Why you should keep using your inhalers in pregnancy, how pregnancy can change asthma, what to do in an attack, labour, breastfeeding, and getting your usual inhaler.
Part of our asthma guide: symptoms, triggers and treatment.
Asthma attack? Get help now. Call 999 if your reliever isn’t helping, you’re too breathless to speak, eat or sleep, your breathing is getting faster, or your lips or fingertips are turning blue or grey. While you wait, sit up straight and take 1 puff of your blue reliever every 30 to 60 seconds, up to 10 puffs, through a spacer if you have one. If the ambulance hasn’t arrived after 10 minutes, repeat. Don’t complete an online consultation in an emergency.
Quick answer: Keep using your asthma inhalers in pregnancy. The NHS says salbutamol (Ventolin) can be used in pregnancy, and inhaled steroid preventers are generally considered safe. Poorly controlled asthma, and especially a severe attack, is a much bigger risk to you and your baby than your inhalers. Don’t stop or change any asthma medicine without advice, and tell your midwife and GP that you have asthma.
Already prescribed an inhaler? See all our asthma inhalers online.
Order Your Usual Inhaler
Access Doctor is a GPhC-registered pharmacy (#9011198). If you need the same inhaler, strength and dose you already use, a pharmacist independent prescriber reviews your online consultation, and we share it with your GP. Changes to treatment, or worsening asthma, need your GP, asthma nurse or midwife. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose. Delivery is free on orders over £40.
Start Asthma Consultation →Who our online service is for. Access Doctor supplies asthma and COPD inhalers to adults aged 18 and over who already have a diagnosis, for the same inhaler, strength and dose they’re prescribed now, and we share the consultation with your GP. We can’t diagnose asthma or start or change treatment online. This online service is not available to pregnant women, because asthma in pregnancy requires in-person review. Children’s inhalers are managed by their GP or asthma nurse.
Asthma is one of the most common long-term conditions in pregnancy. The key message of this guide, shared by NHS and UK clinical guidance, is that the risks of poorly controlled asthma in pregnancy are greater than the risks of the usual asthma medicines. Keep taking your reliever and preventer as prescribed. For more on each, see our guides to what Ventolin is used for and preventer inhalers.
Don’t stop your asthma inhalers in pregnancy. Poorly controlled asthma carries real risks for you and your baby. Talk to your GP, asthma nurse or midwife about any concerns, but keep taking your treatment while you do.
Does Pregnancy Affect Asthma?
Pregnancy affects asthma differently in different women. A commonly quoted pattern, the “rule of thirds”, gives a rough idea:
- About a third improve: possibly linked to hormonal changes
- About a third stay the same
- About a third get worse: most often between about 24 and 36 weeks
How your asthma behaved in a previous pregnancy is often a guide to what to expect. Attacks are less common in the last few weeks of pregnancy. A common reason for asthma getting worse in pregnancy is stopping or cutting down a preventer, so keep taking it.
Heartburn and asthma: reflux (heartburn) is common in pregnancy and can make asthma symptoms worse. If your asthma seems harder to control, mention any heartburn to your GP or midwife; treating it may help.
Risks of Poorly Controlled Asthma in Pregnancy
Poorly controlled asthma, rather than asthma itself, is what carries the risk. Well-controlled asthma carries little or no extra risk. Poor control has been linked to:
| Risk | Linked with |
|---|---|
| Premature birth (before 37 weeks) | Poorly controlled asthma and severe attacks |
| Lower birth weight | Poorly controlled asthma over time |
| Pre-eclampsia | Poorly controlled asthma |
| Caesarean birth | Severe or uncontrolled asthma |
| Low oxygen for the baby | A severe attack that lowers your oxygen level |
Your baby depends on the oxygen in your blood. A severe attack that lowers your oxygen level lowers your baby’s supply too, which is why preventing attacks, and treating them quickly, matters even more in pregnancy.
Is It Safe to Use a Reliever Inhaler During Pregnancy?
Yes. The NHS says salbutamol (Ventolin, Salamol) can be used in pregnancy, and your doctor will usually advise you to keep using it. The UK Teratology Information Service, which advises on medicines in pregnancy, has information on salbutamol for women and healthcare professionals. Salbutamol has been widely used in pregnancy for many years, and only a small amount reaches the bloodstream from an inhaler.
If you need your reliever, use it. Breathlessness or a severe attack is far more dangerous than the inhaler. If you’re needing it more than twice a week, tell your GP or midwife: your asthma needs a review.
Is It Safe to Use a Preventer Inhaler During Pregnancy?
Yes. Inhaled steroid preventers should be continued throughout pregnancy. Only a small amount of steroid reaches the bloodstream from an inhaler, much less than from tablets. Stopping your preventer:
- lets the inflammation in your airways build up again over the following weeks
- increases your risk of attacks
- leaves you and your baby less protected if you catch a cold or meet another trigger
At the doses most women need, inhaled steroids are considered safe in pregnancy. As at any time, your prescriber aims for the lowest dose that keeps your asthma controlled.
Beclometasone (such as Clenil Modulite) and budesonide (such as Pulmicort) are among the most widely used preventers in pregnancy. If you’re on another preventer that controls your asthma, you’ll usually be advised to stay on it rather than switch. See our preventer inhaler guide.
Combination Inhalers and Pregnancy
Combination inhalers, such as Seretide, Symbicort and Fostair, are generally continued in pregnancy if they’re controlling your asthma. The information on salmeterol and formoterol in pregnancy is reassuring. If your combination inhaler is your reliever too (AIR or MART), keep using it as your action plan says. Discuss any change with your GP or asthma nurse.
Don’t change your inhalers in pregnancy without advice. If you’re worried about any of your medicines, talk to your GP, asthma nurse, midwife or pharmacist, and keep taking your treatment in the meantime.
Steroid Tablets and Other Medicines
- Steroid tablets (prednisolone): should still be used if you need them for an attack. Some (but not all) studies have linked steroid tablets in early pregnancy with a higher chance of cleft lip or palate, but the UK Teratology Information Service notes that the vast majority of exposed babies are born without these conditions, and a severe untreated attack is far more dangerous for your baby.
- Montelukast and other add-on treatments: if they helped control your asthma before pregnancy, you’ll usually be advised to continue them. Ask your GP to review them.
- Painkillers: paracetamol is the usual choice in pregnancy. Avoid ibuprofen and aspirin unless a doctor has advised them, particularly if they’ve set off your asthma before.
- Planning a pregnancy: ask your GP to review all your medicines, but don’t stop any asthma medicine on your own.
Asthma Attacks During Pregnancy: What to Do
Treat an asthma attack in pregnancy exactly as you would at any other time:
- sit up straight and try to keep calm
- with a blue reliever, take 1 puff every 30 to 60 seconds, up to 10 puffs, through a spacer if you have one; with an AIR or MART inhaler, 1 puff every 1 to 3 minutes, up to 6 puffs
- call 999 if you feel worse at any point, don’t feel better after the maximum puffs, or don’t have your inhaler, and tell them you’re pregnant
- if the ambulance hasn’t arrived after 10 minutes, repeat the puffs
- afterwards, see your GP within 2 days and let your midwife know
Don’t hold back on your reliever or delay calling 999 because you’re pregnant. Our asthma attack guide explains the warning signs in more detail.
Asthma in Labour
Asthma attacks during labour are uncommon. Bring your inhalers to hospital and keep using them as normal.
- Pain relief: gas and air and epidurals are usually fine with asthma.
- Aspirin-sensitive asthma: make sure the team knows if aspirin or anti-inflammatory painkillers have set off your asthma.
- Some medicines can tighten the airways, such as carboprost, sometimes used for heavy bleeding after birth. Your team will take your asthma into account.
- Steroid tablets: if you’ve needed steroid tablets during pregnancy, you may need extra steroid during labour. Tell your midwife.
Monitoring Your Asthma in Pregnancy
- Tell your midwife about your asthma at your booking appointment
- Keep up your asthma reviews with your GP or asthma nurse, and book one if your asthma changes
- Check your peak flow if your asthma has been hard to control, or if your asthma nurse advises it
- Keep your written asthma action plan up to date
- Contact your GP if you’re using your reliever more, or your asthma is getting worse
- Have the vaccines offered in pregnancy, including the flu vaccine, which is recommended for all pregnant women
- Avoid smoking and second-hand smoke; your midwife can refer you to free stop smoking support
Asthma and Breastfeeding
The NHS says it’s OK to use a salbutamol inhaler as normal while breastfeeding; the amount that passes into breast milk is thought to be very low. Inhaled steroid preventers are also generally considered fine. Keep using your usual inhalers, and talk to your GP, health visitor or pharmacist if you have any concerns.
Getting Your Usual Inhaler While Pregnant
Asthma inhalers are prescription-only medicines. Access Doctor’s online service is not available to pregnant women, because asthma in pregnancy requires in-person review and some treatment adjustments may be needed. If you are pregnant and need your usual inhaler, see your GP, asthma nurse or midwife. They can review your asthma, prescribe your inhaler if appropriate, and coordinate your care with your maternity team.
We can’t start a new inhaler or change your treatment online. If your asthma is getting worse in pregnancy, see your GP, asthma nurse or midwife. In England, prescriptions are free while you’re pregnant and for 12 months after the birth with a maternity exemption certificate, which your midwife or GP can arrange. See our guide to ordering an asthma inhaler online.
Safety, your GP and free NHS options
Asthma inhalers are prescription-only medicines in the UK. Before anything is supplied, a GPhC-registered pharmacist independent prescriber reviews your consultation, including the other medicines you take; some, such as beta-blockers, can make asthma worse.
- Relievers on their own: since 2024, UK guidance (NICE, BTS and SIGN) says no one with asthma should be treated with a reliever alone, and in April 2025 the MHRA told prescribers not to prescribe one without an inhaled steroid to people of any age with asthma. If you don’t use a preventer, we can supply a reliever once and will ask you to see your GP or asthma nurse.
- How many: up to 2 reliever inhalers per order. If you’ve needed 3 or more in the last 12 months, we’ll ask you to have an asthma review first; needing that many is linked to a higher risk of severe attacks.
- Read the leaflet in the pack, and ask a pharmacist or asthma nurse to check your technique.
- Report side effects to a pharmacist or doctor. You can also report them to the MHRA through the Yellow Card scheme.
We share your consultation with your GP because asthma needs ongoing care. Access Doctor is a private service, and there are free NHS options:
- Your GP practice: asthma reviews (at least once a year) and repeat prescriptions; many practices let you order repeats through the NHS App.
- Prescription charges: NHS prescriptions are free in Scotland, Wales and Northern Ireland. In England a charge applies unless you’re exempt, and a prepayment certificate can save money if you need several items.
- Urgent advice: NHS 111 (NHS 24 on 111 in Scotland), or 999 in an emergency.
Need Your Usual Inhaler?
Access Doctor is a GPhC-registered pharmacy (#9011198). If you’re an adult with diagnosed asthma or COPD, a pharmacist independent prescriber reviews your online consultation and supplies your usual inhaler if it’s safe, and we let your GP know. Approved before 3pm, Monday to Friday? Dispatched the same day, by Royal Mail Tracked 48, Tracked 24 or Special Delivery guaranteed by 1pm next working day: you choose. Delivery is free on orders over £40.
Start Asthma Consultation →Frequently Asked Questions
Is it safe to use a Ventolin inhaler during pregnancy?
Yes. The NHS says salbutamol (Ventolin) can be used in pregnancy, and your doctor will usually advise you to keep using it. It has been widely used in pregnancy for many years, and only a small amount reaches the bloodstream from an inhaler. Poorly controlled asthma, and especially a severe attack, is a much bigger risk to you and your baby than the inhaler. Tell your midwife or GP if your asthma gets worse. Our guide to what Ventolin is used for covers doses and side effects.
Is it safe to use a preventer inhaler during pregnancy?
Yes. Inhaled steroid preventers are generally considered safe in pregnancy and should be continued. Only a small amount of steroid reaches the bloodstream from an inhaler. Stopping your preventer increases the risk of asthma attacks, which can reduce the oxygen reaching your baby. Don’t stop or change your preventer without talking to your GP, asthma nurse or midwife.
Does pregnancy make asthma better or worse?
It can go either way. A commonly quoted pattern, the “rule of thirds”, is that roughly a third of women find their asthma improves, a third stay the same and a third get worse. When it worsens, it’s most often between about 24 and 36 weeks, and attacks are less common in the last few weeks of pregnancy. How your asthma behaved in a previous pregnancy is often a guide to what to expect. Keep taking your treatment and tell your midwife and GP about any change.
What are the risks of poorly controlled asthma in pregnancy?
Poorly controlled asthma in pregnancy has been linked to premature birth, a lower birth weight, pre-eclampsia and a higher chance of caesarean birth, and a severe attack can reduce the oxygen reaching your baby. Well-controlled asthma carries little or no extra risk. That’s why the safest thing for you and your baby is to keep taking your inhalers and keep your asthma under control.
Which asthma medications should be avoided in pregnancy?
Most asthma medicines, including relievers, preventers and combination inhalers, should be continued as normal. Steroid tablets should still be used if you need them for an attack: some studies have suggested a small possible link with cleft lip or palate when taken in the first trimester, but a severe untreated attack is far more dangerous. If you’re planning a pregnancy or have just found out you’re pregnant, ask your GP to review your medicines, but don’t stop any asthma medicine without advice.
Can asthma affect labour and delivery?
Asthma attacks during labour are uncommon. Keep your inhalers with you and use them as normal. Pain relief options such as gas and air and epidurals are usually fine with asthma. If you have asthma that’s triggered by aspirin or anti-inflammatory painkillers, make sure the team knows. Some medicines occasionally used during labour or for bleeding afterwards, such as carboprost, can tighten the airways, and if you’ve needed steroid tablets during pregnancy you may need extra steroid during labour, so tell your midwife and obstetric team about your asthma.
Can I order my asthma inhaler online while pregnant?
No. Access Doctor’s online service is not available to pregnant women, because asthma in pregnancy requires in-person review and some treatment adjustments may be needed. If you are pregnant and need your usual inhaler, see your GP, asthma nurse or midwife. They can review your asthma, prescribe your inhaler if appropriate, and coordinate your care with your maternity team.
Can I use my inhalers while breastfeeding?
Yes. The NHS says it’s OK to use a salbutamol inhaler as normal while breastfeeding; the amount that passes into breast milk is thought to be very low. Inhaled steroid preventers are also generally considered fine. Keep using your usual inhalers, and ask your GP, health visitor or pharmacist if you have any concerns.
For symptoms, triggers and how asthma is diagnosed, see our asthma guide.
References
- NHS. Pregnancy, breastfeeding and fertility while using salbutamol inhalers. nhs.uk
- UK Teratology Information Service. Salbutamol in pregnancy (Best Use of Medicines in Pregnancy). medicinesinpregnancy.org
- UK Teratology Information Service. Prednisolone in pregnancy (Best Use of Medicines in Pregnancy). medicinesinpregnancy.org
- NICE, BTS and SIGN. Asthma: diagnosis, monitoring and chronic asthma management (NG245), November 2024. nice.org.uk
- NHS. Asthma attack. nhs.uk
- Electronic Medicines Compendium. Ventolin Evohaler 100 micrograms: Summary of Product Characteristics. medicines.org.uk
- MHRA Drug Safety Update. Short-acting beta-2 agonists (SABA): reminder of the risks from overuse in asthma and changes in the SABA prescribing guidelines, April 2025. gov.uk
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional for diagnosis and treatment. In a medical emergency, call 999.