Overview of nasal congestion during pregnancy

Did you know that this was actually one of the common discomforts of pregnancy - feeling like you have a cold constantly! In medical terms, it is called ‘pregnancy rhinitis’. It may feel like you are having a stuffy nose from a cold or some form of allergy; however, it usually is none of those. We may define it as nasal congestion in the last 6 to 8 weeks of pregnancy. However, it can also start earlier or later.

Nasal congestion of pregnancy does not usually have any other signs of respiratory infection, nor has any known allergic cause. Pregnancy rhinitis usually resolves 2 weeks after delivery. About 20-30% of pregnant women experience it.

What does it feel like?

Pregnancy rhinitis feels like you have a runny nose or a blocked nose. Sometimes it is associated with difficulty sleeping if severe. Some of the common symptoms are runny nose, sneezing, post-nasal drip causing cough, loss of smell, difficulty sleeping due to blocked nose.¹

What causes nasal congestion in pregnancy?

If someone asks, why does a pregnant woman have body aches, engorged breasts, headaches or swollen feet, we usually have an answer to that, which is - hormones. Similarly, pregnancy rhinitis is also partly attributed to the raging and changing hormones. However, we still don’t know the exact cause of it. 

The main mechanism is inflammation of the membranes that line the nose, which causes it to be swollen. This also causes increased blood flow to the nasal passages and enlarging of the nasal veins. This would naturally make you feel like you have a blocked or runny nose. 

How will you know if it is pregnancy rhinitis or something else?

If you are experiencing stuffy nose alone, it is most likely pregnancy rhinitis. Here are a few other conditions that you may consider: 

• It may be allergic rhinitis if you have other symptoms like itchiness in nose, throat, eyes and ears, along with redness of eyes and watering. You might also need to remember that if you are prone to allergies, pregnancy may make you more susceptible to it²
• If you are experiencing body aches, muscle pains, a sore throat, headache with fever, you may be having the flu or cold instead of pregnancy rhinitis
• If you are having a stuffy nose along with fever, headaches, green or yellow mucus, facial pain and pressure, you may be having viral or bacterial sinusitis³

Even though it is easy to mention the different causes in this article, it usually is not so easy to differentiate when you are experiencing the symptoms. It is also very likely to be experiencing nasal congestion due to both pregnancy rhinitis and allergies.

How can you treat it?

Like other pregnancy related discomforts, nasal congestion will most likely resolve on its own within 2-3 weeks of delivery. However, there are some things you can do which may bring some relief. Some general advice would be: Hydration, hydration and more hydration. A healthy, active lifestyle. Pregnancy can make you more lazy, but remember that exercise and staying active will help in numerous ways. 

The following treatment options may help alleviate some of the symptoms:

• Use a humidifier in the room: Avoiding dryness may help with the symptoms
• Saline nasal irrigations or nasal drops or sprays: These can be found over the counter and are helpful in keeping the nasal airway clean. It can be used about three to four times a day
• Mechanical alar dilators⁴ or nasal strips: These can also be found at the drugstore. They will help in keeping the nasal passages open and helping you breathe normally during sleep
• Sleeping on your side or with your head elevated⁵: When sleeping on the back, the nasal passages naturally are slightly closed. During pregnancy the preferred position is usually on the left side. Elevating the head will also help nasal block along with the common discomfort of heartburn
• Taking warm showers: The steam trapped in the bathroom usually helps clear the air passages
• Steam inhalation
• Traditional or natural remedies, including warm lemon ginger tea, or applying vicks/balm

Not everything needs to be treated

Sometimes, we need to remember that if the condition is not very uncomfortable and is bearable, it is best to let time heal it, instead of trying to treat it with medications. Few points to remember:

• Avoid smoke and other known allergens like certain plants, dust, pollen, etc; especially if you are anallergic person
• Avoid taking over-the-counter nasal decongestants without a doctor’s prescription since they tend to be overused, leading to other complications⁶
• Sometimes steroids and antihistamines are prescribed, which may help in treating severe cases. However, they should be taken only after a doctor’s approval

Summary

Nasal congestion, or "pregnancy rhinitis," is a very common pregnancy annoyance. It makes you feel like you have a constant cold. Pregnancy rhinitis usually starts in the last couple of months, although it can start earlier. Symptoms include a stuffy or runny nose, sneezing, post-nasal drip, and sometimes trouble sleeping. It's mostly caused by hormonal changes; however, the exact cause is unknown.

It can be tricky to figure out if it’s pregnancy rhinitis or something else, like allergies or a cold. To summarise, allergies might come with itchy eyes or a scratchy throat, while colds or the flu are often associated with fever and body aches. Sinus infections could cause thick mucus and facial pain.

Fortunately, it usually clears up a few weeks after giving birth. To relieve you of some discomfort, you can try using a humidifier, saline nasal sprays, nasal strips, and sleeping with your head elevated. Staying hydrated and active will also help. Avoid over-the-counter nasal decongestants unless your doctor prescribes them Remember that sometimes the best approach is just to wait it out.

Frequently Asked Questions

Is pregnancy rhinitis harmful to the baby?

Nasal congestion itself is not harmful to the baby. However, any condition that might affect the overall health of the mother may have some negative implication on the baby. For example, if the mother experiences sleeping problems due to the congestion, it may affect her health and therefore the baby. If a pregnant mother is having trouble sleeping or breathing, she should speak with a doctor for ways to ease the symptoms. 

Can it cause snoring or sleep apnea?

Yes, nasal congestion can lead to snoring or contribute to sleep apnea, which is a condition where breathing is temporarily interrupted during sleep. If snoring or the interruption of sleep become severe, consult your doctor.

Does the congestion worsen as pregnancy progresses?

Yes, nasal congestion may become more in the later stages of pregnancy, mainly because of other associated discomforts like increased fluid retention and hormonal changes.

How does pregnancy rhinitis affect labour and delivery?

Pregnancy rhinitis doesn’t usually interfere with labour and delivery. However, if it affects your breathing, you may want to discuss it with your doctor before delivery.

Can nasal congestion persist even after pregnancy?

In nasal congestion of pregnancy, it usually resolves within 2-3 weeks postpartum. If congestion persists beyond this, the cause may perhaps be an allergy or another underlying condition, and should be checked by your doctor.