Circulation & Breathing
Nasal Congestion (Pregnancy Rhinitis)
A stuffy nose caused by pregnancy hormones rather than a cold — common and manageable, but fever or facial pain alongside it needs checking.
Written and fact-checked by the ParentVibes editorial team against WHO, NHS, ACOG and peer-reviewed guidance. Not yet reviewed by a named clinician.
Quick facts
- When most common
- 2nd and 3rd trimester
- How long it can last
- Weeks, sometimes for the rest of pregnancy
- Not caused by
- Infection or allergy (though these can occur too)
- Usual outcome
- Resolves within weeks of delivery
- See a doctor if
- Fever, facial pain, or breathing difficulty
A blocked or runny nose that has nothing to do with a cold is one of the more surprising pregnancy symptoms — and one of the most common. It's called pregnancy rhinitis, and it can make sleeping, breathing comfortably and even smelling your food a bit trickier for weeks at a time.
This guide explains why pregnancy causes a stuffy nose, what helps you breathe more easily, and when congestion might actually be something else — like a sinus infection — that needs a doctor's input.
What is pregnancy rhinitis?
Pregnancy rhinitis is nasal congestion — a blocked, stuffy or runny nose — that lasts six weeks or more during pregnancy, with no signs of infection or allergy. It's caused by rising oestrogen and increased blood volume, which cause the blood vessels and mucous membranes lining your nose to swell and produce more mucus, in the same way they do in your gums (bleeding gums) and can contribute to nosebleeds.
It most often develops or worsens in the second and third trimesters and can persist right up until delivery, typically improving within a couple of weeks after birth as hormone levels fall. It's uncomfortable but not harmful to you or your baby, though ongoing mouth-breathing at night can affect your sleep quality.
Not a cold, and not usually an allergy
Pregnancy rhinitis can feel just like a cold, but it comes without a sore throat, cough or fever, and without the itchy eyes typical of allergies. If those extra symptoms are present, something else may be going on.
What causes nasal congestion in pregnancy?
Pregnancy rhinitis is driven by hormonal and circulatory changes rather than infection.
Rising oestrogen
Oestrogen increases blood flow to mucous membranes throughout the body, including the lining of the nose, causing it to swell and become congested.
Increased blood volume
Higher circulating blood volume in pregnancy adds to the swelling of small blood vessels in the nasal passages, narrowing the airway.
Increased mucus production
Hormonal changes also stimulate the nasal lining to produce more mucus, adding to the feeling of a runny or dripping nose.
Existing allergies or a cold
Pregnancy rhinitis can also make ordinary seasonal allergies or a common cold feel more intense, since your nasal passages are already more swollen and reactive than usual.
Dry indoor air
Centrally heated or air-conditioned air can dry and irritate an already sensitive nasal lining, worsening the feeling of blockage.
How to tell it apart from a cold
- No sore throat, cough or fever with pregnancy rhinitis
- Symptoms last more than a couple of weeks, unlike a typical cold
- No itchy eyes or sneezing fits typical of allergies
- Congestion tends to be fairly constant rather than coming in a short illness
When nasal congestion is normal
A persistently stuffy or runny nose without other illness is a common, harmless part of pregnancy. These features are reassuring:
- A blocked or runny nose that's been present for weeks without a sore throat, cough or fever.
- Symptoms are fairly constant rather than getting suddenly much worse.
- Mucus, if present, is clear or white rather than green, yellow, or thick and discoloured.
- You feel otherwise well, with no facial pain or pressure.
- You can still breathe reasonably comfortably, even if congested.
| Usually normal pregnancy rhinitis | Needs medical attention | |
|---|---|---|
| Duration | Weeks, fairly steady | Sudden worsening after several days of improvement |
| Discharge | Clear or white | Thick, green or yellow discharge |
| Other symptoms | None significant | Fever, facial pain or pressure, headache |
| Breathing | Stuffy but manageable | Significant difficulty breathing |
It usually clears after birth
Pregnancy rhinitis typically resolves within about two weeks of delivery as your hormone levels and blood volume return towards normal.
Warning signs — get medical help now
Ordinary pregnancy rhinitis is not dangerous, but congestion can occasionally be part of a sinus infection or, rarely, a breathing problem that needs attention. Contact your doctor or midwife promptly, or seek urgent care, if you have:
Seek urgent medical care if you have
- A high fever alongside nasal congestion.
- Facial pain or pressure, particularly around your cheeks, forehead or eyes.
- Thick green or yellow nasal discharge that persists for several days.
- A headache that is severe, worsening, or different from your usual headaches.
- Difficulty breathing, especially at rest or when lying down.
- Congestion that suddenly worsens after you'd started to feel better (which can suggest a secondary infection).
Breathing difficulty in pregnancy should always be checked promptly rather than assumed to be 'just congestion'. If you notice reduced or absent baby movements at any point, contact your maternity unit the same day.
Sinus infections can develop on top of rhinitis
Swollen nasal passages from pregnancy rhinitis can occasionally become infected, leading to a sinus infection. Facial pain, fever, or thick coloured discharge are the signals to get checked rather than continuing home treatment alone.
Self-care & home remedies
Pregnancy rhinitis can't always be cured, but several safe measures ease the stuffiness and help you breathe and sleep more comfortably.
Clear and moisten your nose
- Use a saline nasal spray or rinse several times a day to loosen mucus and reduce swelling — safe throughout pregnancy.
- Try steam inhalation, such as sitting in a steamy bathroom or over a bowl of hot (not scalding) water.
- Keep a humidifier running in your bedroom, especially overnight.
- Blow your nose gently, one nostril at a time.
Sleep and daily comfort
- Prop yourself up with extra pillows at night to help mucus drain and ease breathing.
- Stay well hydrated — drinking enough water helps thin mucus.
- Avoid known irritants such as cigarette smoke, strong perfumes or dusty environments where possible.
- Take a warm shower before bed to help clear congestion temporarily.
Medicines — check first
- Don't take decongestant sprays, tablets or other cold and flu remedies without checking with your pharmacist, doctor or midwife first, as not all are recommended in pregnancy.
- Ask your pharmacist about pregnancy-safe options if saline alone isn't enough.
Exercise can help too
Gentle exercise, such as a short walk, can temporarily reduce nasal congestion by improving circulation — always check with your midwife that your activity level is suitable for you.
When to consult a doctor
Book a non-urgent chat with your doctor or midwife if:
- Congestion is significantly affecting your sleep or daily life.
- You're unsure whether over-the-counter treatments are safe to use.
- Symptoms last many weeks without any improvement.
- You develop facial pain, pressure or discoloured discharge, even without fever.
- You have asthma or another breathing condition and congestion is making it harder to manage.
Track how your symptoms change
Noting when congestion started and how it's changing helps your midwife tell ordinary pregnancy rhinitis apart from anything needing more attention.
Open the Pregnancy TrackerFrequently asked questions
Why is my nose so blocked but I don't have a cold?
This is likely pregnancy rhinitis — nasal congestion caused by pregnancy hormones and increased blood volume swelling the lining of your nose, rather than an infection. It's very common, particularly in the second and third trimesters.
How long does pregnancy rhinitis last?
It can last for six weeks or more and, for some people, persists until delivery. It usually improves within about two weeks after birth as hormone levels settle.
Is it safe to use nasal sprays in pregnancy?
Saline sprays and rinses are safe throughout pregnancy and are the first choice for easing congestion. Medicated decongestant sprays and tablets should be checked with your pharmacist, doctor or midwife before use, as not all are suitable in pregnancy.
Can nasal congestion affect my baby?
Ordinary pregnancy rhinitis does not affect your baby. The main things to watch for are signs of a sinus infection or genuine breathing difficulty, which are worth getting checked rather than any risk from stuffiness itself.
How can I tell if it's rhinitis or a sinus infection?
Pregnancy rhinitis usually causes clear or white mucus without fever or facial pain. A sinus infection is more likely if you develop facial pain or pressure, fever, or thick green or yellow discharge — these should be checked by your doctor.
Will nasal congestion go away after I give birth?
Yes, for most people it resolves within a couple of weeks after delivery as pregnancy hormone levels and blood volume return towards their usual, non-pregnant state.
Your next steps
Track your pregnancy
Log symptoms week by week, get personalised tips, and see how your pregnancy is progressing.
Open Pregnancy TrackerPregnancy week-by-week
Follow your baby's growth and your body's changes from week 1 to 40 in plain language.
Explore the guideFind a gynaecologist
Have a personal concern? Book with a trusted obstetrician or gynaecologist near you.
Find a doctorRelated pregnancy symptoms
Helpful resources
Sources
- NHS — Pregnancy: common symptoms & concerns
- ACOG — Pregnancy resources (American College of Obstetricians and Gynecologists)
- WHO — Maternal health & pregnancy care
- NHS — Colds, flu and your baby's chances in pregnancy
- ACOG — Rhinitis of Pregnancy
Next review due: 6 January 2027.
Medical disclaimer
This page is general information about a common pregnancy symptom and does not replace personal medical advice. Every pregnancy is different. If you have severe pain, heavy bleeding, a bad headache with vision changes, reduced or absent baby movements, breathing difficulty, fever, or you feel something is seriously wrong, contact your doctor or midwife or go to your nearest emergency department straight away. When in doubt, always get checked — it is never a waste of anyone's time.
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