What Causes Nosebleeds In Pregnancy And When To Worry

One morning, Leydi from Cumming, Georgia, noticed blood dripping from her nose after brushing her teeth. “Why every time I brush my teeth?!” she remembers thinking.

As her pregnancy progressed, so did her nosebleeds. In her last trimester, nosebleeds became a semi-regular occurrence, sometimes lasting five to ten minutes.

Pregnancy-related nosebleeds are surprisingly common, affecting up to 20 percent of pregnant people. And while they can feel alarming in the moment, they’re usually harmless and short-lived.

Here’s what causes nosebleeds during pregnancy, how to manage them, and when it’s worth checking in with your healthcare provider.

Why nosebleeds happen during pregnancy

Pregnancy changes nearly every part of your body, including your nose. Thanks to hormonal shifts and increased blood volume, many pregnant people find themselves reaching for tissues more often.

“Increased estrogen and progesterone levels during pregnancy cause vascular dilation and increased blood flow, including to the nasal mucosa,” explains Angela Silber, M.D., Associate Professor of Obstetrics and Gynecology at New York Medical College.

“This results in engorged, fragile nasal blood vessels. Additionally, increased blood volume and cardiac output heighten vascular pressure, making vessels more prone to rupture,” she adds.

In simpler terms, your body is pumping more blood than usual to support your growing baby. That added pressure, combined with sensitive, swollen nasal passages, makes it easier for tiny blood vessels in the nose to burst, especially when blowing your nose, sneezing, or even just standing in a warm shower.

Dry air, allergies, colds and sinus infections can also aggravate nasal tissues and increase your risk of a nosebleed. That’s why many people experience more frequent or intense nosebleeds during colder months or in dry indoor environments.

How common are pregnancy nosebleeds and when do they occur?

If you're pregnant and experiencing more nosebleeds than usual, you're not alone. Research shows that over 20 percent of pregnant individuals experience nosebleeds, compared to just six percent of the general population.

These nosebleeds can strike at any point during pregnancy, but they tend to become more frequent—or at least more noticeable—in the second and third trimesters. This timing isn’t coincidental: it lines up with rising hormone levels and a surge in blood volume that peaks later in pregnancy.

One mom-to-be shared her experience on Reddit:

“28 weeks with my third! I have gotten third-trimester nosebleeds with all my pregnancies. Got my first one this pregnancy a couple of days ago…It's one of the more mild symptoms that pop up in the third trimester (at least for me).” — noodlesnoots, r/BabyBumps

Although these episodes can feel alarming, especially if you’re not prone to nosebleeds outside of pregnancy, they’re generally considered a normal, albeit annoying, part of the process. The good news? For most people, the nosebleeds stop shortly after delivery.

How to stop a nosebleed when pregnant

A sudden nosebleed during pregnancy can be startling, but most can be safely managed at home. Here’s what to do if one strikes:

1. Stay calm and take a seat. Stress can elevate your heart rate and blood pressure, which may worsen the bleeding. Try to stay relaxed and breathe slowly through your mouth.
2. Lean slightly forward. Tilting your head back may seem instinctive, but it can cause you to swallow blood, which can irritate your stomach and lead to nausea or vomiting. Instead, lean forward at the waist so the blood can drain from your nose.
3. Pinch your nostrils shut. Using your thumb and index finger, firmly pinch the soft part of your nose, just below the bony bridge. Keep holding steady pressure for 10 to 15 minutes without checking to see if it has stopped.
4. Apply a cold compress. Placing an ice pack or cold washcloth over the bridge of your nose may help constrict blood vessels and slow the bleeding. Be sure to wrap the ice pack in a towel or cloth to prevent skin irritation.

Once the bleeding has stopped, try to rest and avoid blowing your nose, bending over, or engaging in strenuous activity for a few hours, as these actions may trigger another episode.

Preventing nosebleeds during pregnancy

You may not be able to prevent every nosebleed during pregnancy, but taking a few proactive steps can help reduce the frequency of nosebleeds. One of the most effective strategies is keeping your nasal passages moist.

Dry air, especially during winter months or in heated indoor environments, can irritate the delicate blood vessels inside your nose. Using a cool-mist humidifier in your bedroom at night can help maintain a more comfortable moisture level in the air.

Hydrating your nasal passages directly also helps. Regular use of saline nasal sprays or drops can prevent the membranes from drying out. Some people find it helpful to apply a small amount of petroleum jelly or saline gel just inside the nostrils using a cotton swab, which creates a protective barrier against irritation. Just be gentle and don’t insert the swab too far.

If you need to blow your nose, do so gently and avoid picking or rubbing your nose, which can worsen irritation. Staying well-hydrated by drinking plenty of fluids throughout the day also supports healthy nasal tissues and overall blood flow.

Managing related nasal symptoms during pregnancy

Nasal congestion during pregnancy, also known as pregnancy rhinitis, is extremely common, affecting up to 65 percent of pregnant individuals. While it’s usually harmless, the constant stuffiness and need to blow your nose can dry out the nasal passages, making you more susceptible to nosebleeds.

Safe ways to manage congestion during pregnancy include:

• Using saline nasal sprays or rinses
• Breathing in steam or using a humidifier
• Elevating your head while sleeping
• Trying nasal strips to improve airflow

If you're struggling with persistent congestion, it's important to consult your healthcare provider before using any over-the-counter decongestants or antihistamines during pregnancy.

As Dr. Jillian LoPiano, OBGYN and Chief Health Officer at Wisp, explains, “most over-the-counter nasal decongestants are not considered safe during the first trimester of pregnancy, especially those containing pseudoephedrine or oxymetazoline (Afrin), as they can cause potential risks to the fetus and a risk of dependency.”

While nasal congestion is a frustrating but common pregnancy symptom, there are safe ways to manage it without increasing your risk of nosebleeds or affecting your baby’s health.

When to seek medical advice for nosebleeds

While most pregnancy-related nosebleeds are harmless, there are times when they may signal something more serious. If you experience frequent or severe episodes, it's important to speak with your healthcare provider.

You should seek medical attention if:

• The bleeding doesn’t stop after 15 to 30 minutes of applying direct pressure.
• Nosebleeds are happening several times a week.
• The bleeding is especially heavy or leads to symptoms like dizziness, lightheadedness, or weakness.
• You have other signs of concern, such as bruising easily, prolonged bleeding elsewhere, or known high blood pressure.
• Blood is coming from both nostrils, or you're also coughing up blood.

Dr. LoPiano advises, “Note how you are feeling beyond the nosebleed itself—if you have chest pain, trouble breathing, feel lightheaded or dizzy, or have been diagnosed with high blood pressure, you should contact your doctor as they can assess underlying causes and rule out any serious conditions.”

In some cases, recurrent or difficult-to-control nosebleeds may warrant evaluation by an ENT (ear, nose, and throat) specialist.

Dr. Silber explains that while most cases are benign, persistent or severe bleeding could signal underlying issues like hypertensive disorders (such as preeclampsia), bleeding conditions (such as thrombocytopenia), or liver dysfunction. “Evaluation is warranted if bleeding is recurrent, prolonged, or accompanied by other abnormal findings,” she notes.

If you're unsure, bring it up at your next prenatal appointment. Your obstetrician or midwife can determine whether further assessment is needed.

Living with frequent nosebleeds during pregnancy

Frequent nosebleeds can be frustrating, inconvenient, and even a little unsettling—but in most cases, they’re just another quirky part of pregnancy. While it’s always important to keep your provider in the loop, rest assured that regular nosebleeds usually aren’t a sign that something is wrong with you or your baby.

If you’re dealing with them often, a few small adjustments can make life a little easier:

• Keep a “nosebleed kit” on hand with tissues, saline spray, and petroleum jelly to quickly address symptoms or prevent them from worsening.
• Use a humidifier, especially at night, to help maintain moisture in the air and prevent your nasal passages from drying out.
• Try sleeping with your head slightly elevated to reduce blood flow to the nasal area and minimize nighttime bleeding.
• Stay hydrated throughout the day—adequate fluid intake helps keep mucous membranes from becoming dry and irritated.

Most importantly, give yourself some grace. Like many other pregnancy symptoms, nosebleeds typically subside after delivery as hormone levels and blood volume return to normal.

The bottom line

Nosebleeds during pregnancy are surprisingly common, affecting over 1 in 5 pregnant individuals, and are typically the result of hormonal shifts and increased blood volume. While they can be messy and inconvenient, they’re usually harmless and temporary.

If you experience a sudden nosebleed, remember the basics: stay calm, sit down, lean slightly forward, and pinch your nostrils firmly for 10 to 15 minutes. Keeping your nasal passages moist with saline spray or a humidifier can also go a long way in preventing future bleeds.

Still, it’s important to know when to seek help. If your nosebleeds are heavy, don’t stop after 30 minutes, or if you experience other symptoms such as dizziness, lightheadedness, or high blood pressure, contact your healthcare provider.

Above all, know that you’re not alone—and this minor (but annoying) symptom is one of many your body might experience as it prepares to welcome your baby. With a few simple strategies and support from your healthcare provider, you’ll get through this phase with confidence.

Experts

• Angela Silber, M.D., Associate Professor of Obstetrics and Gynecology at New York Medical College
• Dr. Jillian LoPiano, OBGYN + Chief Health Officer at Wisp