Cough during pregnancy

By trimester

Weeks 1–13

1st trimester

Nausea and a stronger sense of smell in the first trimester can make even a mild cough feel worse, and this is also when the baby's organs are developing, so it's worth choosing a single-ingredient product that matches your cough type rather than a multi-symptom combo. A dry, tickly cough usually calls for a suppressant like dextromethorphan, while a wet, productive cough responds better to an expectorant like guaifenesin. Confirm either one with your provider before you start it.

Weeks 14–27

2nd trimester

Energy usually picks up in the second trimester, and a short-lived cough from a common cold typically responds to the same dextromethorphan-or-guaifenesin approach, plus honey, warm fluids, and a humidifier. This is also a good time to confirm your Tdap and flu vaccine timing with your provider, since both lower your chance of a more severe respiratory illness later on.

Weeks 28–birth

3rd trimester

Your growing uterus already reduces lung capacity in the third trimester, so feeling a bit more short of breath than usual, even without being sick, is common. That can make it harder to tell ordinary pregnancy breathlessness from a real warning sign, so report any new or worsening shortness of breath, chest pain, or a cough with a high fever to your care team right away, especially as you near your due date.

What does the evidence show for cough?

• Dextromethorphan, the ingredient in most dry-cough suppressants, is not expected to raise the chance of birth defects when used as directed for a cough, based on data that include a study of roughly 128 pregnant women. 1
• Guaifenesin, an expectorant used to thin and loosen mucus for a wet cough, has current evidence suggesting that any increase in birth-defect chance, if it exists at all, would be low. 2
• Coughing, fever, chills, and muscle aches are classic flu symptoms, and severe breathing problems, called respiratory distress, are a complication that can require hospitalization during pregnancy. 3
• A 2023 trial comparing honey, dextromethorphan, and ipratropium against usual care in adults with acute bronchitis found none of them shortened the days of moderate-to-severe cough any more than routine supportive care did. 4
• When a pregnant person has trouble breathing, they take in less oxygen, which is a key reason new or worsening breathlessness gets a faster medical response than a cough on its own. 5
• Cough is classified as acute under 3 weeks, subacute at 3 to 8 weeks, and chronic beyond 8 weeks, with hemoptysis, dyspnea, fever, unexplained weight loss, and chest pain listed among the alarm features that call for prompt evaluation. 6

When should I call my provider about cough?

Most pregnancy coughs are the acute kind and clear inside 3 weeks. Get seen promptly for coughing up blood, for shortness of breath, for fever, or for chest pain that comes with the cough. A cough still going past 3 weeks has crossed into subacute territory and warrants evaluation rather than another round of lozenges. If you have asthma, trouble breathing means less oxygen reaching the pregnancy, so a flare is a call-now situation rather than a wait-and-see one. Trust your read on your own body. If something feels off beyond the list above, please consult your healthcare provider rather than waiting it out.