Getting sick is likely at the bottom of any person’s to-do list. Let’s be honest: It’s likely not even on your to-do list at all, especially if you are pregnant. But sick happens, including sore throats during pregnancy.
“Illnesses in pregnancy often hit harder and last longer than in the non-pregnant state,” says Monica A. Buescher, MD, the chief of the department of OB-GYN at the University of Maryland St. Joseph Medical Center.
There’s a reason for that. “The immune system is toned down as a normal response to the pregnancy, making pregnant patients more prone to infectious conditions,” says David Caiseda, MD, an OB-GYN at the University of Maryland Charles Regional Medical Group–Women’s Health.
And when it comes to sore throats, some other pregnancy-related symptoms may contribute to or exacerbate the issue. “The nasal sinuses can get swollen in pregnancy and can cause worse congestion than you would typically experience when you are not pregnant,” says Ankita Langan, MD, an OB-GYN with Novant Health.
Aside from swollen nasal sinuses, a few factors may cause sore throats in pregnancy. Experts explain the causes and solutions of sore throats in pregnancy, plus when to get medical help on the line ASAP.
Causes of a Sore Throat in Pregnancy
There are numerous causes of sore throat in pregnancy, and the differences between them will inform treatment, explains Meleen Chuang, MD, the medical director of women’s health at the Family Health Centers at NYU Langone. Dr. Chuang says the primary causes of a sore throat during pregnancy include:
- Common colds and viruses
- Heartburn, which often causes sore throat, burning, and cough with acid reflux
- Morning sickness-related vomiting
- Bacterial infections such as strep throat
- Congestion, which leads to a stuffy nose, post-nasal drip, and sore throat (sometimes associated with nose bleeds)
- Seasonal allergies from pollen, dust, and dander
Symptoms of a Sore Throat in Pregnancy
Generally speaking, sore throat symptoms during pregnancy are similar to the ones you experienced before conceiving.
“Symptoms of a sore throat include inflammation, redness, and pain,” says Monte Swarup, MD, FACOG, an Arizona-based board-certified OB-GYN and founder of the leading vaginal health information site Vaginal Health Hub. “This can cause trouble with swallowing.”
Though a sore throat can have many benign causes, like allergies or pregnancy-related swollen sinuses, a bacterial infection like strep can be especially painful. “It is a sore throat but on steroids,” Dr. Caiseda says.
The good news? “In general, strep throat is a mild disease,” Dr. Chuang says. However, left untreated, it can cause significant issues for the pregnant person and fetus. “Strep throat should be diagnosed and treated with an antibiotic because it can cause rheumatic fever, which is damage to the heart valves, and kidney damage as a late complication of the bacterial infection,” says Dr. Buescher.
And, since it’s a bacterial infection rather than a viral one like a cold, strep throat requires antibiotic treatment. Therefore, experts share it’s important to distinguish between the two.
Strep throat symptoms
Strep throat is a mild and common disease that requires medical attention. Dr. Chuang says strep throat symptoms may include.
- Fever
- Pain when swallowing
- Sore throat that can start very quickly and may look red
- Red and swollen tonsils
- White patches or streaks of pus on the tonsils
- Tiny, red spots on the roof of the mouth, called petechiae
- Swollen lymph nodes in the front of the neck
Virus symptoms
If a virus is causing a sore throat in pregnancy rather than strep throat, Dr. Chuang says symptoms will likely include:
- Cough
- Runny nose
- Hoarseness or a raspy-sounding, strained voice
- Conjunctivitis
Keep in mind, COVID can be a viral cause of a sore throat during pregnancy. This can be diagnosed with culture and may have specific nuances and potential complications as related to pregnancy. That’s why it’s always a good idea to check with your health care provider if you are experiencing a sore throat when pregnant.
At-Home and OTC Treatments for Sore Throat in Pregnancy
Experts share that pregnant people should always feel comfortable discussing concerns with their health care provider. However, some sore throat treatments during pregnancy can be done at home or using over-the-counter (OTC) medications.
“Warm salt water gargles are a safe mechanical strategy for symptomatic relief,” says Dr. Buescher. “The use of room vaporizers can also decrease the tendency to drying with mouth breathing.”
Dr. Langan agrees and adds that hot tea with honey can be soothing for sore throats and congestion.
Are you headed to a pharmacy? You will generally have options. “Safe OTC remedies for a sore throat during a pregnancy include Tylenol, most cough medicines, cough drops, and menthol rubs,” says Dr. Swarup.
If it’s reflux-related, Dr. Chuang suggests Pepcid or Tums. However, she cautions pregnant people should always consult their provider first. “Always consult your obstetrician to provide personalized advice based on your specific circumstances and medical history,” Dr. Chuang says.
What’s more, some medications should definitely be avoided for a sore throat during pregnancy.
“Avoid medications that contain pseudoephedrine,” Dr. Chuang says. “This can cause vasoconstriction of the blood vessel in the placenta, causing severe hypertension, or placental abruption, which happens when the placenta separates from the uterus and will cause significant bleeding from the maternal-fetal blood supply.”
Dr. Chuang points out Dayquil contains pseudoephedrine.
When Pregnant People Should Seek Medical Attention for Sore Throats
If in doubt, call your health care provider if you are concerned about a sore throat during pregnancy. Medical providers also share signs that you should never wait. Dr. Chuang says these include:
- Difficulty swallowing or breathing
- Sore throat is severe or lasts more than three days
- Chronic heartburn or reflux
Since strep throat requires antibiotics and can cause kidney and other damage if left untreated, Dr. Buescher advises all pregnant patients to seek medical attention if they suspect they have the infection. “Fever and swollen lymph nodes together with a sore throat should provoke a diagnostic evaluation,” adds Dr. Buescher.
Whether pregnant people think they have strep or not, they should call the health care provider if their fever reaches 100°F or higher. This advice is consistent with the American College of Obstetricians and Gynecologists (ACOG) recommendations for assessing and treating influenza in pregnancy.
Will a Sore Throat in Pregnancy Affect a Baby?
Generally, no.
“Most of the time, cold symptoms and feeling out of it for a few days will resolve with some basic self-care and rest,” says Dr. Chuang. “Your baby will be fine. It’s important to continue to take your prenatal vitamin and hydrate.”
However, in severe circumstances, a sore throat can harm a fetus. “Severe infections that make you lose weight affect your bloodstream; becoming a systemic infection could affect your baby’s growth,” Dr. Chuang says. “Of course, this is a severe circumstance.”
In other words, your health are provider is your best resource for personal insights and concerns. But know that rest and self-compassion are essential—and deserved—when battling a sore throat in pregnancy.
“Growing a baby is so much work, and we often do not give ourselves enough credit during pregnancy,” Dr. Langan says. “It is important to give yourself grace during pregnancy and allow yourself to rest and recuperate, especially when you are sick.”