Coughing up blood and nosebleeds while pregnant

Is there an increased risk of nosebleeds during pregnancy?  When you become pregnant your circulatory system must expand in order to accommodate your baby. With this expansion, your body creates more blood and the circulation of blood increases. These changes may lead to some problematic side effects such as more frequent nosebleeds while you are pregnant.

How Can You Prevent Nosebleeds During Pregnancy?

Your nose contains many small blood vessels. Due to the increase in blood circulation during your pregnancy, these blood vessels are more prone to burst, causing a nosebleed. If you must blow your nose or wipe it for any reason, make sure you do so gently. This will help reduce your possibility of having a nosebleed during pregnancy.
Also, you are much more likely to get a nosebleed when the air is dry, so during the winter months, it is important to use a humidifier in your home. The moistened air will help decrease your chances of a nosebleed while pregnant.

Care for Nosebleeds While Pregnant

You can slowly end your nosebleed by following these steps:

  1. Make sure to sit or stand with your head upright.
  2. Lightly squeeze your two nostrils towards the center of your nose. Do this for a couple of minutes, and then let go. Repeat this step if the bleeding has not subsided.
  3. If the flow of blood is heavy, you may also lean forward slightly so you do not ingest any blood.

You should call your doctor immediately if your nosebleed follows a head injury.
Other reasons to consult your physician include the following: 

  • You have high blood pressure.
  • The nosebleed continues after completing the steps listed above.
  • The blood flow is substantial.

The good news is that even though these nosebleeds may be inconvenient, under most circumstances they pose no threat to you or your baby.

Want to Know More?

  • Cough and Cold During Pregnancy
  • Sinus Infection While Pregnant
  • How Your Body Changes During Pregnancy

Compiled using information from the following resources:
Harms, R. W. (Ed.). (2004). Mayo Clinic guide to a healthy pregnancy. New York, NY: HarperCollins Publishers Inc.
Johnson, Robert V. (Ed.). (1994). Mayo Clinic complete book of pregnancy & baby’s first year. New York, NY: William Morrow and Company, Inc.

Your nose may bleed unexpectedly during pregnancy, and you might also have some congestion. Find out what causes these strange symptoms and how to feel better.

Updated on April 29, 2020

Photo: katleho Seis/Getty Images

Don't worry if you spot some blood on a tissue after blowing your nose: Nosebleeds and congestion are common (albeit annoying) symptoms of carrying a baby. Learn about the causes, treatment options, and prevention strategies.

What Causes Nosebleeds in Pregnancy?

Your body is producing much more blood during pregnancy. The teeny blood vessels in your nose can swell up, dry out, and rupture, causing your nose to bleed. You may also notice that your nose is more congested than usual, which is the result of increased blood flow to the mucus membranes.

Can You Prevent Pregnancy Nosebleeds?

There isn't a whole lot you can do to prevent nosebleeds in pregnancy, but dry air can make you more susceptible. To avoid this, use a humidifier in your bedroom during the winter months (indoor heating can dry out your nasal passages and make the problem worse). It also helps to dab a little moisturizing petroleum jelly around your nostrils before going to bed. And always be extra gentle when blowing your nose. Now's the time to splurge on the super-soft tissues!

How to Relieve Nosebleeds

When a nosebleed strikes, apply pressure to your nostrils while sitting or standing—lying down or tilting your head back will make it worse. If the blood flow is heavier, try this first-aid trick: Place a clean tampon (you have no other need for them these days!) just inside the opening of your nose. It may look silly, but a tampon is much more absorbent than a wadded-up tissue.

If you have congestion, increase your fluid intake, and try to clear things up by spritzing saline nasal spray into your nose. Make sure it's a simple saline spray; other types of nose sprays aren't safe for pregnant women. Also avoid over-the-counter decongestants.

Pregnancy-related nosebleeds usually subside quickly, but if the bleeding is heavy and frequent, call your doctor. Also let your doctor know about bothersome congestion.

If you get a nosebleed during pregnancy, you are likely to feel alarmed and caught off guard. Nosebleeds often happen suddenly and seeing blood can be frightening...not to mention the fact that mopping up blood is not something any of us enjoy doing!

You might be wondering why this is happening, and if there is any way that a nosebleed could harm you or your baby. Nosebleeds aren't fun, but you can rest assured that they are quite common. In fact, many people notice an uptick in nosebleeds during their pregnancy.

This increase is due to hormonal changes and increased blood volume. Thankfully, nosebleeds during pregnancy are rarely serious. They are more of a nuisance—and a mess—than anything else.

Let’s take a look at why nosebleeds happen in pregnancy, how to manage them, and what you can do to try to prevent them.

Why Do You Get Nosebleeds While Pregnant?

As with so many aspects of pregnancy, you can blame your nosebleeds (also known as "epistaxis") on all the many changes your body is going through to support and grow your little one. Specifically, changes in blood volume and hormones are what are most likely to cause those nosebleeds in pregnancy.

When you are pregnant, your blood volume increases as much as 50%, says Daniel Roshan, MD, a high-risk maternal-fetal OB-GYN in New York City. Additionally, your cardiac output increases to about 25%. “The pressure of the extra blood volume can cause the fragile nose vessels to burst and bleed,” Dr. Roshan describes.

In other words, all that extra blood circulating in your body can cause the blood vessels in your nose to become more vulnerable, leading to the highly annoying and unpleasant experience of a nosebleed.

Your changing hormones play a similar role as well, says Mitchell S. Kramer, MD, chairman of the Department of Obstetrics and Gynecology at Huntington Hospital. Pregnancy hormones also cause the blood vessels in your nose to become more susceptible to those pesky bleeds.

You are also more likely to experience congestion when you are pregnant, Dr. Kramer adds, and sneezing or blowing your nose can more easily result in a nose bleed (how fun, right?). In rare cases, says Dr. Kramer, nose bleeds may be associated with increased blood pressure during pregnancy.

Certain environments, medical conditions, and medications can make you more likely to experience a nosebleed in pregnancy, too, explains Kecia Gaither, MD, who is a double board-certified physician in OBGYN and maternal-fetal medicine.

“Nosebleeds can occur more frequently with colds, allergies, on a blood thinner, have dry mucus membranes due to cold weather, air-conditioned rooms, or dry environments,” Dr. Gaither says.

How Common Are Nosebleeds In Pregnancy?

If a nosebleed during pregnancy has caught you off guard and has you concerned, you can take heart knowing that nosebleeds in pregnancy are actually quite common. Dr. Kramer says that about 1 in 5 pregnant individuals will experience a nosebleed. Additionally, studies have shown that people who are pregnant are three times as likely to experience nosebleeds as non-pregnant people.

When Do Nosebleeds Start During Pregnancy?

Nosebleeds in pregnancy can occur at any time, but according to Dr. Kramer, they typically start in the second trimester. But some people will start having them as early as the first trimester, he says.

What Are the Symptoms?

Symptoms of nosebleeds can come on suddenly, and can be quite shocking. The blood can come from one or both of your nostrils. Flow can be lighter or heavier, and usually doesn’t last for more than 10 minutes.

Sometimes you’ll get a nosebleed while you are sleeping. This can be both startling and very irritating. Plus, no one wants to clean up a nosebleed in the middle of the night! Nighttime nosebleeds often start with a tickle in the back of your throat before the blood flows out of your nose.

Although some nosebleeds are spontaneous and seem to come out of nowhere, many nosebleeds are associated with some sort of irritation of the nasal passage, says Dr. Kramer. This may be a sneeze, or when you have been wiping your nose frequently. Allergies, other nose irritations, or dry weather may also precede a nose bleed.

Importantly, nose bleeds are not associated with other symptoms, such as pain or headaches, says Dr. Kramer. If you have these symptoms, you should contact a healthcare provider.

Are Pregnancy Nosebleeds Preventable?

If you've been getting frequent nosebleeds during pregnancy, you are likely hoping for a way to get them to end. Unfortunately, nosebleeds aren’t always preventable. That said, if you avoid some of the irritants that can trigger a nosebleed, you might be able to prevent them, or at least decrease their frequency.

Dr. Gaither suggests blowing your nose as gently as possible so as not to trigger a nosebleed. She also recommends staying hydrated, using a humidifier to keep the air you breathe moist, and considering using a nasal lubricant. Taking pregnancy-safe allergy or cold medication to decrease sneezing and congestion can help minimize nose bleeds, says Dr. Kramer.

Dr. Roshan recommends making sure not to keep the room you are in too warm because the warm air can dry out your nasal passages. He also recommends against plucking your nose hair, or manipulating the inside of your nose in any way, if you are prone to nosebleeds during pregnancy.

Ways to Relieve and Treat Nosebleeds

If you are experiencing a nosebleed, try not to panic. There are some simple things you can do to quickly resolve your nosebleed.

First, if you are lying down, sit or stand up. Then, lean forward a little and pinch the soft area of your nose, just above your nostrils, for the next 10-15 minutes. Keep this pressure steady for the entire time.

Another option is to put a cold pack, or even a bag of frozen vegetables, across your nose. Cold temperatures can constrict your blood vessels and decrease blood flow. After your nosebleed, try to avoid bending forward too frequently, or blowing your nose too vigorously.

When to See a Healthcare Provider

Most nosebleeds during pregnancy can be managed at home, and don’t usually involve a heavy volume of blood. Dr. Gaither suggests seeking medical attention if your bleeding isn’t responding to at-home remedies and is lasting more than 30 minutes.

You should seek emergency medical attention if your bleeding is heavy, you are having trouble bleeding, or you are feeling dizzy or lightheaded, Dr. Gaither warns.

A Word from Verywell

Facing a bloody nose during pregnancy can be a scary experience. During pregnancy, it’s understandable that you’d react strongly to something like a sudden show of blood. After all, you don’t want anything to be wrong with your body right now!

But, as unsettling as nosebleeds can be, especially the first time, they are generally not harmful. They are just one of those annoying things about being pregnant. Still, if your nosebleeds are frequent and difficult to prevent, or if you have any questions or concerns about them, you should not hesitate to reach out to a healthcare provider.

If you are experiencing heavy, uncontrollable bleeding, labored breathing, or are feeling lightheaded, please seek immediate medical care.

What does it mean if you spit up blood while pregnant?

Vomiting a lot can irritate the lining of the esophagus. This can lead to small amounts of blood or dried blood in your vomit. More serious bleeding might be caused by an esophageal tear. This condition is rare — but serious — and can happen any time during pregnancy.

Why am I blowing blood out of my nose and coughing up blood?

Nasal congestion or respiratory infections You may experience bleeding when blowing your nose because of nasal congestion or a respiratory infection. Frequent blowing of the nose may create broken blood vessels. This can also occur if you sneeze or cough frequently, such as when you have a respiratory condition.

When should I be worried about nosebleeds during pregnancy?

Getting nosebleeds during pregnancy is common and usually harmless. They can be treated at home by pinching your nose closed for 10 minutes. Call your healthcare provider if your bleeding is heavy and lasts longer than 30 minutes or is accompanied by dizziness or trouble breathing.

Can preeclampsia cause nosebleeds?

Preeclampsia can cause HELLP syndrome (hemolysis, elevated liver enzymes and low platelet count). This happens when preeclampsia damages your liver and red blood cells and interferes with blood clotting. Other signs of HELLP syndrome are blurry vision, chest pain, headaches and nosebleeds.