Nosebleeds, medically termed epistaxis, are common during pregnancy. While alarming, these episodes are typically harmless for both the expectant mother and the developing baby. They are a recognized side effect, affecting approximately 20% of pregnant individuals compared to about 6% of those who are not pregnant. This can begin at any stage, though it may become more noticeable in the second and third trimesters.
Understanding Pregnancy-Related Nosebleeds
The body undergoes significant physiological changes during pregnancy, contributing to the increased likelihood of nosebleeds. A primary factor is the dramatic rise in blood volume, which can increase by as much as 50% to support the growing fetus and placenta. This expanded blood supply exerts additional pressure on blood vessels throughout the body, including the delicate vessels lining the nasal passages. These tiny blood vessels are more prone to bursting under this heightened pressure.
Hormonal fluctuations also play a role. Elevated levels of estrogen and progesterone during pregnancy affect how blood vessels function. Estrogen can cause blood vessels to widen, while progesterone contributes to increased blood volume. These hormonal influences can make the mucous membranes inside the nose swell and become more fragile. This fragility, combined with heightened blood flow, makes the nasal blood vessels more prone to rupture and bleeding.
Hormonal changes can lead to pregnancy rhinitis, characterized by nasal congestion and stuffiness. This congestion, and frequent nose blowing or irritation, stresses sensitive nasal blood vessels. Dry air, whether environmental or from indoor heating, can also dry and crack the nasal membranes, making them more susceptible to bleeding.
Responding to a Nosebleed
When a nosebleed occurs during pregnancy, proper first aid can help manage the situation. First, sit upright and lean slightly forward. This position helps reduce blood pressure in nasal blood vessels and prevents blood from flowing down the back of the throat, which could cause nausea or vomiting. Tilting the head backward should be avoided.
Next, firmly pinch the soft part of the nose, just below the bony bridge, using your thumb and index finger. Maintain pressure continuously for 10 to 15 minutes, breathing through your mouth. Do not release pressure to check if bleeding has stopped before the recommended time, as this interferes with clotting. Applying an ice pack or cold compress to the bridge of the nose can also help constrict blood vessels and slow bleeding.
To help prevent nosebleeds, consider these measures:
- Maintain adequate hydration by drinking plenty of water to keep nasal passages moist.
- Use a humidifier, especially in dry environments or during winter, to add moisture to the air and prevent nasal membranes from drying.
- Apply a small amount of petroleum jelly or a saline-based nasal gel inside the nostrils to moisturize the nasal lining.
- Practice gentle nasal care: avoid picking your nose and blow gently.
- If sneezing, try to do so with your mouth open to reduce pressure on the nasal passages.
Indications for Medical Consultation
While most nosebleeds during pregnancy are not serious, seek medical attention in specific circumstances. Contact a healthcare provider if bleeding is very heavy or continues for more than 15 to 20 minutes despite direct pressure. Prolonged bleeding can indicate a more significant issue.
Medical consultation is also recommended if nosebleeds are accompanied by other concerning symptoms, such as:
- Feeling dizzy or lightheaded.
- Experiencing difficulty breathing or appearing pale.
- Swallowing blood that leads to vomiting.
- Occurring after a head injury.
- Being frequent, severe, or occurring alongside conditions like high blood pressure or unusual bruising.
Discussing these symptoms with a healthcare provider is important to rule out any underlying complications.