Colds during pregnancy

By trimester

Weeks 1–13

1st trimester

Lean on non-drug supportive care first. Acetaminophen can help with fever or aches with your provider's direction. Skip most combination cold products, since their layered ingredients include some that are best set aside early in pregnancy.

Weeks 14–27

2nd trimester

Same guidance as the first trimester. Your provider may add antihistamines like cetirizine or loratadine, or an intranasal steroid, if allergy symptoms overlap with your cold.

Weeks 28–birth

3rd trimester

Same guidance as earlier, with two added notes: avoid ibuprofen from 20 weeks on per the FDA, and check with your provider before using an oral decongestant this late in pregnancy.

What does the evidence show for colds?

• Most cold medications only ease symptoms, they don't shorten the illness, so supportive care like rest, fluids, and warm liquids still does most of the work. 1
• Acetaminophen is a reasonable pregnancy option for cold-related fever and aches, at the lowest dose that works for the shortest time you need it. 2
• Single-ingredient guaifenesin and dextromethorphan are generally considered acceptable cough options in pregnancy at standard over-the-counter doses, with your provider's go-ahead. 3
• Pregnant people are at higher risk for complications from some infections, which is why it's worth calling your provider sooner rather than later if a cold is severe or drags on. 4
• A common cold runs about 7 to 10 days with a cough that can linger for weeks, and fever, when present, is usually low-grade, so a high fever or symptoms that worsen after a period of initial improvement points toward a complication such as sinusitis, otitis media, or pneumonia. 5

When should I call my provider about colds?

A cold should follow a recognizable arc: roughly 7 to 10 days, a low-grade fever at most, and a cough that may trail on after the rest clears. Call your provider for a high fever, for symptoms still at full strength past 10 days, or for the double-worsening pattern where you improve for a day or two and then get sicker, which is how a sinus infection, an ear infection, or pneumonia announces itself on top of a cold. New wheezing or shortness of breath belongs in the same call, since lower respiratory infection and asthma flare are both named cold complications. Whatever the pattern, any symptom that feels beyond your usual range is a reason to call: obstetric teams expect these questions and would rather hear early than late.