Congestion During Pregnancy: Why It Happens and How To Resolve It

Many common pregnancy symptoms are well-known. For instance, pregnant women may be disappointed when they have first-trimester morning sickness, but it surprises few when it happens. Pregnancy is full of uncomfortable and frustrating yet understandable symptoms like pelvic pain and pressure, nausea, stretch marks, and fatigue.¹² But being pregnant can also cause symptoms that seem completely unrelated to pregnancy. Symptoms like skin discoloration, cravings for non-food items, and nosebleeds do not make as much obvious or logical sense, but they are also related to pregnancy.^13,14 One of the weird symptoms you can have during pregnancy is nasal congestion, which is common despite many women being surprised when they experience it.¹¹

Besides being uncomfortable and potentially impacting your sleep, severe and prolonged congestion during pregnancy risks decreasing the oxygen supply to the fetus. Here, we will examine why pregnancy congestion happens, how common it is, and some natural remedies you can try to relieve it.¹

What Causes Congestion During Pregnancy?

Many factors can cause pregnancy congestion, sometimes called gestational or pregnancy rhinitis.¹¹ Some causes and influences on whether you might experience congestion during pregnancy include:

• Fluid and blood volume: During pregnancy, the amount of blood circulating in your body increases to supply the fetus and placenta with the necessary nutrients. This increased blood volume reaches the mucus membranes of your respiratory tract and nasal passages, which can cause congestion.²
• Hormones: Higher circulating estrogen and growth hormone levels are suspected to contribute to nasal stuffiness during pregnancy.³
• Body mass index: One study found that increased body mass index significantly impacted whether a mom will experience congestion during pregnancy.¹
• Parity: First-time moms are less likely to experience pregnancy congestion than second-time moms (or third-plus!)¹

How Common Is Congestion During Pregnancy?

In one study, 65% of women reported nasal stuffiness at some point during pregnancy. Nasal congestion appears to be increasingly common as a pregnancy progresses. In the same study, 42% of women reported nasal stuffiness by 36 weeks of pregnancy, up from 27% at 12 weeks.⁴

Remedies for Congestion During Pregnancy

There are several natural ways you can try to help resolve congestion during your pregnancy:

Try Nasal Irrigation

Rinsing your nasal passages with salt water using either a neti pot or a prepackaged aerosolized nasal mist can help decrease pregnancy congestion. These rinses work by rinsing mucus and debris from the sinuses. The salt in these solutions also draws excess fluid out of the mucus membranes in the nose, decreasing swelling and congestion.⁵ If you make a saltwater solution, use distilled water or boiled and cooled tap water. Otherwise, you risk introducing new germs from unpurified water into your sinuses.

Use a Humidifier

A humidifier increases the moisture in the air, which can help to loosen mucus and make it easier to expel. This decreases congestion and allows you to breathe more comfortably.⁶

Try Essential Oils

Some essential oils, such as peppermint and eucalyptus, have reportedly relieved nasal congestion when diffused or applied topically. However, the safety of these remedies during pregnancy is up for debate. Talk to your provider before diffusing or using them on your body. If you apply them topically, dilute them with a carrier oil, as they are very potent in their undiluted state.^7,8

Get Some Exercise

Naturally released during cardiovascular exercise, adrenaline causes dilation or widening of the nasal passages and airways to allow for more airflow. If you are experiencing uncomfortable nasal stuffiness, getting your heart rate up for a few minutes may help it to clear.⁹

Elevate the Head of Your Bed When Sleeping

Congestion may worsen at night, making it difficult to fall or stay asleep and contributing to pregnancy insomnia. Elevating the head of your bed by 30-45 degrees (or sleeping on extra pillows) can decrease blood flow and inflammation in your nasal passages when you lie down. This can help reduce nasal stuffiness during rest and sleep.¹

Use a Nasal Dilation Device

One study showed that a plastic device applied to the outside of the nose could aid in opening nasal passages and increasing airflow by 18%. These devices also demonstrated decreased obstructed breathing or congestion and increased blood oxygen saturation. While this study was not exclusive to pregnancy, the mechanism of congestion is the same, and there is no risk in trying these devices.¹⁰

If you can’t get relief from these remedies, some decongestant medications may be safe during pregnancy and can relieve symptoms in the short term. However, many of these run the risk of dependency, so you should not use them often or for long periods. Intranasal, topical, or oral steroids can also aid in pregnancy congestion, but check with your provider whether these are safe during pregnancy. Some are only safe in certain trimesters and only if you have no other conditions, such as high blood pressure.

The good news is that pregnancy congestion typically resolves within two weeks of delivery. If it gets too unbearable or affects your sleep, contact your provider. They can help rule out other causes of congestion, such as illness or obstruction. But rest assured that like myriad other pregnancy symptoms, congestion during pregnancy is normal and temporary.¹¹