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Nosebleed

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.

Are nosebleeds in pregnancy common?

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).

Further information

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].

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