Sore throat during pregnancy

By trimester

Weeks 1–13

1st trimester

In the first trimester, a scratchy or sore throat most often comes from a viral cold, seasonal allergies, or the dry mouth and mouth breathing that can come with pregnancy nausea. A reasonable first step is the non-drug ladder: warm salt water gargles several times a day, honey stirred into warm water or tea, and a lozenge for on-the-go comfort. Because researchers have looked more closely at high fevers in early pregnancy than at a sore throat on its own, bring any fever down promptly with a dose your provider has approved rather than waiting to see if it passes.

Weeks 14–27

2nd trimester

By the second trimester, viral colds are still the most common cause, though pregnancy rhinitis, the nasal swelling driven by hormone shifts, can add postnasal drip that leaves the throat feeling raw. The gargle-honey-lozenge approach still helps, and this is a convenient window to ask your prenatal care team for a quick in-office strep swab if pain is severe or the lymph nodes in your neck feel swollen and tender, rather than guessing at home.

Weeks 28–birth

3rd trimester

Late pregnancy already narrows breathing room as the growing uterus pushes up on the diaphragm, so throat swelling or postnasal drip can feel more restrictive than it would earlier on. Keep using supportive comfort measures, but do not wait out a sore throat that arrives with a high fever, trouble swallowing fluids, or swelling on just one side this close to delivery: call your care team the same day so they can examine you and coordinate whatever care you need alongside your birth plan.

What does the evidence show for sore throat?

• A sore throat is one of the classic signs of the flu, right alongside fever, chills, and muscle aches, and pregnancy raises the chance that a case of the flu turns into a serious breathing complication needing hospital care. 1
• A sore throat a clinician suspects might be strep is usually checked with a quick throat swab, with an antibiotic like amoxicillin or penicillin used once that test comes back positive, rather than guessing from symptoms alone. 2
• Zinc lozenges may shave a little time off a cold if you start them within the first day of feeling sick, but zinc nasal sprays and gels are a different story and have been linked to permanent loss of smell, so lozenges are the safer way to get zinc's benefit. 3
• If your provider does confirm strep and prescribes an antibiotic, amoxicillin-based options are among the most studied in pregnancy: a few studies have linked first-trimester use to a small rise in cleft lip or palate, but the overall chance stays low, and the same research found no link to preterm birth, low birth weight, or learning and behavior problems by age 11. 4
• Honey stirred into warm tea or taken off a spoon is a nice comfort measure for a scratchy throat, but a 2023 trial in adults with bronchitis found it did not shorten how long a cough lasted any more than simply resting and staying hydrated did, so think of it as soothing rather than a way to speed up recovery. 5
• A peritonsillar abscess causes odynophagia and dysphagia severe enough to cause drooling, a muffled hot potato voice, and trismus (jaw stiffness) in nearly all cases, with severe cases showing respiratory distress from airway compromise that needs emergency airway stabilization. 6

When should I call my provider about sore throat?

A sore throat that makes it hard to swallow your own saliva, causes drooling, or comes with a muffled voice, jaw stiffness, or trouble opening your mouth wide can mean an abscess has formed near the tonsils rather than a simple viral or strep infection, and needs same-day evaluation. Swelling that is clearly worse on one side of the throat fits that same pattern. Go in urgently, do not wait for a scheduled visit, for any trouble breathing or drooling you cannot control, since those signal the airway is being crowded and need emergency care. When in doubt, call your obstetric team the same day. Early input almost always beats waiting, and the on-call line exists exactly for this.