Here is what mums asked our midwives this week: shortness of breath in pregnancy

Feeling short of breath during pregnancy is one of those symptoms that can feel really alarming, especially when it seems to be getting worse. This week a mum at 33 weeks asked us whether the breathlessness she had been experiencing, particularly when lying down, was normal. Here is what our midwives had to say.

Is shortness of breath normal in pregnancy?

Yes, it is very common, particularly from the second trimester onwards and into the third trimester. As your baby grows, your uterus expands upward and puts pressure on your diaphragm and lungs, which reduces the space they have to fully expand. This is what makes breathing feel harder, especially when you are lying flat.

If your baby is in a breech position, their head may be sitting up under your ribs, which can add extra pressure and make breathlessness feel more pronounced. This is not dangerous in itself but it can be uncomfortable.

What can help?

There are a few simple things that can make a real difference to how comfortable you feel.

Propping yourself up with pillows when you sleep or rest can take pressure off your lungs and make breathing easier. Sleeping on your left side is generally recommended in the third trimester as it improves circulation and reduces pressure on major blood vessels.

Sitting with good posture throughout the day helps too. Slouching compresses your lungs further, so sitting upright and keeping your shoulders back gives your body more room to breathe.

Gentle stretching can help to create a little more space and may encourage your baby to shift position slightly. If your baby is breech, your midwife may be able to suggest specific positions or movements to try.

Moving at a pace that feels comfortable is important. If you notice breathlessness when you exert yourself, slow down and take your time. This is your body telling you it is working harder than usual.

When should I seek help?

Mild breathlessness that comes on gradually and does not affect your ability to carry out normal daily activities is usually nothing to worry about. However there are certain symptoms that should always be checked by a midwife or doctor straight away.

Contact your midwife or doctor immediately if your breathlessness comes on suddenly or gets significantly worse, if it is worse when lying flat and you feel you need to sit or stand up to breathe properly, if you have swelling in both legs, feet or ankles, or if you are coughing or wheezing alongside the breathlessness.

Call 999 or go to A&E straight away if you have any of the following alongside breathlessness. Chest pain of any kind, heart palpitations where your heart feels like it is beating too fast or irregularly, swelling in one leg only, coughing up blood, feeling faint or dizzy, or feeling like you are gasping for air and it is getting harder and harder to breathe.

These symptoms can sometimes be signs of more serious conditions including pulmonary embolism, pulmonary oedema or peripartum cardiomyopathy. These conditions can occasionally be missed because their symptoms can look like normal pregnancy symptoms, so it is always better to get checked and be reassured than to wait and see.

What tests might I be offered?

If you go to your midwife or doctor with breathlessness symptoms, they may carry out a physical examination to check your breathing, listen to your chest, and check whether your breathing changes when you lie down. They may also arrange blood tests to check your iron levels and how your heart and organs are functioning.

Depending on your symptoms, you may be referred for further tests including an ultrasound of your legs to check for blood clots, an echocardiogram to check your heart, or an ECG to check your heart rhythm. If your doctor is concerned about your lungs, they may also recommend a CTPA or VQ scan. These scans involve a small amount of radiation but are considered safe in pregnancy when the benefits of getting the right diagnosis outweigh the risks.

A note on advocating for yourself

If you are concerned about your breathlessness and feel like your symptoms are being dismissed, you have every right to ask for further tests or a second opinion. Be clear about how your symptoms are affecting you, explain that you are worried, and ask your midwife or doctor directly whether any of the more serious conditions have been ruled out. You can also bring a friend or family member to your appointment for support.

Got a question of your own?

Every week our midwives answer the questions mums are actually asking.Got a question of your own? Our midwives are available right inside the Dearbump app, ready to answer it directly.