Congratulations on your pregnancy! As you go through this journey, taking extra care of yourself – especially your health – is important. Pregnancy brings many changes, including how you breathe. Now, you’re not only breathing for yourself but also for your growing baby.
If you have asthma, it’s natural to have concerns about how it might affect you and your baby during the next nine months, like: Will my asthma get worse while pregnant? Will the asthma medicines I take hurt my baby?
Asthma is a lifelong condition that affects your airways, making it difficult to breathe. Symptoms can range from mild to severe, including wheezing, coughing and shortness of breath.
Pregnancy may influence how your asthma behaves, but Colleen Cagno, MD, a family medicine physician who specializes in the care of pregnant people with Banner – University Medicine, is here to reassure you that most people with asthma have normal pregnancies.
“The risk of complications is small in people with well-controlled asthma, actively managed during pregnancy,” Dr. Cagno said. “We often inform patients that one-third of pregnant people experience an improvement in their asthma symptoms, one-third see no change and one-third experience worsening asthma symptoms.”
Read on to learn more about how you can stay well with asthma through pregnancy and birth.
The risks of uncontrolled asthma
Your body will undergo major hormonal and physiological changes, as well as shifts in lung function and immune response. These can affect how your asthma behaves during pregnancy.
That’s why it’s important to keep it under control and well-managed. Poorly managed asthma during pregnancy can lead to complications for you and your baby.
“Uncontrolled asthma increases the risk for the pregnant person, including the risk for preeclampsia (high blood pressure during pregnancy), gestational diabetes, deep vein thrombosis and pulmonary embolism,” Dr. Cagno said. “For the baby, uncontrolled asthma can increase the risk for low birth weight, an infant that is small for gestational age, a preterm delivery, problems with the placenta and congenital malformations like cleft lip or palate.”
Uncontrolled asthma can also increase the chance of cesarean delivery and the risk of intensive care or death for the infant at birth.
Tips for managing your asthma during pregnancy
The good news is that the risk of complications is small for people with well-controlled asthma. So how do you do this? Dr. Cagno shares:
Create an asthma care plan
Work with your provider to create an asthma action plan on what to do in case of an asthma attack or flare-up. Knowing when to see your provider versus when to seek emergency medical care is important for you and your baby’s safety.
Follow up with your provider at least monthly to check your symptoms and asthma control and, if necessary, adjust your medication.
“When you arrive at the hospital, make sure to tell the medical team in labor and delivery (L&D) that you have asthma, so they are aware and prepared to help treat you, if necessary,” Dr. Cagno said. “Pain can trigger a flare-up of asthma, so working with your L&D team to manage pain in labor is important.”
Don’t stop your medication
There is a common misconception that it is better to stop taking medicines for asthma during pregnancy. Many people stop or decrease their asthma meds in early pregnancy without realizing the consequences. Remember, it is safer to be on asthma meds during pregnancy versus having symptoms or exacerbations in pregnancy.
“Up to one-half of pregnant people stop their asthma medications, which worsens the control of asthma and is a risk factor for an asthma flare-up or exacerbation,” Dr. Cagno said. “The main problem with asthma in pregnancy is when it is severe or uncontrolled and causes a flare-up. The goal is to prevent a flare-up.”
Most medications used to manage asthma before pregnancy can be continued during pregnancy. The most commonly used medications are daily control medications and rescue short-term relief medicines, such as inhaled corticosteroids and short-acting beta-agonist inhaled albuterol. Ask your health care provider if you have any concerns about the medications you are taking.
Avoid triggers
Identify and avoid asthma triggers whenever possible. Common triggers include allergens, cigarette smoke and vaping, pollution and viral and respiratory infections. Talk to your provider about getting vaccinated for viral infections during (and, if possible, before) becoming pregnant. Vaccines for the flu, COVID and RSV are safe in pregnancy.
“If exercise is a trigger for your asthma, talk to your provider about how to use your medication before exercising to continue staying active in pregnancy,” Dr. Cagno said.
Look for changes: “It is common for pregnant people to feel a degree of air hunger, or harder to breathe in air, but if it gets in the way of being able to do normal activities, you should see your provider,” Dr. Cagno said.
Air hunger, dyspnea or shortness of breath should be mild and gradually occur. If shortness of breath starts suddenly, along with other worrisome symptoms like wheezing or coughing, contact your provider.
Maintain healthy habits
Continue eating well, stay physically active (with your provider’s approval), get enough rest and manage stress. These habits can support your overall health and may also help improve asthma control.
Deep breathing exercises can improve lung function by allowing you to take in more oxygen with each breath. It can also help you gain better control over your breathing and decrease stress levels.
Takeaway
When you’re pregnant, you are breathing for yourself and your baby. By taking proactive steps to manage your asthma, you can focus on embracing the joy of pregnancy and the arrival of your little one.
Listen to your body and talk to your health care team or a Banner Health specialist if you notice changes or symptoms.
