Why Do I Feel So Cold During Pregnancy?

When you’re expecting, your body is working overtime. Hormones surge, your heart races, and blood volume increases. And that’s just the beginning.

With so much internal activity, it’s no wonder many pregnant people reach for tank tops and fans — even during a frigid Minnesota January.

So why are you shivering instead of sweating? And is experiencing chilliness while pregnant normal?

Although most pregnant people tend to feel hotter than usual, feeling cold doesn’t automatically mean something is wrong with you or your baby. Your internal thermostat might simply be doing an excellent job cooling a body that’s running hard. Or you might have a common, often temporary condition (we’ll cover those below).

We know it’s easy to worry about every new ache or symptom in pregnancy — and to answer your immediate concern: feeling cold is not a sign of pregnancy loss.

Take a slow breath and grab a blanket. There are several fairly common reasons pregnancy can leave you feeling chilled, and understanding the causes and symptoms can help you find reassurance — and possible solutions.

Possible causes

Low blood pressure

Not feeling like the stereotypical hot, sweaty pregnant person? Low blood pressure could be at play.

While some expectant mothers develop high blood pressure — sometimes dangerously so — roughly 10 percent actually have low blood pressure, typically defined as 90/60 or below.

Low blood pressure in pregnancy often results from the extra circulatory demands placed on your body as it tries to supply enough blood for you and your growing baby.

Many pregnant people with low blood pressure have no symptoms, but when the body struggles to deliver adequate blood to tissues and organs — including the crucial uterus and placenta — you may notice cool, clammy skin along with:

• nausea
• dizziness
• fainting
• blurred vision
• a weak but rapid pulse

Contact your provider if you experience these signs so they can assess you.

If your readings are low but you feel well, try not to worry. Treatment usually isn’t necessary. The American Heart Association notes that blood pressure typically returns to normal by about the 24th week of pregnancy.

Anemia

Anemia happens when your body lacks sufficient oxygen-carrying red blood cells. Since nearly every system depends on oxygen, anemia can affect the mechanisms that warm and cool you. In developed nations like the U.S., about 14 percent of pregnant people become anemic.

Pregnant people are especially vulnerable to iron-deficiency anemia. Iron is required to make red blood cells, and during pregnancy you need roughly twice the usual amount to supply both you and your baby.

If you didn’t have enough stored iron before pregnancy or aren’t getting enough through diet, anemia can develop — particularly in the second and third trimesters when the baby’s growth accelerates.

Cold hands and feet are a common sign. Other symptoms include:

• weakness
• pale skin
• irregular heartbeat
• shortness of breath

You’ll have blood tests for anemia at intervals during pregnancy, but if you notice symptoms between visits, notify your clinician.

Hypothyroidism

Hypothyroidism — an underactive thyroid — occurs when your body doesn’t produce enough thyroid hormones. Causes include autoimmune thyroid disease (Hashimoto’s thyroiditis), damage to the gland (for example, from radiation), or nutrient shortages like low iodine. Mild cases can go unnoticed until the increased hormonal needs of pregnancy reveal them.

Thyroid hormones are crucial for your baby’s brain and nervous system development and regulate metabolism, heart rate, and body temperature. When levels are low, you may feel:

• cold
• fatigued
• down or depressed
• constipated

Hypothyroidism affects up to about 5 percent of pregnant people. If you have these symptoms, speak with your provider to get tested.

Poor sleep

Waking multiple times a night? Not surprising — pregnancy doesn’t pause at 2 a.m. Back pain, heartburn, and frequent trips to the bathroom that bother you during the day also disrupt sleep at night.

Difficulty getting restorative sleep — which is important for normal body temperature regulation — can leave you feeling colder than usual.

Sleep disturbances are common in early pregnancy due to hormonal shifts and again later when finding a comfortable position is hard with a significantly larger belly.

Anxiety

We get it: childbirth and the lifelong responsibilities that follow are huge life changes. Anxiety is common in pregnancy and can trigger the body’s fight-or-flight response.

When that system activates, blood is shunted away from nonessential areas like the skin to vital organs such as the heart, which can make you feel chilled. Other anxiety symptoms include:

• nausea
• sweating
• rapid heartbeat

A 2019 review found that nearly one quarter of pregnant people experience anxiety. A 2015 study reported that about 16 percent had high anxiety levels.

Infection

If you feel achy and drained in addition to chilled, you could be developing a viral or bacterial infection. Chills are a physiological response to invading pathogens and your immune system’s reaction.

Symptoms depend on the infection type (for instance, respiratory infections bring congestion; stomach bugs cause nausea). Call your clinician if you develop a fever or have any concerns about how you feel.

Ways to warm up

Low blood pressure

Unless it’s severe, low blood pressure in pregnancy usually doesn’t require treatment. Staying well-hydrated and rising slowly from lying or sitting positions can help reduce dizziness and fainting risk.

Anemia

Most prenatal vitamins include iron and help prevent anemia, but some people need more than that.

• Your provider may prescribe an iron supplement.
• In serious cases, intravenous iron in a hospital may be necessary.
• Although diet alone often isn’t enough, adding iron-rich foods like lean red meat, poultry, and beans can help.

Hypothyroidism

Hypothyroidism is treated effectively with thyroid hormone replacement, which is safe during pregnancy. Take thyroid medication separately from prenatal vitamins, as minerals in the vitamin can interfere with absorption.

Poor sleep

Improve sleep habits:

• Consume most fluids during the day to reduce nighttime bathroom trips.
• If heartburn troubles you, avoid spicy, fried, or acidic foods at dinner.
• Avoid caffeine after early afternoon.

Anxiety

Worries about labor, parenting, work, and finances are understandable. Talking with your partner, a trusted friend, or a family member (especially someone who’s been through it) can be comforting. Your provider can also connect you with mental health professionals.

Infection

Any suspected infection should be evaluated by your clinician. Meanwhile, practice self-care:

• Get extra rest.
• Stay well-hydrated.

Bottom line

Although feeling cold in pregnancy is less common, it’s not unusual and often has understandable causes. Talk with your provider about your symptoms so you can be tested and treated if needed — and rest easier knowing you’re taking steps to feel better.