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Week 23 · Second Trimestermild

Nasal Congestion at 23 Weeks Pregnant

Pregnancy rhinitis — nasal congestion caused by pregnancy hormones rather than a cold or allergy — affects up to 30% of pregnant women. It can start as early as the first trimester and persist until delivery.

👶 What's Happening at Week 23

Your baby is now the size of a grapefruit.

  • Lungs begin producing surfactant (needed for breathing outside the womb).
  • The fetus can hear your voice and may respond to music.
  • Skin is wrinkled and translucent but will fill out.

🔬 Why You're Experiencing Nasal Congestion at Week 23

  • Estrogen and progesterone cause mucous membrane swelling throughout the body, including nasal passages
  • Increased blood volume causes swelling of nasal blood vessels
  • Not caused by infection or allergens — purely hormonal
  • Pre-existing allergies or colds may worsen alongside pregnancy rhinitis

💊 Relief Tips for Week 23

1
Saline Nasal SprayPreservative-free saline spray moistens and rinses nasal passages safely throughout pregnancy.
2
Nasal Rinse (Neti Pot)Using a neti pot with distilled water and saline effectively clears nasal passages.
3
HumidifierAdding moisture to indoor air reduces nasal dryness and congestion, especially in winter.
4
Elevate Head While SleepingSleeping with an extra pillow can reduce congestion-related sleep disruption.
5
Nasal StripsAdhesive nasal dilator strips (like Breathe Right) are safe and can improve airflow at night.

📋 Other Week 23 Symptoms

Swelling in hands and feetSnoringIncreased appetiteLinea nigra darkening
See full Week 23 guide →

⚠️ Call Your Doctor If…

  • Congestion accompanied by fever, sore throat, or colored discharge (possible infection)
  • Congestion with severe facial pain or headache (possible sinusitis)
  • Nosebleeds that are frequent or difficult to stop
  • Congestion affecting sleep so severely it causes significant distress

Frequently Asked Questions

Is it safe to use a decongestant spray during pregnancy?

Oxymetazoline (Afrin) nasal spray is generally considered safe for short-term use (3 days or fewer). Oral decongestants containing pseudoephedrine or phenylephrine are not recommended, especially in the first trimester.

How long does pregnancy rhinitis last?

Pregnancy rhinitis typically lasts throughout pregnancy and resolves within 2 weeks of delivery.

Can nasal congestion during pregnancy cause nosebleeds?

Yes — increased blood volume and sensitive mucous membranes make nosebleeds more common in pregnancy. They are usually harmless.

Can I tell the difference between pregnancy rhinitis and a cold?

Pregnancy rhinitis causes nasal congestion without fever, sore throat, or body aches. A cold typically includes at least one of these additional symptoms.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always consult your OB/GYN or midwife about symptoms during pregnancy.