Pregnancy Nosebleed: What to Do

As if you didn’t have enough to think about during pregnancy, you should know that there is an increased risk for nosebleeds. The medical term is epistaxis of pregnancy. About one in five pregnant women will experience a nosebleed. That’s about four times the risk for women who are not pregnant.

A nosebleed can be frightening. Blood can come out one or both sides of your nose, or run down the back of your throat if you are lying down. The good news is that most nosebleeds can be stopped at home and they are very unlikely to affect your pregnancy or your baby.

Why Nosebleeds Occur During Pregnancy?

The main reason is pregnancy hormones:

  • Estrogen goes up during pregnancy. Estrogen increases the production of tiny blood vessels, called increased vascularity. One area where increased vascularity occurs is inside your nose. These tiny blood vessels are covered by a thin layer of mucous membrane and they are very fragile. A slight amount of trauma can rupture a tiny vessel and cause a surprising amount of bleeding.
  • Progesterone is another pregnancy hormone that goes up during pregnancy. It helps your body produce more blood. That is important because you are now supplying blood for you and your baby. More blood coursing through your blood vessels increases your risk for a nosebleed.
  • Hormones produce by your placenta cause blood vessels to become more open, called vasodilation. Dilated blood vessels are more likely to break. Vasodilation also causes tissues in your nose to swell. This causes the nasal congestion many women experience during pregnancy. Blowing your nose frequently to relieve congestion may also cause a nosebleed.

What to Do When You Have a Nosebleed

At the first sign of bleeding:

  • Stand or sit up straight. If you have bleeding going down the back of your throat, lean forward slightly.
  • Firmly pinch the front of your nose, the soft part before the nose becomes bony. Hold the pressure pinch for 10 to 15 minutes.
  • You can put an ice pack or a package of frozen vegetables over the bridge of your nose. This will cause blood vessels that supply your nose to close down a bit, called vasoconstriction.
  • In most cases, bleeding will stop. To avoid another nosebleed, avoid blowing your nose, bending over, or straining for about 12 hours. You might also avoid hot foods or liquids and hot baths or showers. These cause vasodilation.

Can Nosebleeds Be Prevented?

The answer is probably not, but you can reduce your risk by keeping your nose moist. If the lining inside your nose gets too dry, it can crack and expose the blood vessels underneath. This is most common if you live in a dry climate or in the winter with cold and dry air. Try using a humidifier in your home. You can also use a small amount of petroleum jelly (Vaseline or A&D ointment). Place the jelly just inside you nose gently. The warmth inside your nose will allow the jelly to spread and coat the inside of your nose. This can be especially helpful if you have had a few nosebleeds recently.

When to Call for Help

If pinching for 15 minutes does not stop your nosebleed, you can try blowing your nose and repeating the pinching. Blowing your nose may clear a blood clot that is keeping your nosebleed from stopping. If a second attempt does not stop the bleeding, you should contact your health care provider, or go to the emergency room or urgent care.

Other reasons to call or get help include a nosebleed that:

  • Follows a blow to the head or nose
  • Causes you to feel faint or lightheaded
  • Occurs along with high blood pressure or taking blood thinning medications

If you need medical treatment, it may include placing a packing in your nose, putting a vasoconstricting medication in your nose, and/or cauterizing the bleeding blood vessel. Cautery is burning the blood vessel closed. It can be done with a chemical, an electric current, or a laser. Your health care provider will numb the inside of your nose with a numbing solution before cautery. It is not painful.

Epistaxis of pregnancy is common. It can usually be managed at home. In rare cases, it may require medical care. If you have frequent nosebleeds at home, even if you are able to stop them on your own, let your health care provider know. Your provider may want you to see an ear, nose, and throat specialist or do some testing to rule out a medical condition that causes increased bleeding.

Christopher Iliades
Dr. Chris Iliades is a medical doctor with 20 years of experience in clinical medicine and clinical research. Chris has been a full time medical writer and journalist since 2004. His byline appears in over 1,000 articles online including EverydayHealth, The Clinical Advisor, and Healthgrades. He has also written for print media including Cruising World Magazine, MD News, and The Johns Hopkins Children's Center Magazine. Chris lives with his wife and close to his three children and four grandchildren in the Boston area.

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