Why being ill can feel different during pregnancy
During pregnancy the body changes across many systems at once: circulation, breathing, mucous membranes and immune response. That can make an ordinary cold feel more intense, even though medically it is not necessarily more dangerous.
At the same time, caution is sensible because fever, severe breathing problems or dehydration are more likely to have consequences. The aim is not to cause fear but to set clear priorities: relieve symptoms, reduce risk, recognise warning signs.
First assess: which type of infection is most likely
Many complaints can be broadly grouped into patterns. This does not replace a diagnosis, but it helps with decisions.
- Common cold: runny nose, sore throat, cough, usually a slow onset, fever if present is mild.
- Flu or flu-like illness: sudden onset, marked malaise, headache and body aches, often higher fever.
- Gastroenteritis: nausea, vomiting, diarrhoea; the main risk is fluid loss.
- Urinary tract infection: burning, more frequent need to pass urine, lower abdominal pain, sometimes fever.
If you are unsure, use the course and level of impact as a guide: is it getting better each day or clearly worse? The trend is often more informative than a single day.
Colds during pregnancy
Colds are very common during pregnancy. Most are viral and resolve with time, rest and good symptom care. Medicines are mainly used to ease breathing, reduce pain or treat fever.
A practical rule of thumb is: prefer a few well-evidenced single-ingredient treatments rather than a multi-ingredient combination product. An overview of colds and pregnancy can also be found on the NHS. NHS: Colds and flu in pregnancy
Cough remedies, throat and chest
Irritative cough is often due to mucous membrane irritation and not a sign of something dangerous. Drinking fluids, warm air, honey in tea and rest provide the biggest benefit for many people. Cough medicines are often combination products containing several active ingredients, even though you may only need one.
- Dry cough: humidify the air, warm drinks, rest.
- Productive cough: drink plenty of fluids, gentle activity as tolerated, positioning to help mucus drain.
- Warning signs: breathlessness, chest pain, wheeze, blood-stained sputum.
Nasal spray, blocked nose, pressure in the head
A blocked nose is especially common in pregnancy because mucous membranes are more sensitive and better supplied with blood. Saline spray or a nasal rinse is often the best first step. Decongestant nasal sprays are sometimes used short-term in practice when sleep is otherwise impossible, but they are not a long-term solution.
Oral decongestants are a different category and are generally avoided in pregnancy. A factual assessment of decongestants is available from UKTIS. UKTIS: Decongestants in pregnancy
Fever in pregnancy: the key issue
Fever is not automatically dangerous, but it is the symptom you should manage most clearly. Measured temperature is better than feeling. If you have a fever, prioritise fluids, rest and a plan for pain and fever relief.
If fever is high, persistent, or occurs with severe malaise, breathing problems or lower abdominal pain, it should be investigated to find the cause.
Medicines in pregnancy: a safe decision-making approach
Many people look for a list of allowed and forbidden drugs. In reality, it is often a balance of gestational age, dose, duration and alternatives. A good strategy is consistently simple.
- Only take a medicine when it is intended to treat a clear symptom.
- Prefer a single active ingredient rather than combinations, where possible.
- Use the lowest effective dose for the shortest duration.
- If you need something regularly, stop improvising and seek medical advice.
Paracetamol
Paracetamol is often the first choice for pain and fever in pregnancy when needed. It is important not to take it routinely but to use it for clear symptoms, and not to use it long-term without medical supervision. The NHS provides guidance. NHS: Paracetamol in pregnancy
Ibuprofen and other NSAIDs
Ibuprofen is commonly considered because it is a standard medicine outside pregnancy. In pregnancy its suitability depends much more on the gestational week. From around the middle of pregnancy, NSAIDs are generally avoided because they have been linked with issues such as reduced amniotic fluid.
Regulatory agencies (for example the FDA) recommend avoiding NSAIDs from about 20 weeks' gestation unless medically necessary and under supervision. FDA: Avoid NSAIDs at 20 weeks or later
If you have searched for "ibuprofen pregnancy", the main point is usually this: don't panic after a single dose, but it should not be a routine self-treatment, especially in the second and third trimesters.
Antibiotics
Antibiotics are neither universally risky nor universally safe in pregnancy. They are targeted treatments for bacterial infections. They usually do not help with colds because those are most often viral.
If an antibiotic is prescribed, a drug with an established safety profile in pregnancy is typically chosen. It is important not to take antibiotics on suspicion alone, not to start with leftover medicines, and not to shorten a prescribed course without advice.
When to see a doctor: not for every sniffle, but for clear signals
You do not need medical help for every cold. However, keep a low threshold for seeking care if something does not fit the usual pattern or if you feel markedly worse than with a typical infection.
Seek assessment if
- Fever is high, persistent or keeps returning.
- You have breathlessness, chest pain or severe weakness.
- You are unable to drink or show signs of dehydration.
- Your cough becomes severe, clearly worse, or you notice wheeze.
- You have severe lower abdominal pain, flank pain or burning on passing urine.
- You need medicines for several days, as that can be a sign that something more is going on.
Seek urgent help if
- You are very short of breath, cannot speak normally or appear blue-tinged.
- You are faint, collapse or have severe circulatory problems.
- You notice heavy bleeding or a gush of fluid.
If you are unsure, it is often helpful to describe the situation briefly in a structured way: gestational week, highest temperature, duration, main symptoms, medicines taken, and any pre-existing conditions. That makes advice quicker and more accurate.
Practical weekly plan: getting through the acute phase
Many people lose energy because every step feels like a new decision. A calm standard plan is often more helpful than another product.
- Measure temperature rather than guessing, especially if you feel feverish.
- Prioritise fluids; small amounts frequently are often easier to manage.
- Protect sleep and rest periods actively.
- Use saline, humidity and warmth as a basic approach.
- Use medicines only selectively and follow the single-active-ingredient principle.
- If there is no improvement after two to three days or you clearly worsen, seek assessment.
Conclusion
Being ill during pregnancy is usually not dangerous, but it requires clear decisions. For colds, rest, fluids and symptom-oriented measures often help more than combination products. Paracetamol is often the first choice for pain and fever when needed, while ibuprofen depends much more on the stage of pregnancy and is generally avoided from the middle of pregnancy onwards. If fever persists, breathing problems occur, or the course becomes clearly worse instead of better, seeking assessment is the safe step.
