Chest pain in pregnancy 20 weeks and over
Pregnancy can cause discomfort and pain in many parts of the body. When these sensations occur in the chest, the cause is often related to the growing baby putting pressure on other internal organs.
Growing baby
As your baby grows they increase the pressure on surrounding organs, including the lungs and stomach. This pressure can sometimes cause discomfort and pain in the chest, especially in the second half of your pregnancy. Increasing pressure can also cause:
a woman to feel full more quickly while eating
a faster heartbeat
acid reflux
shortness of breath
Heartburn
Hormones and, later in pregnancy, your growing baby pressing on your stomach can sometimes cause bloating, burping and sickness sometimes with a nasty heart burning sensation behind the centre of your chest. This can be unpleasant and painful, however it does not cause any serious harm and is not something to worry about.
Make a note of what sets it off and try to avoid these foods, especially in the evenings. Spicy foods, chocolate and fruit juice can often be the trigger.
Pulmonary Embolism (blood clot in your lung)
Pulmonary Embolism (PE) is rare, but pregnancy hormones do increase your risk (1 in 1000 pregnancies). Your own personal risk of developing a clot is assessed by your midwife throughout your pregnancy and after birth. You can reduce your risk by drinking enough fluids, staying mobile, stopping smoking, having a healthy weight. Please tell us about any travel plans or family history of blood clots.
What we mean when we say “severe, moderate or mild pain’’:
Severe pain:
Always there and so bad it's hard to think or talk
You can't sleep
It's very hard to move, get out of bed, go to the bathroom, wash or dress
Moderate pain:
Always there
Makes it hard to concentrate or sleep
You can manage to get up, wash or dress
Mild pain:
Comes and goes
You can manage to sleep
Is annoying but doesn't stop you doing things like going to work or eating a meal
Call 999 if you have any of the following
Sudden onset of severe chest pain
Pain radiating to arm, shoulder, back or jaw
Coughing up blood
Breathlessness
Loss of consciousness
Any change to your thinking including confusion
Pre-existing heart disease
Contact your GP surgery today if you have any of the following (NHS111 out of hours) If:
You have pain when taking a deep breath in or coughing
Your mild/ moderate pain has not improved after taking Paracetamol 2x 500mg tablets (1g) 4-6 hourly not exceeding 4g in 24hours. Do not take NSAIDS such as Ibuprofen whilst pregnant.
Have a chesty cough (you may cough up green or brown mucous) and feel unwell, have a temperature of 38°C or over, or your chesty cough lasts longer that 14 days
Heartburn and indigestion
Rib flare (pain related to your growing baby distorting the normal position of the lower ribs)
Tell your community midwife at your next appointment. Contact your GP surgery if you are still worried.
Pain relief
Paracetamol 2x 500mg tablets (1g) 4-6 hourly not exceeding 4g in 24hours. Do not take NSAIDS such as Ibuprofen whilst pregnant.
Things that may help when you have heartburn:
Eating smaller meals more frequently
Sitting up straight when you’re eating to take the pressure of your stomach
Finishing eating about three hours before bedtime
Drinking milk (reduced fat milk is preferable) when you get heartburn and keep a glass handy in the night
Propping yourself up with pillows in bed or tilting the bed so that the head is up slightly
Talk to your pharmacist about antacids
Stopping smoking
Ribflare
This is the name given to discomfort over your lower ribs caused by your growing baby lifting your ribs up and out from their normal position. Try not to sit for long periods especially in the car and avoid sitting on low chairs. Try sleeping on the unaffected side with your arm stretched forwards on a pillow.
