Q: Are nosebleeds normal during pregnancy? What should I do if I have one?

A: Nosebleeds are not unusual during pregnancy. This is because pregnancy can cause the blood vessels in your nose to expand, and your increased blood supply puts more pressure on those delicate vessels, causing them to rupture more easily. Although it's unpleasant and inconvenient, an occasional minor nosebleed is generally harmless. You're especially likely to get a nosebleed when you have a cold, sinus infection, allergies, or when the membranes inside your nose dry out, as they do in cold weather, air-conditioned rooms, airline cabins, and other dry environments. Trauma and certain medical conditions, such as high blood pressure or a clotting disorder, may cause nosebleeds as well.

When your nose starts to bleed, sit down, keep your head higher than your heart, and put pressure on the bleeding nostril for five to ten minutes. We recommend using a watch to make sure you've kept the pressure for long enough. Using your thumb and the side of your bent index finger, firmly pinch the whole soft lower part of your nose and exert pressure toward your face. Don't let up for a second - even if you're curious to see if the bleeding has stopped - because that could interfere with the coagulation process.

Applying ice can help, too, because it constricts blood vessels. Hold a cold pack or a bag of frozen peas over your nose and cheeks with the hand that's not pinching your nostrils closed. Don't lie down or tilt your head back: You might end up swallowing blood, which could cause nausea or even vomiting.

If the bleeding hasn't stopped after ten minutes of pressure and ice, continue for another ten minutes as long as you're not bleeding heavily. Consult your healthcare practitioner if the bleeding doesn't stop after 20 minutes of pressure.

You'll need a medical evaluation if you get a nosebleed following a head injury, even if you only have minor bleeding. Let your practitioner know if you have frequent nosebleeds so she can rule out underlying problems.

Can I do anything to avoid getting a nosebleed?
• Drink extra fluids to help keep all of your mucous membranes well hydrated.
• Blow your nose gently. Aggressive blowing can lead to nosebleeds.
• Try to keep your mouth open when you sneeze.
• Avoid dry air, especially in wintertime or in dry climates, by running a humidifier inside your house and not overheating your bedroom. Also stay away from irritants like smoke, which you should be avoiding anyway.
• Use a lubricant to prevent nasal dryness. Some experts recommend petroleum jelly. Others suggest a special water-based nasal lubricant that is available over the counter at pharmacies. Saline nasal sprays or drops can help, too.