Why does shortness of breath happen during pregnancy?

What causes shortness of breath during pregnancy?

You may be out of breath now because you need more oxygen during pregnancy, and your body adapts to meet this need in several ways. Rising hormones, particularly progesterone, directly affect your lungs and stimulate the respiratory center in your brain. And although the number of breaths you take per minute changes very little during pregnancy, the amount of air you inhale and exhale with each breath increases significantly.

Being short of breath in early pregnancy may feel more like a heightened awareness of the need to breathe. Later in pregnancy, your breathing might feel more labored as your growing uterus puts pressure on your diaphragm – especially if you're carrying your baby high, are pregnant with multiples, or have excessive amniotic fluid.

Shortness of breath during pregnancy can also be aggravated by a preexisting condition, such as asthma, anemia, or high blood pressure.

You may get some breathing relief a few weeks before you're due (especially if it's your first pregnancy) when your baby drops into your pelvis as labor approaches. When this happens, there's less pressure on your lungs and diaphragm. 

Is it possible to have shortness of breath in very early pregnancy?

It is possible to have shortness of breath in very early pregnancy, although it's more common to experience this later in pregnancy, especially in the third trimester. If you do experience it early on, it's likely due to increased progesterone, which begins rising at the beginning of the first trimester.

This can come as a surprise but it doesn't indicate that anything is amiss – this tends to be due to normal changes in your hormone levels. The good news is that the hormone also expands your lung capacity so you can take in more oxygen for your baby. That means you can take deeper breaths, which may be helpful to alleviate the issue.

However, if you're experiencing other symptoms like chest pain or rapid heartbeat, seek medical attention immediately.

What can I do if I have shortness of breath during pregnancy?

If you're feeling a little breathless, try these tips for relief:

• Take things a bit more slowly and don't push yourself too hard when being active.
• Sit up straight and keep your shoulders back (especially when sitting) to give your lungs as much room as possible to expand.
• Prop yourself up a bit with a few extra pillows when you're in bed at night.
• Lift your arms over your head. This will take pressure off the rib cage, so you can usually breathe in more oxygen.
• Try to be patient. It's no fun to be uncomfortably out of breath. But after you give birth, your breathing will soon feel like it did before you were pregnant.

Can having shortness of breath during pregnancy lead to any complications?

If you have occasional shortness of breath – especially in your third trimester when your growing baby is pressing upward – it shouldn't be a concern. But it is possible that it could worsen if you have another respiratory problem, such as asthma or the flu.

Up to 45 percent of women with asthma experience worsening symptoms during pregnancy, and severe bouts could be harmful to both you and your baby.

Pregnant women with respiratory illnesses like the flu and COVID often have more serious symptoms and are more likely to develop complications, such as pneumonia and preterm birth. That's why it's important to get a flu shot during pregnancy, as well as the COVID vaccine.

Also, because of changes in the way your blood clots during pregnancy, you're at higher risk for developing a blood clot that goes to your lungs (pulmonary embolism). This condition is rare but very serious.

When should I call my doctor about shortness of breath during pregnancy?

If you're having mild shortness of breath when doing an activity like walking up stairs or carrying something heavy, it's probably okay to just observe yourself and make sure it passes when you pause and relax for a few minutes. However, if you have severe symptoms you'll need to call your doctor right away. These include:

• Sudden or severe shortness of breath
• Worsening asthma
• Rapid pulse
• A rapid or irregular heartbeat
• A feeling that you're going to faint
• Chest pain or pain when you breathe
• Paleness
• Blue-tinged lips, fingers, or toes
• A sense of apprehension that you're not getting enough oxygen
• A persistent cough, a cough along with fever or chills, or coughing up blood

Even without shortness of breath, symptoms like these need immediate attention.

Call 911 or go to the emergency room if you can't reach your provider.