shortness of breath, or feeling like you can't get enough air, is a common symptom during pregnancy. It can happen for simple reasons, like your growing baby pressing on your diaphragm, or because of normal changes in your breathing pattern. In some cases, it can be a sign of another health problem that needs checking. This article explains the causes, what you can do, and when to seek help.

Yes. Many pregnant people notice breathlessness at some point. It is one of the most common breathing-related symptoms in pregnancy.

It can affect anyone who is pregnant, but it is more noticeable if you are expecting twins, if you are very active, or if you have a health condition before pregnancy such as asthma, anaemia, obesity, or heart disease.

Symptoms

Common symptoms

• A feeling of not getting enough air, especially when lying flat or climbing stairs.
• Breathing faster than usual.
• Sighing often to 'catch your breath'.
• Feeling breathless with activity that did not bother you before.

Causes

Main causes

• A growing uterus pushing up on the diaphragm (the muscle below the lungs), making it harder for the lungs to fully expand.
• Natural hormone changes that increase your breathing rate and tell your body to take in more oxygen for the baby.
• Carrying twins or a larger baby, which puts more pressure on the lungs.
• Anaemia (low iron) – less oxygen in the blood, making you feel breathless.
• Asthma that is becoming more active during pregnancy.
• Anxiety or worry, which can make you feel tight in the chest.

Risk factors

• Having asthma or a lung condition before pregnancy.
• Having heart disease or a heart condition.
• Anaemia from low iron or a previous heavy period.
• Expecting twins or multiple babies.
• Smoking or exposure to smoke.
• Being overweight before pregnancy.

When to see a doctor

See a doctor urgently if:

• Sudden or severe breathlessness that doesn't improve with rest.
• Breathlessness with chest pain, coughing blood, or fainting. (Call emergency services immediately.)
• Breathlessness that stops you from doing daily tasks, like dressing or walking to the bathroom.
• Feeling like your throat is closing or your lips are tingling.

Book a routine appointment if:

• Mild breathlessness that happens only with activity and goes away with rest.
• Breathlessness that is new and you want reassurance.
• Symptoms that wake you at night and make it hard to sleep.

Diagnosis

A healthcare provider (like your midwife, GP, or obstetrician) will ask you about your symptoms, examine you, and may check your heart and lungs. They will often measure the oxygen level in your blood with a small clip on your finger, and may listen to your chest.

Tests that may be done

• A pulse oximeter to check blood oxygen levels.
• A blood test to look for anaemia or other conditions.
• An ECG (electrical tracing of your heart) if the doctor is worried about heart issues.
• A chest X-ray or V/Q scan (to check for blood clots in the lungs) – these are considered safe with proper shielding during pregnancy.

What to expect at your appointment

You may be seen the same day if your symptoms are more concerning. The provider will explain what they find, and if breathing tests are needed, they will arrange them. In most cases, a clear answer and reassurance can be given after a simple check.

Treatment

Treatment depends on the cause. If shortness of breath is from normal pregnancy changes, no specific treatment is needed. You can learn positioning, breathing techniques, and pacing activities to feel better. If there is an underlying condition like asthma or anaemia, that will be managed with safe approaches during pregnancy.

Self-care at home

• Rest when you need to, but keep up light activity like walking.
• Sleep propped up with extra pillows to ease pressure on your diaphragm.
• Try breathing exercises: slow in through your nose, steady out through your mouth.
• Avoid lying flat on your back in later pregnancy – lie on your side instead.
• Sit with your shoulders back and chest open to make more room for your lungs.
• Avoid smoking and second-hand smoke.

Medical treatments

If an underlying cause is found, your provider will treat it. For example, iron supplements if you have anaemia, or a safe inhaler if your asthma flares. In hospital settings, oxygen therapy or other medication may be used if needed. Always discuss any treatment with your healthcare team – do not stop or start any medication without advice. Specific drug names are not mentioned here because your provider will choose what is safe for you.

When is surgery considered?

Surgery is not usually part of the treatment for shortness of breath in pregnancy. Very rare heart or lung problems might require specialist procedures, but that is only decided by your medical team if an urgent issue is found.

Living with this condition

Live one day at a time. Break tasks into smaller steps, and pause before you get too breathless. Wear loose clothing and avoid tight waistbands. Take your time with stairs and ask for help when you need it. You don't have to 'push through' – rest is important.

Lifestyle tips

• Regular light exercise such as prenatal yoga, swimming, or walking – with your doctor's okay.
• Stay active but don't overdo it. If you can talk while moving, you are going at a safe pace.
• Eat iron-rich foods like leafy greens, beans, and lean meat to help prevent anaemia.

Diet and exercise

Eat small, frequent meals to avoid feeling too full, which can press on your diaphragm. Drink plenty of water unless your doctor says otherwise. Gentle exercise can actually improve your breathing, as it strengthens your heart and lungs.

Mental health and emotional wellbeing

Feeling breathless can be scary and may cause anxiety, which can make breathing even harder. Remember that anxiety itself can cause breathlessness. Talk to your partner, midwife, or a trusted friend about your worries. If you feel overwhelmed, ask for mental health support early.

Prevention

You cannot fully prevent the normal breathlessness of pregnancy, but you can reduce its impact. Keeping regular checkups, staying reasonably active, and avoiding smoking help. Managing asthma or other conditions well before and during pregnancy is the best prevention.

Vaccines

Stay up to date with recommended vaccines (like the flu, whooping cough, and COVID-19 vaccines) – as your healthcare provider advises. These help protect your lungs from infections that could cause shortness of breath.

Screening programmes

Routine pregnancy checkups include blood tests and blood pressure checks. These can pick up anaemia, pre-eclampsia, or other conditions that sometimes cause breathlessness. Ask your midwife about monitoring at your appointments.

Complications

If left untreated

• If a blood clot in the lung (pulmonary embolism) is not treated, it can be life-threatening.
• If anaemia is severe and left untreated, you may feel exhausted and your baby may be affected.
• Placenta problems or pre-eclampsia (a dangerous form of high blood pressure in pregnancy) can cause breathlessness and swelling – these need urgent care.
• Serious asthma attacks are dangerous for both you and the baby.

Long-term outlook

Most people with breathlessness in pregnancy have a normal, healthy pregnancy and delivery. Breathlessness usually improves after the baby is born. With the right care and monitoring, any underlying issue can be managed. You and your baby will be cared for by a team who wants the best for you.

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