Shortness of Breath and Rib Pain in Pregnancy

Causes, Treatments, When to Call the Doctor, and How to Get Through It

A pregnant girl feels pain. She is holding her back and belly.

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Changes in your body and hormones during pregnancy are responsible for a lot of different symptoms. Two common complaints are shortness of breath and rib pain. Here’s what you need to know about the causes and treatments of these discomforts of pregnancy plus how to cope with them, and when to call the doctor.

Shortness of Breath

Pregnancy can quite literally take your breath away. 

Dyspnea is the medical term for shortness of breath or breathlessness, and it’s a very common pregnancy symptom. In fact, about 60 - 70% of expecting moms say they feel short of breath sometimes.

Symptoms

When you're short of breath, it may feel like it's hard to breathe or as though you're breathing heavy. Here is how some expecting moms describe it.

  • It is more work to get enough air. It may seem like you have to think about breathing, or you have to put more effort into taking deep breaths instead of it being as natural as it usually is.
  • There's a tightness in your throat or chest. You may feel as if your airway or lungs are tighter, and it's harder to get the air through your throat and into your lungs.
  • You aren't getting enough oxygen. You may feel as though your breaths are not big or strong enough to take in the air that you need.

Causes

You can feel short of breath at any time during your pregnancy, but it’s more common in the last trimester. You may not know why it’s happening, but here are some of the pregnancy-related causes.

  • Hormones. Pregnancy hormones affect your heart and lungs, which can lead to changes in your breathing that you may or may not notice.
  • A growing uterus. As your uterus grows up into your abdomen, it begins to put pressure on the diaphragm (the muscle that helps with breathing). It can crowd your lungs and give them less room to expand, making it more difficult to take a deep breath.
  • How you carry. Women carry differently. Carrying high and closer to the diaphragm and lungs can cause more shortness of breath. Carrying low can give your lungs a little more room and lead to less shortness of breath.
  • Exercise. Prenatal exercise is healthy for you. However, overdoing it can cause pain, dizziness, and shortness of breath. Be sure to exercise at a healthy pace and take frequent breaks. You should also stay hydrated, and listen to your body’s signals, so you know when to slow down and stop.
  • You are having multiples. When you’re pregnant with more than one baby, they take up even more room in your already crammed abdomen.
  • Your weight. Obesity and gaining an excessive amount of weight during pregnancy can lead to many health issues, including shortness of breath and other breathing disorders.

What to Expect During Pregnancy

Shortness of breath has many causes so that it can start at any stage of pregnancy.

First Trimester: In early pregnancy, changing hormones can affect the way you breathe. They can alter your breathing pattern and make you feel short of breath. You may also feel tired and like you need more oxygen.  

Second Trimester: If you’re like some women, you may begin to notice shortness of breath in the second trimester. It is most likely due to the changes in your respiratory (lungs and breathing) and cardiovascular (heart and blood) systems along with your expanding midsection

Third Trimester: Shortness of breath usually gets worse in the third trimester. By 31 to 34 weeks, your growing baby and uterus take up a lot more space in your abdomen. Your baby and uterus are big enough to put pressure on your diaphragm and crowd your lungs. Your diaphragm is the muscle that helps you to breathe, so it may feel like it’s more difficult to take a deep breath.  

End of Pregnancy: The final weeks of pregnancy may bring some relief. When the baby drops down into position for delivery, it can give you a little extra breathing room. In a first pregnancy, the baby usually drops down into the pelvis between 36 and 38 weeks. However, in pregnancies after the first one, the baby may not drop until the very end or even when labor begins. 

Diagnosis

You should always talk to your doctor about your pregnancy symptoms and discomforts at your prenatal care appointments. Your doctor can ask you questions and examine you to make sure what you’re feeling is normal.

To diagnose shortness of breath, your doctor will:

  • Check your breathing and heart rate.
  • Ask you about your exercise habits and daily activities.

You doctor may also want to check for any conditions other than pregnancy that could be causing your symptoms.

What Else It Could Be

Everyone gets a little short of breath once in a while, and there are many reasons for it.

Most of the time, it’s nothing to worry about and completely normal. However, if a little shortness of breath turns into having trouble breathing or you have pain along with breathlessness, it could be a sign of an underlying health issue.

Other conditions that can affect your breathing are:

  • Anemia
  • Asthma
  • Allergic reaction
  • Anxiety
  • Cold or flu
  • Pneumonia
  • Lung condition
  • Heart condition
  • Hyperthyroidism
  • Something blocking the airway
  • Pulmonary embolism (a blood clot in the lungs)

Treatment

Pregnancy-related shortness of breath does not usually need medical treatment. But your doctor will:

  • Monitor your breathing and heart rate at your prenatal appointments.
  • Talk to you about exercise and your daily activities.
  • Provide you with information and answer your questions.
  • Treat any other health issues that could be causing the problem.
  • Refer you to other doctors, if necessary.

Coping

When you're short of breath because of pregnancy, it can be a little annoying, but it's rarely dangerous and unlikely to interfere with your daily life.

Even if it doesn't seem like you're taking in enough air, you and your baby are in fact getting all the oxygen you need. 

There isn't too much you can do to prevent it, especially as your belly expands in the third trimester. But, here are a few things you can do to help you get through it.

  • Change your position. Sit up straight or stand up to give your lungs more room to expand and take in more air.
  • Pay attention to your posture. Good posture during pregnancy can help to relieve shortness of breath and increase your comfort both during and after your pregnancy. 
  • Sleep on an incline. Use pillows or a sleeping wedge to prop up your upper body and take some pressure off of your lungs while you sleep. 
  • Stay calm. Getting nervous or tense could make it more difficult to breathe.
  • Slow down. If you are exercising or moving quickly, take a break to catch your breath.
  • Make more room to breathe. Pull your body up by raising your arms over your head to make more room for your lungs to expand and take a deep breath.
  • Breathing exercises. Learn and practice breathing exercises and techniques. They will help with deep breathing and also relaxation and pain during childbirth.
  • Watch your weight. Follow your doctor's guidelines for weight gain in pregnancy. Gaining too much can lead to more shortness of breath, especially with moving.
  • Wait it out. Sometimes, there's not much you can do but hang in there and wait. You may just have to deal with the uncomfortable symptoms until your baby is born.

When to Call the Doctor

When you feel short of breath during pregnancy, it will usually go away with a change of position and a few moments rest. But, you should call the doctor or go to the hospital if:

  • You have a cough along with shortness of breath.
  • The shortness of breath is getting worse.
  • You are having trouble breathing and talking.
  • Your heart is racing.
  • You have chest pain.
  • You feel dizzy or faint.
  • You have a fever.
  • You have swelling along with shortness of breath. 
  • You are wheezing.
  • Your fingers, toes, or lips are turning blue.

Rib Pain

Rib pain is another common pregnancy complaint, especially in the last trimester. Rib pain and shortness of breath are often experienced together since pain in the ribs can make it more challenging to take a deep breath and cause you to feel short of breath. 

Causes of Rib Pain

Pregnancy and the changes in your body that go along with it can affect your musculoskeletal system, especially your ribs. Rib pain during pregnancy is usually the result of:

  • Hormones. Pregnancy hormones, especially progesterone and relaxin, work to loosen and relax the muscles and ligaments in your body. These changes help you get through pregnancy and delivery, but they can also lead to soreness in your ribs and other parts of your body.
  • Your growing uterus. As your baby grows and your uterus stretches into the upper part of your abdomen, it can push on your rib bones.
  • The baby’s position. The baby’s body may be lying in a way that puts pressure on your ribs, especially if you are petite, the baby is large, you're carrying high, or the baby is breech.
  • Kicking. During your last trimester, your baby’s legs and feet are developed, strong, and ready to kick. Sometimes those kicks can get you right in the ribs.
  • Weight gain. The extra weight you’re carrying, especially in your breasts, can lead to pain in your back, shoulders, and rib cage.
  • Heartburn. Heartburn and indigestion can feel like a burning in the back of your throat or down into your chest. It can even feel like a pain in your chest and ribs.

Other Causes

Dealing With Rib Pain

Your body is made to stretch and grow with pregnancy. But, that doesn't mean it isn't uncomfortable at times. You might not be able to avoid it, but you can try to relieve it. To combat rib pain during pregnancy, you can:

  • Maintain a healthy weight.
  • Practice good posture.
  • Wear comfortable, loose clothing.
  • Eat healthy foods to prevent weight gain, gas and bloating, constipation, and gallstones, which can lead to pain.
  • Stabilize, strengthen, and stretch out your muscles and joints with safe, prenatal exercises or pregnancy yoga.
  • Wear a supportive bra that fits you properly.
  • Try a pregnancy belly belt or band to support your bump.
  • If you sit down at a desk all day for work, you should take breaks, stand up, and move around often.
  • Practice deep breathing exercises.
  • Take a warm (not hot) shower or bath.
  • Try warm compresses or ice packs on the sore area.
  • Use extra pillows or body pillows to help you get comfortable in bed.
  • Do not use any pain medication without talking to your doctor first. Your doctor may recommend Tylenol (acetaminophen) to relieve discomfort.
  • Ask your doctor about seeing an alternative care practitioner such as a chiropractor or an acupuncturist for relief.

When to Worry

You should let your doctor know if you are in any pain during your pregnancy, even if you believe it’s normal. You should contact your doctor right away or go to the emergency room if: 

  • You are having constant pain.
  • The pain comes on suddenly.
  • It is getting worse.
  • You believe the pain is not normal.

 A Word From Verywell

When you’re expecting, it’s not unusual to have to stop to catch your breath more often or to feel some aches and pains in ribs. These symptoms can be annoying and intense or only slightly bothersome. Most of the time, these issues are normal and rarely a cause for concern. However, you should always discuss all your symptoms with your doctor, even if you believe they are just part of pregnancy. It’s always best to be safe and have your doctor check it out. 

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Article Sources

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Additional Reading

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