Updated 10 October 2026
At a glance
- Dysautonomia International says POTS is most often seen in women of child bearing age, between 15 and 50, and Johns Hopkins Medicine says that in some studies slightly more than half of pregnant women with POTS felt better than usual during pregnancy.
- A Buffalo questionnaire study of 10 women found POTS symptoms improved or stable in six during pregnancy, and the DINET page says there is very little literature about the effects of POTS on pregnancy.
- A table of the statements, a trimester notes table, a word list, four steps and a one-page summary are set out below.
- POTS Journey keeps standing symptoms, heart-rate context, heat and prenatal visit questions in one dated history, and its Doctor Report exports that history as a one-page summary.
Pregnancy changes blood volume, appetite, sleep and energy, so a person with postural orthostatic tachycardia syndrome may not know which standing symptom belongs to which stage. Lightheadedness in the tenth week and lightheadedness in the thirtieth can mean different things to the clinician hearing about them later, and memory tends to flatten the order of the months.
This guide sets out what Dysautonomia International, Johns Hopkins Medicine, DINET, ACOG and a small questionnaire study say about POTS and pregnancy, then offers a table of the statements, a trimester notes table, a word list, four steps and a one-page summary. Its scope is the symptoms you notice and the answers you receive. A clinician decides what any symptom means for you and your pregnancy, and nothing here diagnoses a cause or advises on treatment.
What Dysautonomia International, Hopkins, DINET, ACOG and a Buffalo study say about POTS in pregnancy
The sources describe a course that varies. Johns Hopkins Medicine says: "In some studies, slightly more than half of pregnant women with POTS felt better than usual during their pregnancies, which might be due to the increase in blood volume that is present after the first few weeks of pregnancy." It adds that others had a more variable course, with either stable symptoms or an increase in symptoms. A Dysautonomia International article by Dr. Svetlana Blitshteyn puts the range as 60-70% of patients with improved symptoms during pregnancy and 30-40% feeling worse, and lists presyncope and tachycardia among common symptoms during pregnancy.
The Buffalo study, a questionnaire completed by 10 women with pre-existing POTS, concluded that POTS may have a variable clinical course in pregnancy, with 60% of women reporting either improved or stable symptoms during pregnancy and 50% reporting either improved or stable symptoms six months after delivery. The same abstract reports severe vomiting or hyperemesis gravidarum in the first trimester in 59% of the women, and the sample is only 10 women.
A DINET information page says there is very little literature about the effects of POTS on pregnancy, and reports that two thirds of women experience improvement of symptoms in the second and third trimester and one third develop worsening symptoms. ACOG is not writing about pregnancy here, yet its committee opinion notes that symptoms of postural tachycardia syndrome can worsen in the premenstrual period or during menses.
The figures differ from page to page, and they describe groups, so none of them tells you what your own months will look like. Notes with dates and trimester labels give your clinicians something specific to set beside the general numbers.
A passing thought about how standing felt that week can be written in your own words in the Daily Journal of POTS Journey (by Health Journey Labs), under the day it happened.
A table of the statements: who was studied, what each source says and how it differs
The sources rest on different kinds of evidence, so the table sets out what each says and what kind of statement it is.
Source statements table, by POTS Journey
| Source | What it says | Kind of statement |
|---|---|---|
| Dysautonomia International (conditions) | Most often seen in women of child bearing age, between 15 and 50 | Who is affected |
| Johns Hopkins Medicine | Slightly more than half felt better than usual in some studies; others had a more variable course | Course statement |
| Dysautonomia International (pregnancy) | 60-70% improved during pregnancy, 30-40% felt worse | Range statement |
| Buffalo questionnaire study (10 women) | 60% improved or stable in pregnancy; 50% at six months after delivery; severe vomiting in 59% in the first trimester | Small-study figures |
| DINET | Very little literature; two thirds improve in the second and third trimester, one third worsen | Summary of research |
| ACOG | Symptoms can worsen in the premenstrual period or during menses | Cycle statement |
The table shows that every source calls the course variable. Postpartum numbers diverge: DINET says the majority of women remain stable, while the Buffalo study found worsening at six months in five of ten women. None of the pages gives a rule for a single day or a way to predict your own pregnancy.
A log cannot resolve those differences. It can show your clinicians how your own months went, which no table can supply. The guide to starting to track POTS symptoms describes a light first step for the standing side of the record.
Tilt-table notes, blood counts and other test dates go into My Labs in POTS Journey, so those dates appear in the same history as the weeks they fall near.
POTS standing symptoms by trimester, from before pregnancy to after birth
Rows grouped by stage let a prenatal clinician and a POTS clinician read the same months in order. The Buffalo study asked about the clinical course before, during and after pregnancy, and the notes below borrow that layout. The sample rows only show the layout.
Trimester standing table, by POTS Journey
| Stage and week | Standing symptoms | Nausea or vomiting | Surroundings | What I was told |
|---|---|---|---|---|
| Before pregnancy | Lightheaded after a few minutes upright | Occasional | Warm rooms, long queues | Baseline noted |
| First trimester, week 8 | Racing heart on stairs, foggy mornings | Daily, hard to keep food down | Heat, poor sleep | Mentioned at the booking visit |
| Second trimester, week 22 | Fewer dizzy spells | Gone | Cool weather | Asked to bring these notes |
| Third trimester, week 35 | Faint on standing quickly | None | Hot afternoon, long wait | Question for the clinician |
| After delivery, week 6 | Dizzy again in the evenings | None | Broken sleep | Noted for the next visit |
For each row, give the stage and week, then the standing symptom in your own words, any nausea or vomiting, the surroundings and what you were told. Rows can stay brief. The Buffalo abstract and the DI article both name vomiting, fatigue, presyncope and tachycardia, which is why those have a place in the columns.
Read down the stage column after a few weeks. A clinician can see which stages were calm and which were busy, something recollection rarely holds. The notes record what happened, and what it means is for the care team. The guide to what to track backward and forward shows how to add the months before pregnancy to the baseline row.
Standing load, heart-rate context and heat for the day go into the Daily check-in of POTS Journey, and a standout day can be flagged in the Flare Tracker with a short note.
Words for standing and pregnancy notes: symptoms, surroundings and stage
Your prenatal clinician and your POTS clinician will ask what you felt and what was going on, and a short list of words helps you answer in the same terms each time.
Words for standing in pregnancy
In pregnancy, POTS Journey uses these standing words in the notes.
- Standing words: lightheaded, faint, racing heart, pounding heart, foggy, shaky, after standing up, after standing a while.
- Pregnancy words: nausea, vomiting, tired, hard to eat, hard to sleep, as I would say it.
- Change words: new, more often, less often, worse than last week, better than last week.
- Surroundings words: warm room, hot shower, long queue, crowded place, a cold or infection, poor sleep.
- Stage words: before pregnancy, first trimester, second trimester, third trimester, after delivery.
Pick the words that fit and write them down with the stage and week. Where a word fits only partly, quotation marks can record that it was a guess.
The standing words follow the symptoms that Hopkins lists for POTS, such as lightheadedness, fatigue, brain fog, palpitations and nausea, and the surroundings words follow its note that symptoms typically get worse in warm environments and in situations with a lot of standing. Your clinician may use other terms and will say so. Fainting, severe vomiting or any sudden severe symptom during pregnancy is a reason to contact your clinician or your local emergency number straight away, and the notes can be written afterward.
Words for the symptom and the surroundings can go into the Daily Journal of POTS Journey the way you say them, with the date, so a clinician reads each day as you described it.
Pregnancy with POTS: four steps and questions for both clinicians
Prenatal appointments are brief, and a few steps before the day make the notes easy to use at the desk.
Steps and questions for the visit, by POTS Journey
- Fill the notes for each week since the last visit, and leave cells empty where you are unsure.
- Mark the stage rows that stood out, and any row that says new or more often.
- Write down any test dates, and the explanation you were given, in the same words.
- Write the trimester questions in order of worry, starting with the change you noticed most since the last visit.
From POTS Journey, we recommend finishing the notes the day before the visit (POTS Journey trimester notes), so the latest week is on the page.
Questions can stay descriptive, such as which clinician follows the POTS side during pregnancy, whether the notes give them what they need and what to bring next time. The sources give no answers about your own case, and your clinicians are the people who can.
Jot down each reply with its date during the visit, so the next appointment starts from it. The guide to getting through a POTS flare day without losing notes lists other items worth keeping close.
Topics for the clinician can be parked in My Care Team within POTS Journey, and the Doctor Report condenses the notes into one page for the visit.
A summary page for both clinicians: POTS symptoms and trimesters side by side
A single page lets a clinician take in the shape of your months before the first question is asked. Limit it to one side and carry the weekly rows separately for any question about a particular week.
Summary page, by POTS Journey
- The weeks the notes cover and the stage each one belongs to.
- Your baseline standing symptoms before pregnancy, in a line or two.
- Each trimester in a line: how often symptoms came, which were new and which stayed the same.
- Nausea, vomiting and the surroundings that came up most often, as you recorded them.
- Test dates and the answers that came with them.
- Two or three questions for this visit.
Hand the clinician the page as the visit opens and offer to read it together. Anything the clinician asks you to record goes in with its date, which lets the next summary pick up where this one stops. A copy for yourself is worth keeping too.
What the page shows is the order of events and the answers you got. How POTS and pregnancy affect each other in your case is a question for the obstetric and POTS teams. A sudden severe symptom means calling your local emergency number first, and the page can wait.
One page built through the Doctor Report in POTS Journey carries the dates, entries and questions across when the visit begins.
How POTS Journey can help
A notebook is enough to begin. If you want standing symptoms, heart-rate context and prenatal questions in one dated history, the best POTS apps guide compares the options.
POTS Journey is a personal pots tracker from Health Journey Labs on the App Store and Google Play. Notes grouped by stage hand a prenatal visit an order of events that memory alone would blur. Interpreting the course of the pregnancy is for your clinicians, and the notes contribute the weeks, the words and the surroundings as they were. Below is what you can use and how each part helps.
- Daily check-in — Logs physical symptoms, emotional state, nutrition, sleep, exercise, meds, external factors; app-specific items: upright load, heart-rate context, heat, fluids, fog, recovery; read together with the rest of the logged history.
- Daily Journal — Logs free-text notes, voice entry; app-specific items: what upright time cost, heat context, partner talks, visit debriefs, leftover guilt after you canceled, a look-fine mismatch line; read together with scores and other logged history (adds context).
- Flare Tracker — Logs flag a day clearly worse than the usual hard week, onset, intensity, short note; app-specific items: upright dizziness, racing heart, heat crash, fog; read together with history across weeks (one-off spike vs repeating pattern).
- Weekly Goals — Logs one small aim, whether it held; read together with real check-ins.
- My Meds — Logs medicine names, timing, dose; app-specific items: options you already take as prescribed — fluids/salt plans your clinician set, compression notes, other treatments; read together with upright weeks, sleep, heat days, the rest of the tracked history.
- My Labs — Logs result dates; app-specific items: tilt-table notes, blood counts, iron, thyroid, other tests; read together with upright symptoms, fog, function.
- My Care Team — Logs clinicians, short visit notes; app-specific items: tends to ask mainly about heart rate rather than function; read together with logged history; used for: visit prep (what to ask and bring); notes during the visit; review afterward.
- Doctor Report — Logs one-page summary exported from logged history; app-specific items: dates, upright symptoms, heat, fluids, fog, how you functioned; read together with the history already logged; visit type: cardiology or neurology.
- Learn — Logs short education topics, prompts; app-specific items: upright load, heat, pacing, visit prep, upright symptoms on days that look fine; read together with your own logged weeks.
- AI companions — Logs Clara (general chat), specialist companions; app-specific items: knowledge, fitness, nutrition, relationships; read together with your logged history (companions already see it); used for: visit wording; a calm partner script; a soft rain-check line; a listening ear after a hard upright or heat day.
- Food Tracker — Logs meal or drink lines, caffeine, alcohol; read together with energy and symptoms.
- Weight Tracker — Logs scale or body notes; read together with the rest of the logged history.
- Period Tracker — Logs start and stop dates, flow, how heavy or light bleeding felt; read together with upright symptoms, fog, heat, everything else logged.
- My Assessments — Logs structured check-ins beyond daily scores, onboarding life and social context; read together with ongoing history.
Everything you log builds one history, and insights get stronger as it grows. Custom symptoms let you add your own labels.
We make POTS Journey at Health Journey Labs. This guide is educational and does not replace medical advice. Diagnosis, medication decisions, and urgent care decisions belong with your treating clinicians.
Sources
- Dysautonomia International: POTS and pregnancy, safety and other concerns
- Johns Hopkins Medicine: postural orthostatic tachycardia syndrome
- Dysautonomia Information Network: considerations of pregnancy in patients with POTS
- Dysautonomia International: postural orthostatic tachycardia syndrome
- ACOG Committee Opinion 813: gynecologic considerations for adolescents and young women with cardiac conditions
- Journal of Maternal-Fetal and Neonatal Medicine: pregnancy in postural tachycardia syndrome
FAQ
The answers below draw on the sources cited in this guide, and the app they mention is POTS Journey (by Health Journey Labs).
Does POTS usually get better or worse in pregnancy?
The sources say it varies: Hopkins reports that in some studies slightly more than half felt better than usual, while a Dysautonomia International article gives 60-70% improved and 30-40% worse. No one can tell beforehand which of these will be your case.
With a date and a stage on every row of POTS Journey, your clinicians can read your own direction of travel, and the visit starts from your months and not from a range.
Why do the percentages differ between sources?
The studies are small and ask different questions, and the Buffalo study covered just 10 women. A spread from about 50% to about 70% tells you the course varies, and it cannot tell you where you will land.
Your own weeks in POTS Journey stay in your words and under your dates, so the numbers from papers remain in the background and the record answers what a clinician asks about you.
Why does the log begin before pregnancy?
Rows from before pregnancy give the later ones something to be compared with, since they show how standing felt at your usual. The Buffalo study asked about the course before, during and after pregnancy, and the notes borrow that layout.
Earlier months remain reachable in POTS Journey by scrolling back, because each entry sits under its date, and a clinician can hold the earlier weeks against the later ones in one reading.
Is it worth recording nausea and vomiting?
The Buffalo abstract reports severe vomiting or hyperemesis gravidarum in 59% of its 10 women during the first trimester from a sample of just 10 women. A line for nausea gives your clinicians the facts, and what it means is for them.
Nausea notes entered in the Daily check-in of POTS Journey share the date with standing symptoms, so a clinician can see which weeks held both without asking you to piece them together.
What counts as a change worth marking?
Anything new, or any symptom that comes more or less often than before, is worth a note saying so. Deciding whether the change matters is for your clinician, and a marked row makes the date easy to find.
Flagging a standout day in the Flare Tracker of POTS Journey with a short note makes the date quick to find when a clinician asks which one you mean, and the note says what was different.
What should I write about the surroundings?
Hopkins says POTS symptoms typically get worse in warm environments and in situations involving a lot of standing, so heat, queues and long waits are useful lines. Your clinician decides what any pattern means for you.
Context kept in the Daily Journal of POTS Journey stays with the day's symptoms, and reading down the weeks shows which hard days came with company and which came alone, so the clinician can ask about either.
Who decides whether a symptom is from POTS or from the pregnancy?
Your obstetric and POTS clinicians decide, since notes show when something happened and give no cause. The date, the week of pregnancy and the surroundings are the facts to bring along.
What a clinician said can be kept as a short note in My Care Team of POTS Journey, so the reply stays attached to the stage and the symptom it answered, whoever you see next.
Should test dates go in the record?
A date for a tilt-table test, a blood count or a scan helps the team place it among your weeks, while the clinician reads the result. A date attached to a stage gives context that a result may lack alone.
A tilt-table date or a blood count date recorded in My Labs of POTS Journey sits in one history with the daily entries, so tests and trimester weeks come up together on the page you give the clinician.
What goes in the bag for a prenatal visit?
Bring the trimester notes, the one-page summary, any result letters with dates and two or three questions. One page reads faster than a pile of papers, and the weekly rows stay in your bag.
At the desk, one page from POTS Journey made through the Doctor Report replaces a pile of papers, while the longer record stays on your phone in case an older week comes up during the visit.
Can an AI chat tell me whether a symptom is safe in pregnancy?
Judging a symptom during pregnancy takes a clinician who knows your history, and urgent symptoms call for your clinician or your local emergency number. A chat with an AI can tidy notes and phrase questions, and nothing more than that.
A brief summary of your logged weeks can come from the companion in POTS Journey, and each line stays yours to read before anything goes to a clinician, who decides what it means.
Which clinicians should see the notes?
Obstetric, cardiology or neurology and primary care teams may each hold a piece of your history, so a single page shared with all of them keeps your account consistent through the pregnancy.
Handing the same exported page from POTS Journey to every clinician on your list is simple, and dates on the handovers show whose copy is newest and which older ones to set aside.
How long should I keep the notes going?
The Buffalo study followed women to six months after delivery, and postpartum numbers in the sources differ, so the notes can continue after the birth. Ask your clinician how long they want them, since no source names a number of weeks.
Setting one small recurring aim in Weekly Goals of POTS Journey keeps the notes current without long catch-up sessions, and the effort stays small enough to continue through broken nights and busy weeks.
What if I miss weeks of the notes?
Rows written afterwards are fine when they say so, and weeks you cannot recall can stay empty. A cell left empty says more to a clinician than a confident guess, and the clinic can follow up.
A word or two is enough for POTS Journey on a rough day, and a skipped week shows as a gap read as it stands, so no cell needs padding to look complete.
When does a symptom need urgent help?
Fainting, severe vomiting or any sudden severe symptom during pregnancy is a reason to contact your clinician or your local emergency number straight away. The notes support your visits, and urgent situations call for urgent help.
Once help has been reached, the date and the events can be written into POTS Journey, which hands the next visit an ordered account of that day so nobody depends on memory alone.
How can I protect my privacy in what I write about my health?
Heart rate readings, fainting episodes and notes on school or work absences can be misread as anxiety by someone who does not know POTS. Lock the device and share the standing heart rate summary only with the clinicians and offices that ask for it.
With POTS Journey, you decide which health notes to add. Read the app's privacy policy to see how data is stored and handled. This guide gives general information, not medical advice.