How to Manage Asthma Through Pregnancy


First Trimester: Months 1-3

Monitoring Your Health

Some women develop asthma for the first time during pregnancy. If that’s true for you, your first step is a diagnosis. To diagnose asthma, your doctor will run a series of lung function tests.

Diagnosing asthma during pregnancy can be tricky because pregnant women often experience shortness of breath, or dyspnea. When you’re pregnant, rising hormone levels, weight gain, and other physical changes can affect the rate at which your lungs and heart work. Using objective breathing tests, like spirometry, will help your doctor determine if asthma really is the cause of your breathing difficulties.

Asthama During Pregnancy

If you’ve already been diagnosed with asthma, you’ll need to get and record what’s called a “personal peak-flow best.” A peak-flow meter is a device that measures how well your lungs use and exhale air. The rate at which your lungs do this is called your peak expiratory flow rate (PEFR). “Managing Your Asthma Day To Day.”

Your doctor will show you how to use a peak-flow meter at home. Every day for a couple of weeks, you will record your PEFR. Using your records, your doctor will help you determine your personal peak-flow best, this is the best job your lungs can do. Your personal best becomes a baseline, or point of comparison. Then, as you measure your PEFRs throughout pregnancy, you can see when your breathing changes. If you have moderate or severe asthma, your doctor will suggest you take a peak-flow reading every day. If your PEFRs drop, your asthma may be getting out of control.

It’s important to monitor your breathing because it can change without you noticing. Even with few symptoms, you may be taking in less oxygen, which endangers your baby. Peak-flow readings will alert you as soon as your breathing changes.

When it comes to acute asthma attacks, these episodes appear to peak between 24 and 36 weeks of pregnancy. Below, you’ll learn what to do during an asthma attack.

Monitoring Your Baby’s Health

Much like you, your baby benefits from getting an initial assessment, or “baseline” measurement, between 12 to 20 weeks of pregnancy. This time, the measurement is fetal growth rate. Using a sonogram, your obstetrician or nurse-midwife will measure your baby’s size. A sonogram is an easy, painless procedure in which a health care provider applies sound waves (ultrasound) to your abdomen. (Although “ultrasound” refers to the type of sound waves used, and “sonogram” refers to the actual procedure, the two terms are sometimes used interchangeably). The projected images of the baby, which help show its size and location, can be watched and recorded on a video screen. With these initial sonogram measurements, health care providers can be sure your baby is growing at a healthy rate in later months.

If everything seems normal, your health care provider will simply measure the size of your abdomen from 20 to 32 weeks of pregnancy. During this time, the height (in centimeters) of your unborn baby equals his or her age in weeks. In other words, a fetus will grow at an expected rate. If the readings indicate your baby is not as big as expected, your doctor will perform another sonogram to double-check.

Second Trimester: Months 4-6

Monitoring Your Health

As your pregnancy progresses, think “maintenance.” By now, you have forged a partnership with your health care provider and are taking asthma medication. You also know how to avoid asthma triggers and measure your daily peak-flow readings.

During this time, it’s also important to be on the lookout for other conditions that might aggravate your asthma. If you get a chest cold, for example, your asthma could quickly get worse. Upper respiratory infections are the most common cause of asthma exacerbations in pregnant women.

One of the best things you can do now is communicate with your health care provider. If you have questions or concerns, express them. Feel free to make a list of questions and call your health care provider. When you get the answers you need, you’ll feel confident about your health.

Monitoring Your Baby’s Health

Again, if everything seems normal, your doctor will measure your abdomen at regular check-ups, keeping track of the measurements to ensure that your baby is growing at a normal rate. If you have severe asthma, or if your asthma has gotten out of control, your baby’s health may be monitored with periodic sonograms, which provide a more precise picture of fetal growth.

Third Trimester: Months 6-9

Monitoring Your Health

As you approach your due date, it’s time to start planning for your delivery. Talk to your doctor about what will happen if you get an asthma attack during labor, for example. Although asthma attacks during labor are rare, you’ll feel confident if you know what to expect. According to studies, the last four weeks of pregnancy (weeks 36-40) often are the most symptom-free for women with asthma.

Monitoring Your Baby’s Health

During your last trimester, your health care provider will pay close attention to your growing baby, making sure he or she seems to be growing well. If your asthma is under control, you may only need weekly check-ups. At home, you’ll also do daily “kick counts,” in which you count the number of times you feel the baby kick during, say, 10 minutes. Kick counts help asses the baby’s activity level.

If you have severe asthma, or if your baby seems to be growing more slowly than normal, your doctor also may do sonograms or electronic fetal heart rate monitoring. In this last procedure, health care providers lightly place a belt, much like seat belt, around your abdomen. This belt is attached to a machine that records your baby’s heartbeat. The recordings let health care providers make sure your baby’s heartbeat is normal.

If you have a serious asthma attack that might affect your baby’s oxygen level, your doctor may do what’s called “intensive fetal monitoring. Intensive fetal monitoring refers to one or several types of monitoring, such as the electronic fetal heart rate tests mentioned above. Health care providers will continue this kind of monitoring until they’re sure everything is okay.

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About the Author: Andrew Reinert is a health care professional who loves to share different tips on health and personal care. He is a regular contributor to MegaHowTo and lives in Canada.

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