What causes nose bleeding during pregnancy

Yes. A nosebleed is a loss of blood from the tissues lining the nose. Because pregnancy can make the blood vessels in your nose expand, it makes them prone to breaking and bleeding more easily. Twenty percent of pregnant women have nosebleeds, compared with 6 percent of nonpregnant women.

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What causes nosebleeds during pregnancy?
How can I stop a nosebleed during pregnancy?
When should I seek medical care for my nosebleed?
How to avoid a nosebleed during pregnancy
What causes nosebleeds during pregnancy?
How to stop a nosebleed
When to worry about a nosebleed

Fortunately, the occasional minor nosebleed is usually harmless. Some doctors say even a few nosebleeds over the course of pregnancy aren't cause for alarm.

What causes nosebleeds during pregnancy?

In addition to the expansion of blood vessels that makes you more prone to nosebleeds when you're pregnant, you're also especially likely to get a nosebleed if:

You have a cold
You have a sinus infection
You have allergies
The membranes inside your nose dry out, as they do in cold weather, air-conditioned rooms, airline cabins, and other environments with dry air
You have an injury to the area
You use chemical irritants, such as nasal medicines or drugs that are sprayed or snorted
You have certain medical condition, such as high blood pressure or a clotting disorder

How can I stop a nosebleed during pregnancy?

If you have a bloody nose during pregnancy:

Sit down and lean forward a bit, but keep your head higher than your heart.
Using your thumb and index finger, firmly pinch the whole soft lower part of your nose – that's both nostrils.
Breathe through your mouth and squeeze your nostrils closed for 10 to 15 minutes. Don't let up or check to see if the bleeding has stopped before then because that could interfere with clotting. (You may want to set a timer.)
Apply ice to constrict the blood vessels and slow the bleeding. Hold a cold pack or a bag of frozen peas over the bridge of your nose with the hand that's not pinching your nostrils closed.

Don't pack your nose with gauze or tissues. And don't lie down or tilt your head back: You might end up swallowing blood, which could cause nausea and vomiting or even make you accidentally inhale some blood into your lungs.

If the bleeding hasn't stopped after 15 minutes of applying pressure and ice, continue for another 10 to 15 minutes.

When should I seek medical care for my nosebleed?

Contact your provider if you have frequent nosebleeds during pregnancy. She may want to do an exam to rule out any bigger problems. If you get nosebleeds often, it could be a symptom of something else, such as high blood pressure or a bleeding disorder.

Sometimes, a nosebleed during pregnancy requires immediate medical attention. Call 911 or have someone drive you to the emergency room if:

The bleeding doesn't stop after 30 minutes of pressure
The blood flow is extremely heavy
You have trouble breathing because of the bleeding
You get a nosebleed following a head injury, even if you only have minor bleeding
The bleeding causes fatigue, lightheadedness, or disorientation
You turn pale from the bleeding
You have chest pain
You think your nose might be broken
You are taking blood thinners and you have a nosebleed

How to avoid a nosebleed during pregnancy

Drink plenty of fluids to keep your mucous membranes well hydrated.
Blow your nose gently. Blowing too hard can cause a nosebleed.
Try to keep your mouth open when you sneeze. This distributes the pressure of your sneeze rather than concentrating all of it in your nose.
Use a humidifier inside your house, especially during the winter or if you live in a dry climate. Don't overheat your bedroom, and stay away from irritants like smoke.
Use a lubricant to prevent dryness in your nose. Some experts recommend petroleum jelly. Others suggest a special water-based lubricant that's available over the counter at pharmacies. Saline nose sprays or drops can help, too.
If your provider recommends that you use a medicated nose spray or decongestant, take it exactly as instructed. (Don't overuse it.) These medications can dry out and further irritate your nose.

Even though nosebleeds are common in pregnancy, it can be a little unnerving to be bleeding. If you're ever in doubt about whether or not to call your practitioner, err on the side of caution during pregnancy. It might also help you feel prepared to read our article on Pregnancy symptoms you should never ignore.

Learn more:

It may seem like one of the odder quirks of pregnancy but there’s reason behind that bleeding nose. Here’s what’s going on.

Yes, absolutely. Around one in five pregnant women get nosebleeds, so you aren’t alone if you’re suffering from them (Dugan-Kim et al, 2009).

What causes nosebleeds during pregnancy?

As with most odd things that happen to your body during pregnancy, nosebleeds are down to the hormones. If you’re prone to nosebleeds during your pregnancy, it’s because pregnancy hormones increase blood flow and relax tissue, including in your nose (Shiny Sherlie and Varghese, 2014).

How to stop a nosebleed

If a nosebleed hits, you should:

sit or stand upright
pinch both nostrils under the bridge of your nose and lean forwards

maintain constant pressure for 10 to 15 minutes while breathing through your mouth
lie down on your side if you feel faint
get medical help straightaway if bleeding persists, feels uncontrollable or if you start to feel ill.

For the next 24 hours, you should try to avoid:

blowing or picking your nose

heavy lifting
strenuous exercise
lying flat
drinking alcohol or hot drinks.
(NICE, 2015)

It’s a good idea to swallow lots of water, as dryness in your nose can make nosebleeds worse. Other ideas to reduce dryness include using a humidifier in your house or dabbing some petroleum jelly in each nostril (NHS Choices, 2015).

When to worry about a nosebleed

While the odd nosebleed may be annoying, serious nosebleeds in otherwise healthy pregnant women are very rare (NHS Choices, 2015). But if your nosebleeds are heavy, recurrent or occur alongside other symptoms, speak to your midwife or doctor. Nosebleeds in pregnancy are sometimes associated with:

a higher incidence of postpartum haemorrhage
hypertension and pre-eclampsia
nasal haemangioma (a small harmless growth in the nose)
pregnancy-related coagulopathies (blood-clotting disorders)
taking aspirin or other anti-coagulant treatments.

(Dugan-Kim et al, 2009; Shiny Sherlie and Varghese, 2014; NHS Choices, 2015)

If nosebleed are serious, your doctor may use various treatments and will check whether any underlying issues are causing your nosebleeds. The doctor may offer cauterisation, which is a burning treatment that seals bleeding blood vessels, or nasal packing, where gauze is packed into the nose (Crunkhorn et al, 2014).

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about birth, labour and life with a new baby.

Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.

NHS choices offers information about nosebleeds when you are pregnant and advice on treating a nosebleed.

Crunkhorn RE, Mitchell-Innes A, Muzaffar J. (2014) Torrential epistaxis in the third trimester: a management conundrum. BMJ Case Reports. pii: bcr2014203892. doi: 10.1136/bcr-2014-203892. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25301417 [Accessed 1st March 2018].

Dugan-Kim M, Connell S, Stika C, Wong CA, Gossett DR. (2009) Epistaxis of pregnancy and association with postpartum hemorrhage. Obstet Gynecol. ObstetGynecol 114(6):1322-1325 doi: 10.1097/AOG.0b013e3181bea830. Available from: https://www.ncbi.nlm.nih.gov/pubmed/19935036 [Accessed 1st March 2018].

NHS Choices. (2015) Nosebleed. Available from: https://www.nhs.uk/conditions/nosebleed [Accessed 1st March 2018].

NICE. (2015) Epistaxis (nosebleeds). Available from: https://cks.nice.org.uk/epistaxis-nosebleeds [Accessed 1st March 2018].

Shiny Sherlie V, Varghese A. (2014) ENT changes of pregnancy and its management. Indian Journal of Otolaryngology and Head & Neck Surgery, 66(Suppl 1):6-9. doi:10.1007/s12070-011-0376-6. Available from: https://www.ncbi.nlm.nih.gov/pubmed/PMC3918343. [Accessed 1st March 2018].