Shortness of breath during pregnancy

By trimester

Weeks 1–13

1st trimester

Breathlessness can start surprisingly early, often before your bump shows, because rising hormones increase your drive to breathe well before the uterus takes up much room. Nausea, fatigue, and a stronger sense of smell can make this normal air hunger feel more noticeable than it really is. If breathlessness this early comes on suddenly or comes with chest pain, a racing heart, or fainting, call your care team the same day.

Weeks 14–27

2nd trimester

Blood volume and heart output keep climbing in the second trimester, so feeling winded on stairs or mid-conversation is common and usually nothing to worry about. This is also when iron-deficiency anemia often shows up, since blood volume grows faster than new red blood cells can keep up, so mention any new or heavier breathlessness at your next visit so your provider can check your iron levels.

Weeks 28–birth

3rd trimester

Breathlessness often peaks in the third trimester as the growing uterus crowds your diaphragm and lungs, especially lying flat, and propping up on pillows or shifting onto your left side usually helps. Sudden or severe breathlessness, or breathlessness with chest or rib pain, a racing heartbeat, a severe headache, vision changes, or new swelling in your face or hands, is a different pattern and calls for urgent evaluation.

What does the evidence show for shortness of breath?

• Pregnancy naturally increases the brain's drive to breathe from early on, so many people feel more aware of their breathing than usual even though their oxygen levels are fine. 1
• More than a third of pregnant women notice breathlessness at some point, and for most it becomes more noticeable as the third trimester goes on. 2
• Feeling short of breath along with unusual tiredness or looking pale can point to iron-deficiency anemia, which is common in pregnancy and easy to check with a simple blood test. 3
• A severe headache, blurry or spotty vision, or pain under the right ribs alongside breathlessness points toward preeclampsia, and that combination deserves a same-day call to your provider. 4
• Breathlessness that shows up suddenly and comes with pain on deep breaths can mean a blood clot has traveled to the lungs, and this kind of emergency can develop within minutes or build gradually over several days. 5

When should I call my provider about shortness of breath?

Normal pregnancy breathlessness builds gradually, eases when you sit up or slow down, and does not travel with a crowd of other symptoms. Call right away for breathlessness that starts suddenly, particularly with pain on deep breathing, a higher heart rate, rapid breathing, coughing with or without blood, sweating, or lightheadedness and fainting, because that is the pulmonary embolism cluster NHLBI says to act on immediately. Breathlessness alongside headache, blurred vision, right upper quadrant pain, or swelling of the face and hands points toward preeclampsia instead. Breathlessness with tiredness, faintness, and pale skin is the iron-deficiency anemia picture and earns a blood count rather than more pillows. 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.