Giving Birth with Confidence

Is Your Stuffy Nose from Allergies or Pregnancy Congestion?

Cara Terreri

'Tis the season for tissues. Seasonal allergies affect up to 30% of the global population. Pregnancy-related congestion affects up to 42% of people during their pregnancy. Given that more than 200 million people across the world are pregnant at any given time, that's a whole lot of stuffy noses!

So, how do you know if your stuffy or runny nose is due to allergies or your pregnancy? And do you treat them in the same way? Let's take a look. 

Pregnancy congestion, also known as pregnancy rhinitis, can begin at any time during pregnancy and can last until you give birth. Symptoms include:

  • Sneezing 
  • Congestion (stuffiness) 
  • Runny nose
  • Postnasal drip 
  • Increased ear pressure
  • Poor sleep, as a result of the above symptoms

One of the main reasons people experience congestion in pregnancy is due to the increase in blood flow to mucous membranes throughout the body, including the nose. This results in nasal swelling, resulting in stuffiness and drainage. If you experience pregnancy congestion throughout your pregnancy, you can expect it to go away within a week or two after pregnancy. 

Seasonal allergies can happen to anyone -- pregnant or not. Some people find their seasonal allergies worsen during pregnancy, some find they improve, and others' stay the same. You may also experience seasonal allergies for the very first time during pregnancy (yay you!). Seasonal allergy symptoms include:

  • Itchy, watery, or red eyes
  • Dark circles under eyes
  • Itchy mouth, nose, or throat
  • Runny nose
  • Congestion (stuffiness)
  • Postnasal drip
  • Temporary loss of smell
  • Headache
  • Sneezing
  • Dry cough
  • Scratchy or sore throat due to postnasal drip 
  • Snoring, due to congestion
  • Poor sleep, as a result of the above symptoms
  • Tiredness, due to poor sleep

As you can see, seasonal allergies and pregnancy rhinitis overlap, though allergies can increased and/or more severe symptoms. The good news is that common treatments for seasonal allergies can also improve pregnancy congestion symptoms.   

Researchers at MotherToBaby have found that first generation antihistamines (i.e. the ones that have been around the longest, like chlorpheniramine or diphenhydramine) have relatively reassuring (ie, safer) pregnancy profiles, and are often preferred for having the most pregnancy data. These medications include Loratadine (Claritin), Cetirizine (Zyrtec), Diphenhydramine (Benadryl), Fexofenadine (Allegra), and Chlorpheniramine (Chlor-Trimeton). Learn more about these medications here. It is recommended, however, to skip the "D" component (oral decongestant) of antihistamines during the first trimester due to possible, but unproven, small concerns.

For seasonal allergies, there are little things you can do to reduce your exposure, like limiting time outdoors, keeping your windows closed when the pollen count is high, and taking a shower and/or changing clothes after being outside.

For both seasonal allergies and pregnancy congestion, there are natural remedies you can try, too, including:

Nasal saline rinse (aka, "neti pot")

  • Acupuncture
  • Installing HEPA filters (for allergies)
  • Daily doses of apple cider vinegar
  • Dietary changes to reduce inflammation 
  • Running a humidifier at night
  • Sleeping with your head elevated
  • Breathe Right strips to open your nasal passageways

As with any treatment in pregnancy -- natural or over-the-counter medication -- consult with your care provider (OB, physician, or midwife) before beginning something new.