Feeling Cold and Shivery in Pregnancy

Shivering is a fever symptom, not the opposite of one

This is the point of the page, and it is the thing people get backwards.

The NHS lists the signs of a high temperature as: "feeling hotter than usual, shivering (chills) or a thermometer says your temperature is 38C or above." Shivering sits on that list as an equal, not as an alternative.

Tommy's says the same from the pregnancy side. Among the common signs of a high temperature it names "chills (shivers and feeling cold)", alongside sweating, headache, fatigue and muscle aches.

The mechanism is straightforward: at the start of a fever the body raises its internal set point, and until your actual temperature catches up you feel cold and shiver, because shivering is how the body generates the extra heat. Which means feeling suddenly, unaccountably cold and shivery is often the first half hour of a fever, before any thermometer would show it.

What to do

• Take your temperature. Tommy's says to call your GP, midwife or hospital maternity unit if your temperature is above 37.5C, even with no other symptoms.
• Call anyway if you are shivering, even if the thermometer reads normal. Shivering is on the NHS list in its own right.
• Call 999 if you have signs of sepsis: fast breathing, slurred speech, confusion, clammy, blotchy or mottled skin that can look bluish on some skin tones, a rash that does not fade when you press a glass on it, not having a wee all day, or feeling very drowsy.

Tommy's makes one more point that is easy to miss: "A high or very low temperature can also be a sign of something called sepsis." A temperature below normal is not reassurance.

The infections that present this way in pregnancy

Urine infection. The NHS lists among the signs that a UTI may have reached a kidney: a very high temperature, or feeling hot, cold or shivery; a very low temperature; pain in the lower tummy or in the back, just under the ribs; blood in your pee; feeling or being sick; and not having had a pee all day. It says pregnancy is a reason to ask for an urgent GP appointment with UTI symptoms rather than trying self-care first.

Flu and other viral illness. Tommy's notes pregnancy puts you in the at-risk group for flu and that a sudden high temperature may be a sign of it, with treatment being time-limited.

Infection after waters have broken. The NHS advises calling your midwife or maternity unit immediately if your waters have broken early and "your temperature is raised, or you feel hot, cold or shivery", or if fluid is greenish or smelly.

Feeling cold without shivering

A separate and much more common complaint is simply feeling cold all the time — wearing more layers than everyone else, cold hands and feet, unable to warm up. That is not fever, and it has different explanations.

Anaemia. The NHS lists the main symptoms of iron deficiency anaemia as tiredness and lack of energy, shortness of breath, noticeable heartbeats, paler than usual skin and headaches, and states that pregnancy is a very common cause. Reduced circulation to the extremities is part of the same picture, and people commonly describe it as being cold.

Underactive thyroid. The NHS names "feeling cold more than usual" among the common symptoms of hypothyroidism, and notes symptoms "usually develop slowly and get worse over time" and can be mild and hard to notice. Thyroid function is checked by a blood test.

Blood being redirected. Pregnancy sends a great deal of extra blood to the skin and to the uterus. Hands and feet can end up feeling cold while your core feels warm, which is the opposite of what people expect.

Not eating enough, or long gaps between meals. A dip in blood sugar reliably produces shakiness and a chilled feeling, particularly in the first trimester when eating is difficult.

What to mention at your next appointment

Feeling cold on its own is not urgent. It is worth raising, because it points at things that are found on routine blood tests:

• Cold with tiredness, breathlessness or palpitations — ask about anaemia.
• Cold with weight change, constipation, dry skin or hair changes — ask about thyroid.
• Cold with shakiness between meals — worth reviewing how and when you are eating.

The NHS also lists less common anaemia symptoms that are useful supporting clues: food tasting strange, feeling itchy, a sore tongue, hair loss, restless legs, and wanting to eat non-food items such as paper or ice.

Practical things that help the ordinary version

• Layer rather than heat the whole room, since you may swing between hot and cold within an hour.
• Warm your hands and feet directly — socks and slippers do more than a thermostat.
• Eat something at regular intervals rather than leaving long gaps.
• Keep moving. Gentle activity raises circulation to the extremities more reliably than sitting under a blanket.

None of that applies if you are shivering. Shivering is not a signal to put on a jumper; it is a signal to take your temperature and pick up the phone.

The distinction that matters

Feeling generally cold, over days or weeks, with cold hands and feet, is a next-appointment conversation and usually turns out to be anaemia, thyroid or simply how your circulation has redistributed.

Feeling suddenly cold and shivery, in a way that is unlike you, over minutes to hours, is a fever presenting from the cold end. That is a phone call, and it is the one people wait out because it does not feel like the symptom they were told to watch for.