Breathing Difficulty in Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, NIH, March of Dimes guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with breathing difficulty in pregnancy, here is what you need to know.
The short answer
Shortness of breath affects up to 75% of pregnant people. It is caused by hormonal changes (progesterone increases respiratory drive), increased oxygen demand, and the growing uterus pushing the diaphragm upward. While usually normal, sudden or severe breathlessness should be evaluated promptly.
Key takeaways
- Shortness of breath affects up to 75% of pregnant people. It is caused by hormonal changes (progesterone increases respiratory drive), increased oxygen demand, and the growing uterus pushing the diaphragm upward. While usually normal, sudden or severe breathlessness should be evaluated promptly.
- Usually normal when: Gradual onset of breathlessness that worsened as pregnancy progressed
- Call your doctor if: Sudden severe shortness of breath, especially with chest pain, rapid heartbeat, or calf swelling, which could indicate a pulmonary embolism
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to ACOG, NIH, March of Dimes guidelines, shortness of breath affects up to 75% of pregnant people. It is caused by hormonal changes (progesterone increases respiratory drive), increased oxygen demand, and the growing uterus pushing the diaphragm upward. While usually normal, sudden or severe breathlessness should be evaluated promptly. At First trimester, breathlessness can begin surprisingly early due to progesterone, which increases your breathing rate and depth. You may feel more aware of your breathing even without exertion. This is normal and does not mean you or your baby are not getting enough oxygen. It is generally considered normal when gradual onset of breathlessness that worsened as pregnancy progressed. However, you should contact your pediatrician promptly if sudden severe shortness of breath, especially with chest pain, rapid heartbeat, or calf swelling, which could indicate a pulmonary embolism.
Normal vs. Concerning
By Age
What to expect by age
First trimester
Breathlessness can begin surprisingly early due to progesterone, which increases your breathing rate and depth. You may feel more aware of your breathing even without exertion. This is normal and does not mean you or your baby are not getting enough oxygen.
Second trimester
Shortness of breath may continue as blood volume increases and oxygen demands rise. Regular gentle exercise like walking or swimming can actually improve your cardiovascular fitness and help manage breathlessness. Good posture and sleeping slightly propped up can also help.
Third trimester
Breathlessness is often worst in the third trimester as the uterus pushes the diaphragm up by about 4 centimeters. You may feel winded doing simple activities like talking or climbing stairs. In the final weeks, when the baby drops into the pelvis (lightening), many people experience relief. Sitting up straight, sleeping propped up, and pacing activities can help.
What to Tell Your Pediatrician
- Describe when you first noticed breathing difficulty in pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if shortness of breath is significantly limiting your daily activities.
- Mention if you have a history of asthma that is worsening during pregnancy.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Gradual onset of breathlessness that worsened as pregnancy progressed
- Feeling winded with activities that previously felt easy
- Breathlessness that improves with rest or changing position
- No chest pain, wheezing, coughing, or blue lips accompanying the breathlessness
- Shortness of breath is significantly limiting your daily activities
- You have a history of asthma that is worsening during pregnancy
- Breathlessness is accompanied by persistent cough or wheezing
- Sudden severe shortness of breath, especially with chest pain, rapid heartbeat, or calf swelling, which could indicate a pulmonary embolism
- Difficulty breathing with blue or gray lips, fingertips, or face
- Shortness of breath with fever and cough, suggesting possible pneumonia
What You Can Do at Home
- Keep track of when you notice breathing difficulty in pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that gradual onset of breathlessness that worsened as pregnancy progressed — this is generally within the range of normal.
- At First trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if sudden severe shortness of breath, especially with chest pain, rapid heartbeat, or calf swelling, which could indicate a pulmonary embolism.
Related Conditions
Blood Clot Risk During Pregnancy (DVT)
Pregnancy increases the risk of blood clots (venous thromboembolism or VTE) by 4-5 times due to increased clotting factors, slower blood flow, and vein compression from the growing uterus. While the overall risk is still low (about 1-2 per 1,000 pregnancies), awareness of symptoms is important because blood clots can be life-threatening if untreated.
Anemia During Pregnancy
Anemia during pregnancy is very common, affecting up to 40% of pregnant people worldwide. It is most often caused by iron deficiency due to the increased blood volume and iron demands of pregnancy. Symptoms include extreme fatigue, weakness, pale skin, dizziness, and shortness of breath. It is treatable with iron supplementation and dietary changes.
Related Resources
Breathing Difficulty Triage
Assess breathing concerns and know when to seek emergency care.
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is breathing difficulty in pregnancy normal?
When should I call the doctor about breathing difficulty in pregnancy?
When is breathing difficulty in pregnancy normal?
What causes breathing difficulty in pregnancy?
What should I mention to my pediatrician about breathing difficulty in pregnancy?
Is breathing difficulty in pregnancy normal at First trimester?
Is breathing difficulty in pregnancy normal at Second trimester?
Should I go to the ER for breathing difficulty in pregnancy?
Does breathing difficulty in pregnancy go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. Pregnancy FAQs. ACOG, 2022. ACOG
- [2]National Library of Medicine. Dyspnea in Pregnancy. StatPearls, 2023. NIH
- [3]March of Dimes. Common Discomforts of Pregnancy. March of Dimes, 2023. March of Dimes
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Breathing Difficulty in Pregnancy.
Things to mention
- Describe when you first noticed breathing difficulty in pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if shortness of breath is significantly limiting your daily activities.
- Mention if you have a history of asthma that is worsening during pregnancy.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Shortness of breath is significantly limiting your daily activities
- You have a history of asthma that is worsening during pregnancy
- Breathlessness is accompanied by persistent cough or wheezing
Urgent signs to report immediately
- Sudden severe shortness of breath, especially with chest pain, rapid heartbeat, or calf swelling, which could indicate a pulmonary embolism
- Difficulty breathing with blue or gray lips, fingertips, or face
- Shortness of breath with fever and cough, suggesting possible pneumonia
My notes
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Related Resources
Bottom line
Most cases of breathing difficulty in pregnancy are normal. Talk to your pediatrician if sudden severe shortness of breath, especially with chest pain, rapid heartbeat, or calf swelling, which could indicate a pulmonary embolism.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Maternal Concerns
Blood Clot Risk During Pregnancy (DVT)
Pregnancy increases the risk of blood clots (venous thromboembolism or VTE) by 4-5 times due to increased clotting factors, slower blood flow, and vein compression from the growing uterus. While the overall risk is still low (about 1-2 per 1,000 pregnancies), awareness of symptoms is important because blood clots can be life-threatening if untreated.
Anemia During Pregnancy
Anemia during pregnancy is very common, affecting up to 40% of pregnant people worldwide. It is most often caused by iron deficiency due to the increased blood volume and iron demands of pregnancy. Symptoms include extreme fatigue, weakness, pale skin, dizziness, and shortness of breath. It is treatable with iron supplementation and dietary changes.
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