Many pregnancy symptoms are temporary and often brushed off as something you simply have to deal with until your baby arrives. However, even minor symptoms like a stuffy nose can significantly affect your overall quality of life. Understanding the root cause of pregnancy rhinitis and knowing what treatment options are available can make a big difference. In this episode, learn what causes pregnancy rhinitis, how it impacts you and your baby, and which remedies are safe during pregnancy. From natural strategies to medications, we explore what can help, what to avoid, and when to talk to your doctor or midwife.

Listen Now

This episode is made possible with support from our sponsors. I appreciate your support for the brands that help power this podcast.

20% off Mommy Steps or Form insoles with the promo code FEET. Instead of asking whether your feet will grow, be proactive about protecting the structure and size of your feet during pregnancy by wearing Mommy Steps insoles.

Article and Resources

Hi Vanessa,

I have learned so much from your episodes and thank you so much for everything you do with the Pregnancy Podcast. It has been so helpful and I recommend it to everyone. I’m just starting the third trimester and I am having an issue I hope you can help with.

I have been dealing with the most frustrating stuffy nose for what feels like forever. I know congestion can be common during pregnancy, but this is driving me crazy! It makes it hard to sleep, I constantly feel like I need to blow my nose, and I am trying to avoid taking anything that might not be safe for the baby.

Is there anything I can do to get some relief? I would love to know whether there are any safe treatments or remedies to help me breathe easier.

Thanks again for all that you do!
– Brianna

Brianna, thank you for your kind words about the podcast and for sharing your questions. You are definitely not alone in experiencing a stuffy nose and being frustrated with this symptom. Let’s discuss what causes this and possible treatment options to give you some relief.

Pregnancy Rhinitis

Pregnancy rhinitis is nasal congestion or a stuffy nose that occurs during pregnancy. Although there is a name for this, it isn’t a serious condition, but rather a common and pesky pregnancy symptom. The prevalence of pregnancy rhinitis in pregnancy affects up to 30% of expecting mothers. An increase in estrogen and progesterone can cause the mucous membranes in your nose to swell and excess mucus production. An increase in blood volume can cause swelling in the tiny blood vessels lining your nose and congestion in the surrounding tissue. As a result of these changes, you may experience congestion, sleep disruption, and occasional nosebleeds. These symptoms can start anytime during your pregnancy and there is a strong correlation between symptoms and gestational week. A stuffy nose is most common in the third trimester.

Side Effects of Pregnancy Rhinitis

A stuffy nose can reduce how much nitric oxide you breathe in from your sinuses. Nitric oxide helps blood vessels relax and enhances the body’s ability to utilize oxygen. If you are not inhaling enough of it, it may contribute to pregnancy complications like high blood pressure, poor fetal growth, preeclampsia, and lower Apgar scores.

Pregnancy rhinitis can also contribute to sleep-disordered breathing like snoring or sleep apnea. These conditions are more common in individuals with a higher BMI and can become more frequent or severe in the third trimester. Loud snoring is reported in up to 45% of expecting mothers. Sleep apnea is snoring followed by gasping or choking because your airway collapses. In pregnancy, sleep-disordered breathing is linked to increased risks of complications such as preeclampsia, gestational diabetes, cesarean birth, and having a baby with low birth weight or preterm. If you think you may have sleep apnea, please bring it up with your doctor or midwife to discuss your treatment options. The most effective treatment for sleep apnea is a CPAP (continuous positive airway pressure) machine.

Pregnancy Symptoms and Quality of Life

There are so many common pregnancy symptoms that you are simply told are common and just a pesky symptom you have to deal with that will eventually go away after you have your baby. Many things fall into this category, but that doesn’t mean these symptoms are always easy to deal with. There is evidence that pregnancy rhinitis, as common as it is, can negatively impact your quality of life. While you may have to deal with it there are some things you can do that may provide some temporary relief.

Treatment Options

There are several safe, drug-free options that can help ease the symptoms of pregnancy rhinitis. These are the first line of defense before resorting to medications.

One of the easiest and most effective remedies is a saline nasal spray or rinse. These are completely safe during pregnancy and can help clear out your nasal passages and reduce some of the inflammation. A Neti pot or a squeeze bottle-style sinus rinse with sterile saline solution can make a big difference, especially before bed or when you wake up feeling particularly congested.

Using a warm compress over your nose and sinuses can help open up your nasal passages. You may also consider taking a warm shower for temporary relief.

At night you may consider elevating the head of your bed or using pillows to prop up your head and upper body. Avoid sleeping on your back. Running a humidifier in your bedroom can help prevent the air from becoming too dry, which often exacerbates nasal symptoms.

Staying well hydrated is also key, because it keeps your mucus thin and easier to clear out. You may also want to avoid known irritants or allergens if you are sensitive to things like dust, smoke, or strong scents. While blowing your nose may offer temporary relief, try not to overdo it. Excessive force can irritate your nasal passages even more. If you implement these strategies and are still struggling with bothersome symptoms you may want to discuss medications.

Medications

You should always run any medication by your doctor or midwife before taking it, even if it is available over the counter.

Pseudoephedrine

Some decongestants, like pseudoephedrine, are not recommended in early pregnancy and may only be considered later on in specific circumstances. According to ACOG, pseudoephedrine, has been linked to a small risk of abdominal wall birth defects and should not be taken during the first 3 months of pregnancy.

Oxymetazoline

Oxymetazoline, commonly sold under brand names like Afrin, can offer short-term relief and reduce swelling in the nasal passages. However, these sprays should be used with caution. Overuse can lead to rebound congestion and drug-induced rhinitis, which may persist even after pregnancy. The evidence on the safety of nasal sprays during pregnancy is mixed. As a result, if it is utilized it should be only used occasionally, at the lowest effective dose, preferably after the first trimester and never close to delivery.

Corticosteroids and Antihistamines

Topical corticosteroids are applied via a nasal spray and are commonly used for a stuffy nose associated with allergies or asthma. Typically, these are only recommended during pregnancy if you were already using them to treat allergies or asthma before getting pregnant. These medications have not been shown to be effective for pregnancy rhinitis, so they are not recommended for that purpose. Systemic corticosteroids are not recommended for routine use in pregnancy-related rhinitis. They may be used in rare cases for short periods. Long-term use or high doses can lead to risks like low birth weight or birth defects. If you have allergies, some antihistamines are safe during pregnancy. Please talk to your doctor or midwife before taking any over-the-counter allergy medication.

Weighing the Pros and Cons of Medications

If you were taking a medication to treat a stuffy nose due to allergies or asthma prior to getting pregnant, your care provider may be comfortable with you continuing that medication. There is little evidence that these medications make a significant difference for pregnancy-induced rhinitis. Although having a stuffy nose can be bothersome, certain medications used to treat it carry risks, and most are only short-term solutions. You should always consult your doctor or midwife before taking any medication, even if it is available over-the-counter.

When to Contact Your Doctor or Midwife

While this is usually a harmless and temporary symptom, you deserve to feel as comfortable as possible. It never hurts to talk about your symptoms with your doctor or midwife and discuss possible treatment options. If your stuffy nose is accompanied by a fever, green or yellow mucus, or facial or sinus pain, it could be a sign of a sinus infection or another issue that warrants discussion with your doctor or midwife.

Thank you to the brands that help power this podcast.

20% off Mommy Steps or Form insoles with the promo code FEET

You may have heard that pregnancy can cause your feet to grow. Studies that measure arch height and foot length and width show this is true. In one study, 61% of participants had a measurable increase in foot length, and 22% reported going up a shoe size. Mommy Steps have biomechanically designed support for your feet, preventing your arches from collapsing and your feet from going up a shoe size. Instead of asking whether your feet will grow, be proactive about protecting the structure and size of your feet by wearing Mommy Steps insoles.