Asthma and pregnancy – what to expect
Because every pregnancy is unique, it’s hard to predict what will happen with your asthma.
Some pregnant women find their asthma improves. Some don’t notice any changes in their symptoms at all. And some women – especially those with severe asthma – may find their symptoms get worse.
Sometimes, asthma can even be triggered by pregnancy – so you might notice symptoms where you had none before.
The good news is that the risk from your asthma to you and your baby is very small, as long as you take your asthma medicines as prescribed and look after your asthma well.
Your GP, asthma nurse, pharmacist or consultant are there to support you. They can tell you what medicines are safe to take during your pregnancy and talk you through all the things you can do to stay well with your asthma. Make an appointment as soon as possible if you notice any of the following:
- Your nose gets stuffier when you’re pregnant. This is a common symptom of pregnancy, but could also be an asthma trigger because it causes you to breathe through your mouth, so your nose can’t filter out allergens or warm up the air going into your lungs
- You feel more breathless – again, a common symptom of pregnancy, but also a sign your asthma is getting worse
- Your hay fever or allergies get worse. Allergies are a common asthma trigger and it’s important to treat the symptoms so you can cut your risk of an asthma attack. Most hay fever treatments are safe in pregnancy – ask your GP or pharmacist for more details
- Coughing, especially at night
- Feeling tight-chested
- Taking your reliever inhaler (usually blue) more often. If you’re taking it three or more times a week, you may be at risk of an asthma attack and should get an urgent GP appointment.
Having an asthma attack is always an emergency, whether you’re pregnant or not. Make sure you, and the people around you, know what to do in an asthma attack.
It’s important for you and your baby that you look after your asthma during your pregnancy.
Here’s how you can lower your risk of asthma symptoms and asthma attacks:
- Take your asthma medicines as prescribed. Your medicines are safe to take when you’re pregnant – find out more
- Make an appointment with your GP to review your asthma medicines and check that your written asthma action plan is up to date
- Ask your GP, asthma nurse or pharmacist to check your inhaler technique
- Tell your midwife you have asthma and make a note of it in your birth plan
- If you have difficult or severe asthma, ask your GP or asthma nurse if you need an asthma specialist as well as an obstetrician caring for you during your pregnancy
- The flu vaccine is recommended for both pregnant women and people with asthma, because both groups have a higher risk of developing complications from flu. It’s safe to have in pregnancy and will also help protect your baby from flu for the first few months of their life. See NHS guidance for details.
Avoid smoking and second-hand smoke
Women who smoke while they’re pregnant are more likely to have babies with breathing problems, including asthma.
Smoking also increases your risk of miscarriage and premature labour – if your baby is born too early their lungs won’t be fully developed and they’ll be more at risk of coughing and wheezing in childhood.
Don’t forget to ask friends and family to avoid smoking around you, as second-hand smoke also increases your risk of asthma symptoms and an asthma attack.
The medicines used to treat asthma are safe in pregnancy and won’t harm your baby. This includes reliever and preventer inhalers; long-acting and combined relievers; theophylline; and steroid (prednisolone) tablets. There are more risks to both you and your baby if you don’t take your medicines and your asthma gets worse.
The group of medicines called leukotriene receptor antagonists (the most common one is Montelukast) are also safe to take during pregnancy, and you should be allowed to keep taking them.
Don’t hesitate to talk to your GP, asthma nurse or pharmacist if you have any questions or concerns about your medicines when you’re pregnant. You can also talk about medicines and any potential side effects during your asthma review.
Talk to your GP, asthma nurse or midwife during the weeks and months before your due date and make sure your asthma is included in your birth plan. This can help reduce any fears you may be having about asthma and giving birth.
- If you’re on high doses of steroids for more than two weeks before you go into labour, make sure you tell your midwife and/or the hospital staff. They’ll need to make sure you continue to take these medicines while you’re in labour.
- Some people with asthma also have a latex allergy. If you do, make sure you tell your midwife and the hospital staff so they can use latex-free gloves.
- If you’re feeling anxious, you could find out about breathing and relaxation techniques to use in labour, and look at our page on anxiety and asthma.
What if I have an asthma attack during labour?
- Asthma attacks during labour are very rare. This might be because the steroids your body naturally produces to help with labour also help reduce inflammation in your airways.
- It’s also more common to have asthma attacks earlier in your pregnancy than towards the end.
- If you do have asthma symptoms during labour, it’s safe to use your reliever inhaler as normal. It won’t harm your baby in any way.
Pain relief during labour for women with asthma
Make sure your midwife and everyone supporting you with the birth knows you have asthma. There are a number of different ways to relieve pain during labour and they're all safe for women with asthma:
- Gas and air (Entonox)
- Pain relief injections (usually Pethidine)
If you have severe asthma, your GP, midwife and/or obstetrician will discuss which pain relief is suitable for you when you create your birth plan.
Most women with asthma can aim for a vaginal birth.
Home birth or midwife-led units
If you’ve needed to increase your asthma medicines during pregnancy, or have needed hospital treatment, you’ll probably be advised that it’s safer to give birth in hospital.
Induced or accelerated labour
If your labour has to be induced (started medically) or you need help moving things along, make sure you remind your doctor or midwife that you have asthma so they can use the safest medicines for you.
Planned (elective) caesarean
Guidelines say that having asthma doesn’t mean you’ll need a planned caesarean but if you’re anxious about whether your asthma will affect you giving birth vaginally, talk to your midwife or consultant.
If, after discussion and support, you still feel you’d prefer a planned caesarean, it’s your right to ask for one.
Unplanned (‘emergency’) caesareans usually happen if problems develop during labour.
If you need a caesarean, the anaesthetist will aim to use a spinal block or epidural. These are safe for women with asthma.
It’s safe to use your inhalers during a caesarean if you need them.
Caesarean under general anaesthetic
Occasionally, women need a general anaesthetic for their caesarean – usually if the baby needs to be delivered very quickly.
Try not to worry about how this will affect your asthma. Some anaesthetic medicines actually help to open your airways.
If you do develop asthma symptoms under general anaesthetic, you can be given your inhaler through a special adaptor.
It’s generally safe to breastfeed your baby when you’re taking asthma medicines – your GP or health visitor will be able to advise you.
Breastfeeding has lots of health benefits for both you and your baby. There’s some evidence that suggests breastfed babies may be less likely to develop asthma, but this isn’t conclusive. If you decide to bottle-feed your baby for whatever reason, it doesn’t mean your baby will develop asthma.
Only very small amounts of asthma medicines pass into breast milk and these are no risk to your baby.
We don’t know the exact cause of asthma, but we do know that asthma often runs in families. Your baby is more at risk of developing asthma or breathing problems if:
- both parents have asthma. If only one parent has asthma, the baby has a greater chance of developing asthma if it’s the mother who has asthma rather than the father
- you smoke while you’re pregnant or you smoke around your child when they’re born
- your baby is born prematurely.
If you’ve got more questions about asthma and pregnancy, call our friendly asthma nurse specialists on 0300 222 5800 or message them via WhatsApp on 07378 606 728 (Monday-Friday, 9am-5pm).
Last reviewed July 2019
Next review July 2022