Nosebleeds

What It Is & Why It Happens

Nosebleeds, or epistaxis, are a very common and usually harmless symptom during pregnancy, affecting up to 20% of pregnant individuals.

During gestation, your body experiences a 50% increase in total blood volume to support fetal development. To accommodate this extra fluid, pregnancy hormones (specifically estrogen and progesterone) signal the blood vessels throughout your body to dilate and expand.

The blood vessels lining the nasal passages are exceptionally small, delicate, and close to the surface. The combination of increased blood pressure inside these vessels and hormonal dilation causes them to swell and rupture easily under minor irritation, such as dry air, allergies, or blowing your nose.

Typical Timeline

Nosebleeds typically begin during the second trimester (around Week 12) and can continue intermittently throughout the third trimester (up to Week 40). This timeline corresponds with the rapid expansion of blood volume and peak hormone levels. They usually resolve completely within a few weeks postpartum as blood volume and hormones return to baseline.

Safe Comfort Measures

You can safely relieve nosebleeds and prevent nasal dryness with these self-care guidelines:

• Lean Forward, Not Back: When a nosebleed occurs, sit down and lean your head slightly forward. Leaning backward causes blood to flow down the back of your throat, which can irritate your stomach and cause nausea or vomiting.
• Pinch and Breathe: Pinch the soft lower half of your nose firmly between your thumb and forefinger. Breathe through your mouth. Keep pinching continuously for 10 to 15 minutes without checking if the bleeding has stopped, as releasing pressure early can disrupt clot formation.
• Apply Cold: Place an ice pack or a cold compress wrapped in a towel over the bridge of your nose to help constrict the blood vessels.
• Moisturize Nasal Passages: Apply a thin layer of petroleum jelly or saline nasal gel inside your nostrils to keep them moist. Use a saline nasal spray daily.
• Use a Humidifier: Run a cool-mist humidifier in your bedroom at night to keep the air moist.
• Blow Gently: Avoid blowing your nose forcefully, and sneeze with your mouth open to prevent pressure spikes in your nasal cavity.

When to Call the Doctor (Red Flags)

While occasional minor nosebleeds are benign, frequent, heavy, or uncontrolled bleeding can indicate underlying complications (such as high blood pressure or clotting disorders).

Contact your healthcare provider immediately or seek emergency medical care if you experience:

• A nosebleed that does not stop bleeding after 20 minutes of continuous, firm pressure.
• Bleeding that is exceptionally heavy, pouring from both nostrils, or flowing down the back of your throat rapidly.
• Nosebleeds accompanied by dizziness, lightheadedness, fainting, or difficulty breathing.
• Nosebleeds that occur alongside a severe headache, blurry vision, or sudden swelling in your face/hands (possible signs of preeclampsia).
• Frequent, recurring nosebleeds (multiple times a week).