Asthma & Pregnancy: Management

Reviewed by David Tinkelman, MD

Early awareness of asthma symptoms and peak flow monitoring can help you and your doctor respond quickly to worsening of your asthma during pregnancy. It is important to identify and treat your asthma when the symptoms are still mild, so as to reduce the risk of a more serious episode. Common asthma symptoms may vary from person to person and include:

  • Cough

  • Shortness of breath

  • Tightness in the chest

  • Wheeze

  • Shortness of breath

Many of these symptoms are common during pregnancy, and it sometimes may be difficult to tell if the cause is the increasing size of your baby or your asthma. A peak flow meter may enable you to tell the difference. A peak flow meter measures the airflow out of your lungs and can sometimes show a decrease hours or even a day before other asthma symptoms appear. Ask your doctor about using a peak flow meter to help monitor your asthma.


Asthma Action Plan for Your Pregnancy

An asthma action plan is a written plan based on changes in asthma symptoms and peak flow numbers, customized to your needs by your doctor to help you manage asthma worsening. It will give you information about when and how to use long-term control medicine and quick-relief medicine. It is a reminder of what to watch for and what steps to take so you will be able to make timely and appropriate decisions about managing your asthma during your pregnancy. Print a copy of our Asthma Symptom Action Plan (PDF) for you and your doctor.


Severe Asthma Episodes During Pregnancy

When asthma symptoms and low peak flow numbers indicate your asthma is worsening, it is important to take action to ensure you and your baby receive enough oxygen. A severe asthma attack is a true medical emergency and you should seek medical assistance immediately. A small number of women with asthma may have an asthma episode severe enough to be hospitalized so that you and your baby can be closely monitored. A severe asthma attack is a true medical emergency and you should seek medical assistance immediately. Your treatment may include oxygen, frequent inhaled medications, and IV steroids, all of which can be given without risk to your baby.


Asthma Management During Labor and Delivery

It is important to continue long-term control medicines and have quick-relief medicines available throughout labor and delivery. Your breathing will be closely monitored as will your baby's heart rate with a fetal monitor to make sure that he or she is not showing signs of distress. Plan ahead and discuss these decisions and potential problems with your healthcare providers. This will help decrease fears and problems that may arise once labor begins.

  • Bring your own medications to the hospital, so everyone will understand what you have been taking. The hospital will then provide whatever medication is needed.

  • Talk with your healthcare provider about pain control during delivery before your delivery date. If anesthesia is required, spinal anesthesia is preferred to general ("gas") anesthesia. If you receive anesthesia of this form, you may be able to use your inhaled medicine as directed by your doctor. If a Cesarean-section is required you may need IV steroids.


Breastfeeding When You Have Asthma

Research shows that breastfeeding for the first 6-12 months of life may help prevent or delay the development of certain allergies. The decision to breastfeed should be based on what you desire and your baby's needs. The medicines safe for use during pregnancy are generally used while breastfeeding without problems. Because your blood stream absorbs less medicine with inhaled medicine, less medicine passes into your breast milk. It is important to discuss your use of any medicines with your baby's doctor. Read more about asthma medications during pregnancy.

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