When you’re pregnant, breathing for two is serious business. Your baby-to-be needs a steady supply of oxygen to fuel her growth and development. So if your own oxygen supply is compromised due to untreated asthma, it could present a problem for the health of your pregnancy and your baby.
Here’s the good news: If you’re under close medical supervision by your obstetrician and your pulmonologist, you have just as excellent of a chance of having a healthy pregnancy as a mom without asthma.
What is asthma?
Asthma is a condition in which your airways become narrow and inflamed, making it difficult to breathe. For some people, the condition is mild, but others can have severe attacks that flare up after even a little bit of physical activity.
What are the symptoms of asthma during pregnancy?
Common asthma symptoms during pregnancy include:[1]
- Wheezing
- Chest tightness
- Coughing
- Shortness of breath
If you have asthma, it’s hard to predict how having a baby on board will affect your symptoms. A third of women find that their asthma gets better during pregnancy, while a third find it gets worse.
What causes asthma during pregnancy?
The hormonal changes that occur during pregnancy are likely to blame for your increase in allergy symptoms. As estrogen increases, especially during the third trimester, you may find yourself blowing a constantly-stuffy nose — this, combined with the rise in progesterone levels, can cause shortness of breath. You may also notice your asthmatic flare-ups worsen as your growing uterus begins to crowd your lungs, also in the third trimester.
If you didn’t have asthma before you conceived, there’s no evidence to show that you can develop it from pregnancy. You may, however, experience mild shortness of breath, particularly during the last trimester as your baby presses up against your diaphragm. Don’t worry — it’s normal, and it isn’t dangerous.
More on Allergies & Asthma During Pregnancy
How is asthma treated during pregnancy?
It’s not surprising that getting your asthma under control before you conceive or as early in pregnancy as possible is the best strategy for you and your baby. Doctors often recommend the following steps to treat asthma during pregnancy:[2]
1. Regularly see your doctor
Attend all your prenatal appointments as scheduled, and be sure to let the doctor who’s treating your asthma know that you’re pregnant.
Your care team may want to change your medications, test your lung function and make sure that your asthma is being managed in the best way possible. Be sure to give your doctors a heads-up if it seems that your asthma symptoms are worsening.
2. Take your asthma meds as prescribed
As with all medications, only use the asthma treatments that your physician has prescribed during your pregnancy.
Don’t hesitate to take the medication that you need — remember, you’re breathing for two now. Stopping your medications will exacerbate your symptoms, increasing the risk of pregnancy complications.
3. Keep a close eye on your peak flow
Follow your doctor’s orders to make sure you’re getting the oxygen that you and your baby need. Your practitioner may recommend monitoring your breathing with a peak-flow meter.
Are there safe asthma inhalers and medications I can use while I’m pregnant?
Most asthma medications, including inhalers, are safe to take during pregnancy. In fact, it’s essential to continue the treatment plan that your doctor recommends to reduce the risk of potential pregnancy complications.
If your symptoms are moderate to severe, you’ll be given one of the several asthma medications that are considered safe during pregnancy. Inhalers like budesonide (an inhaled corticosteroid) and albuterol (a short-acting beta-2 agonist) are the treatments of choice. Very little of the medication in the inhaler makes it from your lungs into your bloodstream.
Anti-leukotriene medications like montelukast (Singulair) are also generally considered safe in most cases.
If these medications aren’t controlling your asthma, your doctor may recommend long-acting beta-2 agonists (like Serevent, Symbicort or Advair) or possibly theophylline. For severe asthma attacks, your doctor may also prescribe oral corticosteroids (like prednisone).
If you started getting allergy shots before pregnancy, you’ll likely be able to continue. However experts don’t recommend starting allergy shots if you’re already pregnant.
How common is asthma during pregnancy?
Asthma affects at least 8.2 percent of pregnant women and 9.4 percent of women of childbearing age, according to the Centers for Disease Control and Prevention (CDC).
Can I prevent asthma while I’m pregnant?
Beyond working with your doctor to adjust your medications for pregnancy and keep your asthma under control, the following steps will help you keep your asthma well-managed:
1. Avoid environmental triggers
Allergies are a major cause of asthma, and you probably already know which ones lead to problems for you. Avoid those allergens or control them with safe-for-pregnancy medications, and you’ll likely find that you'll be able to breathe a lot easier.
Common offenders include:
- Pollen
- Animal dander
- Dust
- Mold
- Household cleaning products
- Perfumes
If you have allergies, talk to your doctor about whether it’s safe to take antihistamines during pregnancy to control your symptoms.
2. Steer clear of tobacco smoke
If you’re currently a smoker, now’s a good time to quit. If your close family and friends smoke, they should understand if you ask them to avoid lighting up around you.
3. Exercise safely
Regular physical activity during pregnancy is healthy and recommended for both you and your baby. Talk to your practitioner about exercise recommendations. (For instance, swimming might be a good choice).
If your asthma is exercise-induced, taking your prescribed medication before your workout or any other kind of exertion can usually prevent an attack and allow you to stay active.
4. Stay healthy
Try to keep your distance from people who are sick with colds, the flu, COVID-19 and other respiratory infections, which can set off asthma symptoms. Your doctor may give you medication to ward off an asthma attack at the beginning of a cold and will probably treat any bacterial respiratory infections with antibiotics.
A flu shot — recommended for every expectant mom — is especially important for you, as is the COVID-19 vaccine and the pneumococcal vaccine (which may be given during pregnancy if you’re considered high risk for pneumococcal infections, so ask your doctor).
5. Talk to your doctor about related chronic conditions
Acid reflux is more common in pregnancy whether you have asthma or not. Meanwhile, nasal congestion is also more common during pregnancy, which may exacerbate preexisting chronic sinusitis. This inflammation of the nasal cavities tends to be more common in people with asthma.
If you have either condition, be sure to ask your doctor for a treatment plan. Both can interfere with the management of your asthma.
What should I do about an asthma attack when I’m pregnant?
Asthma attacks most often occur toward the end of pregnancy. If you have an asthma attack, treating it promptly with your prescribed medication (usually albuterol) helps ensure that your baby continues to get a steady flow of oxygen.
If the medicine doesn’t do the trick, call your doctor or head to the nearest emergency room immediately. Asthma attacks sometimes trigger early uterine contractions, but the contractions usually stop when the attack does (which is why it’s so important to get it under control quickly).
Will asthma affect labor and delivery?
It’s very rare for asthma attacks to occur during labor and delivery, and it usually doesn’t interfere with Lamaze and other breathing techniques. If you’re hoping for an epidural, that shouldn’t be a problem either — and it can even be a good thing, since you may not have to work as hard to breathe.
Your doctor will probably recommend that you keep taking your regular medications when you’re in labor. If your asthma has been serious, you may require IV steroids to help you get through labor and delivery. Your oxygenation will be checked when you’re admitted to the hospital, and if it’s low, you may need to take preventive medications.
Can I breastfeed if I have asthma?
Breastfeeding is considered safe and beneficial for both you and your baby if you have asthma. What’s more, breastfeeding has been linked to a lower future risk of allergies, which are often associated with asthma.
However, there’s no conclusive evidence that breastfeeding itself actually prevents allergies or asthma, so try not to stress if you don’t end up nursing.
If you do decide to breastfeed, it’s essential to follow your doctor’s treatment plan and continue taking the same asthma drugs you were taking during pregnancy to keep your condition under control. Be sure to drink plenty of fluids, since dehydration can trigger asthma attacks.
If you experience new severe shortness of breath at any point in late pregnancy or postpartum, especially when you’re lying down, be sure to let your doctor know. They’ll be able to rule out a rare form of heart failure known as peripartum cardiomyopathy (PPCM). Other common symptoms of PPCM include heart palpitations or swelling in the feet and legs.
Can I give my baby asthma when I’m pregnant?
Asthma has a genetic component and often runs in families, which means if you or your partner has asthma, there’s a chance that your baby will too. However there are several steps you can take during pregnancy to reduce the risk of your child developing asthma:
- Quit smoking
- Eat a healthy diet
- Keep stress in check as best as possible
- Avoid unnecessary antibiotics
Does asthma cause pregnancy complications?
The vast majority of moms-to-be with asthma and their babies don't have any complications during pregnancy. However, uncontrolled asthma can reduce the amount of oxygen that makes it to your baby, which in turn can create a somewhat higher risk for a number of complications including:
- Preterm delivery
- Low birth weight
- High blood pressure
- Preeclampsia
- C-section
- A low birth weight baby
- An increased risk of breathing and other health problems in babies
Good asthma control can almost completely counteract the slightly elevated risks of those potential complications. As long as you attend your regularly scheduled prenatal appointments, you can rest easy knowing that your baby is being well-monitored.
It’s perfectly normal to be concerned about asthma during pregnancy. Working with your doctor to manage your symptoms greatly lowers any risk to your baby. Rest assured, the vast majority of moms with asthma go on to give birth to healthy babies.
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