It's Monday morning, shortly after six. Lisa is in the kitchen preparing her breakfast as the city slowly awakens outside. She opens the window a crack—not too wide, because the cold winter air irritates her airways. Her peak flow meter lies on the kitchen table, right next to her medication. Measure, inhale, eat breakfast—she has perfected this routine. She has to. Because Lisa is five months pregnant, and with her growing belly, breathing has become more difficult.
Before her pregnancy, her asthma was well-controlled, almost invisible in everyday life. But now, with her body performing at its peak, her diaphragm being pushed upwards, and her oxygen requirements increasing, she realizes anew each day: asthma during pregnancy isn't simply asthma plus a baby bump. It's a completely new challenge that affects every aspect of daily life. From climbing stairs to cleaning the apartment to the question of whether her asthma inhaler could be dangerous for her baby during pregnancy.
Many people are familiar with these everyday questions and uncertainties. Around five to eight percent of all pregnant women suffer from asthma – and for all of them, a chronic condition becomes a double responsibility. Because anyone expecting a child must not only keep an eye on their own health, but also that of the growing life within them. When shortness of breath means pregnancy or asthma, when every breath has to be consciously controlled, then more than just medication is needed. Strategies, knowledge, and small adjustments are needed to make everyday life easier.
The invisible burden: When pregnancy and asthma collide
Asthma is one of those conditions that often remains invisible to others. No one sees the constricted bronchi, the thick mucus, the overactive airways. What others take for granted—effortless breathing—becomes a conscious effort for asthmatics. During pregnancy, this strain is intensified. The body undergoes a hormonal revolution, the uterus grows and pushes the diaphragm upwards, and oxygen demand increases by about twenty percent. What was previously only occasionally problematic can suddenly become a daily challenge.
The Medication Dilemma
The biggest concern for many pregnant women with asthma revolves around their medication. Budesonide, in particular, is frequently searched for on platforms like Embryotox – an information portal for drug safety during pregnancy and breastfeeding. The uncertainty is understandable: any substance that enters the mother's body also reaches the child via the placenta. However, the reality is more complex than this fear suggests.
Modern medicine has collected data over decades, and the result is clear: Common asthma medications, especially inhaled corticosteroids like budesonide and bronchodilators like salbutamol, are considered safe for use during pregnancy. Scientific evidence shows that the risk to the unborn child from uncontrolled asthma is many times higher than from the proper use of these medications. An asthma attack during pregnancy that affects the baby can be more serious than any medication – the oxygen deprivation in the baby caused by asthma during pregnancy is the real danger.
The morning begins with routine: structure as an anchor in everyday life
For Sarah, who is seven months pregnant, every day begins the same way: Even before she gets out of bed, she reaches for the peak flow meter on her nightstand. This morning measurement is more than routine – it's her early warning system. A drop in readings of more than twenty percent would mean that an asthma worsening during pregnancy is on the horizon, long before she notices it subjectively.
After the measurement, she takes her baseline medication, which she never skips, even if she feels well or has no symptoms. She has learned that other women's experiences with salbutamol during pregnancy have shown that relying solely on the rescue inhaler is a mistake. The inhaled corticosteroid reduces inflammation and prevents attacks from occurring in the first place. It forms the basis of her asthma control during pregnancy – a guideline she follows consistently.
Then she opens the window, but not just any old way. Sarah has the pollen forecast app on her phone and knows when the pollen count is lowest. In spring and summer, the early morning hours are best in the city because the pollen settles to the ground overnight. In the countryside, it would be the opposite. Details like these make all the difference between a day of clear breathing and a day full of discomfort.
The bedroom as a sanctuary
Sarah has declared her bedroom an allergen-free zone. The mattress and pillow are encased in mite-proof covers – an investment that has paid off. Every other day, she vacuums with a HEPA-filter vacuum cleaner, which doesn't simply blow the tiny particles back into the air. Stuffed animals and heavy curtains that collect dust have been banished from the room. Instead, there's a smooth Venetian blind and washable bedding, which is washed at sixty degrees.
It might sound excessive, but for Sarah, it's the foundation for peaceful nights. Since implementing these measures, her nighttime asthma attacks have become less frequent. She no longer wakes up drenched in sweat, gasping for air. That alone makes it worthwhile – especially now, when her body is already under strain from the pregnancy.
Movement between necessity and caution
The midwife recommended prenatal yoga to Sarah, and at first she was skeptical. Yoga with asthma? But the gentle movements, combined with conscious breathing, have proven beneficial. The breathing exercises for asthma during pregnancy that she learns there—pursed-lip breathing, extended exhalation, abdominal breathing—help her when she gets out of breath. They give her back a sense of control.
However, Sarah has learned to respect her limits. The fast power walks she loved before her pregnancy are a thing of the past. Now she walks more slowly, takes more frequent breaks, and listens to her body. She always carries her emergency inhaler with her, in her jacket pocket, within easy reach. Sometimes, when she's walking uphill and notices her breathing becoming more difficult, she wonders: Is this normal shortness of breath during pregnancy or asthma? By now, she knows the difference. Pregnancy-related shortness of breath comes on gradually, without the typical wheezing. Asthma, on the other hand, manifests as tightness in the chest and audible wheezing when exhaling.
Stairs, loads, and new priorities
The move to the third floor, which Sarah and her husband made last year, now seems like a completely different chapter in her life. Back then, she took the stairs with ease. Today, every flight is a conscious effort. She climbs slowly, breathes evenly, and pauses on the landing. Her husband carries the shopping bags upstairs, and she has stopped feeling ashamed about it. This isn't weakness—it's wisdom. Because overexertion is a classic asthma trigger, and risking an attack just to appear strong would be foolish.
Her cleaning strategy has also changed. She used to do all the housework in one go, thoroughly and quickly. Now she spreads the tasks out over the week: vacuuming on Monday, cleaning the bathroom on Wednesday, and the kitchen on Friday. She has largely replaced chemical cleaning products with milder alternatives – vinegar, baking soda, and special eco-cleaners without strong fragrances. Aggressive fumes can irritate the respiratory system, and she wants to avoid that.
The home as a sanctuary: Indoor climate and air quality
Sophie's hygrometer reads 42 percent humidity – right in the optimal range. In winter, when the heating is on, this is a constant challenge. Dry air from the heating system dries out the mucous membranes, making them more susceptible to irritation and infections. Sophie has therefore placed bowls of water on the radiators and ventilates the rooms several times a day for short periods. Five minutes is enough to exchange the air without cooling the rooms down.
An air purifier with a HEPA filter sits in the living room, humming quietly. It filters pollen, dust, and other particles from the air – especially valuable during pollen season or when there are high levels of particulate matter outside. Sophie has learned to check the air quality data for her city. On days with poor air quality, the window stays closed, and the air purifier runs on its highest setting.
Salty air: More than just holiday romance
For the past few months, Sophie has had a small mini-graduation tower in her bedroom, enriching the air with fine salt particles – similar to what you'd find at the seaside or in old spa towns. The idea came to her after a vacation on the North Sea coast, where she was finally able to breathe freely for the first time in months. What initially sounds like a romantic memory of a sea breeze actually has a scientific basis: Salty air contains tiny sodium chloride aerosols that, when inhaled, can penetrate deep into the respiratory tract. These particles bind water and draw fluid into the mucous membranes – a purely physical, osmotic effect. This can loosen stubborn mucus and support the lungs' self-cleaning process.
Sophie has positioned her mini salt inhalation system so that it sits next to her bed at night. It operates silently and creates a fine layer of salty air in the room. Since she started using it, she wakes up less often with a stuffy nose. The morning cough that used to plague her has noticeably lessened. Whether this is simply due to the increased humidity or actually to the salt aerosols – she can't say for sure. But she finds it soothing.
For Sophie, it's important to note: the device doesn't replace medication. She continues to use her regular medication regimen, and her emergency inhaler is always within easy reach. However, the mini-graduation tower has proven effective for her as a supplementary measure to humidify the air in her home and her airways, as a quiet companion in her daily life. She especially appreciates this gentle, passive form of support during pregnancy, when dry air from heating systems puts extra strain on her respiratory system.
Fragrances and smells in everyday life
What Sophie used to love—scented candles, room sprays, the intense perfume of her favorite cream—has disappeared from her life. Not out of principle, but out of necessity. Strong smells can trigger an asthma attack, and her nose has become more sensitive during her pregnancy anyway. Her husband has switched his aftershave, and the neighbor has been politely asked not to smoke in the stairwell. These are small things, but they add up to a noticeably better quality of life.
Sophie has also become more careful when cooking. She avoids frying at high heat, which releases a lot of steam and grease into the air. The extractor fan is always on, and she ventilates thoroughly after cooking. These small adjustments require hardly any effort, but they save her from coughing and breathing difficulties.
Social strategies: Communication as a tool
At first, Sophie found it difficult to talk openly about her asthma. It felt like a weakness, a burden she was imposing on others. But as her pregnancy progressed, it became increasingly clear to her that silence helps no one. Today, she clearly states when she needs a break. She asks colleagues to close their windows when the lawnmower is outside and grass clippings are swirling through the air. She declines invitations to smoky pubs without having to justify herself.
Her friends have understood. Meetings now more often take place at Sophie's house, where she can control the environment. Or in cafés she knows, where the air is fresh. This openness is also liberating. Sophie no longer has to waste energy hiding her symptoms or pushing through when she really can't.
The emergency plan in mind
Despite all precautions, Sophie knows that an asthma attack can always happen. That's why she has an emergency plan. Her husband knows exactly what to do – when to use her rescue inhaler and when to call an ambulance. Her pulmonologist's phone number is saved, as is the number for the maternity ward. Sophie carries an emergency card with her, listing her medication.
This preparation gives her peace of mind. She's not paranoid, but realistic. Controlling her asthma during pregnancy according to current guidelines also means being prepared for an emergency. And paradoxically, this very preparation reduces her anxiety. Knowing what to do in an emergency makes you feel less helpless.
Nutrition and weight management: The underestimated factor
What you eat affects asthma more than many people realize. Maria has experienced this firsthand. Since largely avoiding highly processed foods with numerous additives, she feels much better. Glutamate, sulfites, artificial colors – these substances can trigger symptoms in some asthmatics. Maria now cooks more for herself and knows exactly what's in her food.
At the same time, she's mindful of her weight. Not for vanity reasons, but because being overweight can worsen asthma. Every extra pound means more pressure on the diaphragm, more effort when breathing. Weight gain is, of course, normal and necessary during pregnancy, but Maria follows her doctor's recommendations: plenty of vegetables, sufficient protein, whole grains, and healthy fats. Sweets in moderation, fast food only as an exception.
Hydration as a daily task
Maria drinks at least two liters of water a day, often more. It sounds simple, but adequate fluid intake keeps mucous membranes moist and makes it easier to cough up thick mucus. Fluid requirements are increased during pregnancy anyway, and even more so with asthma. Maria has water bottles everywhere – next to her bed, on her desk, in the kitchen. Drinking is routine, not a conscious decision.
Stress management: The mental component
Stress is a powerful asthma trigger, and pregnancy brings its own set of stresses. The worry about the baby, the physical changes, preparing for birth, financial considerations. Maria has learned that she can't simply ignore this stress. It affects her body, her breathing.
That's why she's developed some strategies. Every evening before bed, she does a short meditation, just ten minutes. An app guides her; she focuses on her breathing and lets her thoughts drift away. It's not a magic bullet, but it helps. Just like the walks in nature that she consciously takes for herself. Half an hour in the park, among the trees, away from the traffic noise and the hustle and bustle.
The Power of Sleep
Good sleep is essential for asthmatics, but often difficult to achieve during pregnancy. The growing belly makes it uncomfortable, the urge to urinate drives one out of bed at night, and worries race through one's mind. Maria has optimized her bedroom: blackout blinds, a comfortable temperature of around nineteen degrees Celsius, and a nursing pillow that she places between her legs to relieve back pain.
She goes to bed earlier than before her pregnancy and sometimes takes a power nap during the day. Fatigue weakens the immune system, and a weakened immune system makes one more susceptible to infections – which in turn can worsen asthma. She is aware of this connection, and therefore treats sleep not as a luxury, but as a medical necessity.
Outlook: Hope through knowledge and consistent care
An asthma diagnosis doesn't disappear with pregnancy. But living with this chronic condition is more manageable today than ever before. Women like Sarah, Sophie, and Maria demonstrate that with the right everyday strategies, mindfulness, and consistency, this special time can be successfully navigated. Modern medications are safe and effective. While the adjustments to daily life may initially seem time-consuming, they will eventually become routine.
The most important realization is that good asthma control protects not only your own health but also that of your child. Oxygen deprivation is far more harmful to the baby than the proper use of asthma medication. The fear of using asthma inhalers during pregnancy is understandable, but unfounded. Budesonide, salbutamol, and other common medications are well-researched and considered safe.
In addition to medical treatment and daily adjustments, small mini-saltworks for home use can be a quiet companion. These compact devices enrich the room air with fine salt particles – similar to what you'd experience at the coast or in traditional spas. The salty air can help moisturize the airways and support the natural function of the mucous membranes. As a passive, gentle measure, they blend unobtrusively into everyday life and can be particularly beneficial at night when the airways need to rest. Such approaches do not replace medical therapy, but can contribute to improving the indoor climate as part of a holistic approach.
Ultimately, it's the combination of medical knowledge, consistent daily routine, and mindful self-care that makes the difference. Asthma during pregnancy is certainly a challenge. But it's a challenge that can be overcome – breath by breath, day by day.
Medical note:
The information presented in this article is for general knowledge purposes only and is in no way a substitute for professional advice, diagnosis, or treatment by licensed physicians. In case of health problems, especially during pregnancy and in the case of chronic or acute respiratory illnesses, please always consult a medical professional. The use of asthma medications should always be medically supervised. Do not discontinue any prescribed medication without consulting your doctor.
(Image source: Envato)
