Sore Throat During Pregnancy — Is it Strep Throat?

If you have a sore throat during pregnancy, you might wonder what’s the cause? How can you tell if it’s bacterial (that needs to see a doctor), just a viral infection that needs to run it’s course? — OR is it one of those annoying pregnancy symptoms you’re just going to get to tolerate.

I am here to say that much of pregnancy is confusing and things that may not have bothered you before are worrisome during pregnancy. So, I’m glad to be here with this article. Since I’ve been a nurse since 1997 (3 years of that working in a pediatric clinic where I did SO many throat swabs for strep) and 20 years in labor and delivery, I think I’m a good one to listen to on this. Don’t miss out on my other site — The Pregnancy Nurse®.

What can cause a sore throat in pregnancy?

The causes of a sore throat in pregnancy are very similar to those when you’re not pregnant.  It can be:

• Cold or flu (a viral infection)
• Strep throat (a bacterial infection that you will need antibiotics for)
• Allergies or Irritants (like smoke)

However, it can also be a pregnancy symptom from pregnancy rhinitis.  This is an increased blood flow to your nasal tissues and makes a lot of women feel like they have a stuffy nose for much of pregnancy.  This can also extend to throat irritation that can be really annoying. It can also cause more bloody noses during pregnancy (annoying, I know!).

That being said — that type of sore throat should be pretty mild — if the pain is severe that is likely not from pregnancy rhinitis.

How do you know what’s causing your sore throat?

If you have a very sore throat (that isn’t fixed by a drink and eating something), I always recommend getting a Strep test.  I, in fact, keep some at home — you can find them here, here or here (they do go out of stock pretty often though)…  Most often your doctor’s office has them.  Your OBGYN office may keep them in stock as well. I talk about these home tests in my post on how to tell if it’s a sore throat or strep (it also has some helpful videos on what to look for).

The main issue with strep is that it can lead to a severe infection that can go to your heart and damage it (called rheumatic fever, which usually comes after scarlet fever, a strep rash)

The good news is that strep is easily treated with penicillin antibiotics (usually amoxicillin) — which are completely fine during pregnancy.  If you’re allergic to penicillin they can give you something like Cephalexin.  It is, however, important that you have a strep diagnosis — as you would not want to take antibiotics unless necessary.

Pro Tip: Make sure to take ALL the medication you are given for a sore throat.  If not, the bacteria can come back and be even more problematic

Symptoms of Strep in adults are normally:

• An extremely sore throat
• This can extend to ear pain
• Difficulty swallowing 
• You can also have some nausea or a headache
• Most often it does NOT include much of a runny nose or sneezing
• May have a low grade fever

One of the banner indicators that it is strep throat (not just a sore throat) is the white puss on your tonsils.  If you open your mouth wide you may be able to see white puss on your tonsils if you have strep. 

If it’s just a sore throat that area (and the back of your throat) will mostly look red and maybe a bit swollen.  Remember your tonsils are little pieces of tissue on the sides behind your teeth (it is not your tongue).

In general, cold and flus include sneezing, or body aches.

Allergies may have other symptoms like itchy or water eyes, and itchy throat and sneezing.

But the truth is that only a test can truly tell.  Sometimes strep tests surprise providers.

One other thing to know is that strep is EXTREMELY contagious.  So, if you’ve been around someone with strep (especially a child) it’s a good chance they passed it on to you.

Ok, so at this point hopefully you’ve figured out what’s causing the sore throat.  SO, what can you do for it?

Sore Throat Home Remedies

As a reminder, the remedy for strep is antibiotics.  You aren’t going to fix it by cutting up an onion and keeping it in your room.  Yes, some people are able to fight a strep infection their own, but prior to antibiotics a strep infection was the cause of a lot of deaths. 

My own Great-Grandmother ended up dying from a heart issue caused by Rheumatic Fever that she’d had as a child — so this a passion of mine.  

Lozenges — There are a lot of lozenges on the market that can help a sore throat.  Ask your provider or pharmacist which ones they recommend during pregnancy.  Be especially careful if you have gestational diabetes that they aren’t full of extra sugar.

Gargle with Salt Water — This is a favorite of mine, and I’m always surprised by HOW much it takes away pain.  You want it to be VERY salty (like the ocean).  And, don’t swallow it — just spit it out.  Helps a LOT

Lemon and Honey Tea – This can be helpful for both sore throats and coughs. It’s just like it sounds. Warm up some water, an add some lemon juice and honey to taste.

Warm Compress for Gland Pain — At times your glands may be swollen and painful in addition to your actual throat hurting.  Using a heating pack around your throat (like this one) can help those be less painful.

Lots of Fluids — A favorite of labor nurses everywhere (we sometimes pretend like water can fix anything) lots of fluids can only help.  When you hydrate, it helps flushes out the irritants in your throat.  it helps keep your system feeling good too.  In fact, dehydration can be the cause of a mild sore throat too!

Hilary Story: I had a cold/flu while pregnant with my second baby and was really sick.  They ended-up giving me 2L of IV fluids and I can’t tell you how much better I felt afterwards.  I really had been trying to keep up on my fluids but I was so tired (and taking care of my other son) I probably wasn’t at my best and that baby just takes all it wants from you.  

Pain Medicine – Talk with your provider about what pain medicine could be appropriate for you.  Most often it’s Tylenol or sometimes ibuprofen.

Rest – I know it’s easier than it sounds, but be kind to yourself. It can be harder/slower for you to heal from something simple like a cold — so get lots of rest, and take it easy!

Before taking cold medication (like Sudafed) talk with your provider. I have a whole post on what to do about a cold during pregnancy.

When do I Need to Call My Provider About My Sore Throat?

Like I said I think that any very painful sore throat should be checked to make sure that it is not strep.  Beyond that….

If you have a fever over 100 I would call your provider.  We do NOT want you getting a high fever with baby inside and that is something we will watch carefully.

If there is any respiratory issues (lots of coughing and possibly wheezing) I’d stay in touch with your provider.  Even a simple flu or Covid can be really bad for pregnant women at times, so it’s important to just keep an eye on.  This is why they recommend the Covid and Flu shots for pregnant people.

Continuing illness.  If you’ve been sick heading into 5 days I’d call your provider and just touch base.  They may want to see you, or may have advice for you based on your circumstances.

Is strep throat the same as group beta strep (GBS)?

When you’re about 36 weeks your provider will screen for GBS.  That is group beta strep, but strep throat is caused by group A Streptococcus.  They’re different, and the way they check for them is a different test.

BTW if you’re in your second trimester, or even already had your GBS screen — did you know it’s not too late to take a prenatal class? This one can be done in just a few hours!

Sore Throat in Pregnancy Faq’s

Am I more likely to get a sore throat when pregnant?

Because of the increased blood flow to those types of tissues many people feel sore throats more frequent than they did before pregnancy.  Also likely from pregnancy rhinitis as well.

Your risk of infection in general is not increased when you are pregnant.

Am I more likely to get strep throat during pregnancy?

I don’t see anything that says strep throat is more likely when you’re pregnant.  However, there are times in your pregnancy where your body lowers your immune system to protect your growing baby.  I have a whole post on if pregnant people are immunocompromised.

What Is A Sore Throat?

In general it’s an irritation of the throat area.  Caused by:

• Inflammation
• Irritation from sinus mucus
• Irritation from pollution allergies, or other irritations (like smoke)
• Tonsillitis (a viral infection of the tonsils)

Can a sore throat turn into strep?

If you test too early a strep test could be negative, but if you waited a day it would be positive (sort of like a pregnancy test).  However, viral illness don’t turn into a bacterial illness like strep – they’re two separate things.  You can have both at the same time though.

Is Sore Throat An Early Sign Of Pregnancy?

Sore throat is not typically considered an early sign of pregnancy, but it can occur as a symptom of pregnancy. While some women may experience a sore throat during pregnancy, it is uncommon for it to be the first sign of pregnancy. Sore throat during pregnancy can be caused by a variety of factors such as a cold, allergies or strep throat. 

Can strep throat affect my unborn baby?

If you let strep go untreated with antibiotics it can be problematic for you and your baby.  Clearly, if you get a serious illness it can affect your baby. 

I believe if the strep goes through your entire system (often shows-up as scarlet fever) it can go to the uterus and the baby (although I have only read that a few places).  Scarlet fever can also bring on a pretty high fever, which isn’t good for you or baby at this point (plus, it’s miserable).

The good news is that treatment is quick and simple — so, just be sure to get treated if that’s the issue.

Should I be worried about a sore throat while pregnant?

In general, it’s not much more dangerous than it could be for anyone else for you to have a sore throat. You just need to be mindful to take care of yourself.

Preventing strep throat while pregnant

In general trying not to get sick during pregnancy is in your best interest.  Making sure that you wash your hands, and stay away from people who have illness when possible is best.

Ok, that’s sore throats in pregnancy.

I think we’ve verified that pregnancy often makes stuff complicated. However, if you use an expert like in this class you’ll find that it can actually be pretty simple and easy to understand.

Come join me in The Online Prenatal Class for Couples where we simplify birth education for both of you!

Or, if you’re not quite ready for the full class, check out my free prenatal class — It’s your first step towards being your own birth boss.