What to Know About Throwing Up Blood While Pregnant

Many people won't know they're pregnant at six weeks, but that doesn't mean there aren't any symptoms. As many as 70% of pregnant people experience morning sickness in the first trimester, with the first waves of nausea and vomiting beginning at week 6 and peaking with the worst morning sickness symptoms at week 9. Thankfully, most cases of morning sickness subside by week 14.

The good news is that, in most cases, throwing up is harmless to both you and the fetus. But while vomiting while pregnant is common, throwing up blood while pregnant—or hematemesis—could indicate something more serious.

Here are some things you should know about throwing up blood while pregnant, including causes, treatments, and when to call a doctor.

What Causes Throwing Up Blood During Pregnancy?

If you find blood in your vomit while expecting, call a health care provider right away. While it may not always be serious, your doctor will ask more detailed questions to get a sense of the potential causes and order further evaluation depending on their level of concern. This might include an ultrasound, oxygen reading, or blood tests.

Here are a few things that may be causing blood in your vomit.

Morning sickness

"Morning sickness" is a misnomer since nausea and vomiting can happen anytime, day or night. Scientists don't fully understand what causes morning sickness, but these factors can contribute.

• A surge in hormones human chorionic gonadotropin (HCG) or estrogen
• Low blood sugar
• Stress and exhaustion
• Food sensitivities and aversions
• Heightened motion sickness
• In one study, researchers found that a bloodborne protein may be what triggers nausea and vomiting, especially in extreme cases like hyperemesis gravidarum

Typical morning sickness will include feeling generally nauseated and vomiting once or twice a day, and you shouldn't have blood in your vomit. However, an extreme form of morning sickness called hyperemesis gravidarum can lead to throwing up blood.

Hyperemesis gravidarum

If your morning sickness has gone into overdrive and you're vomiting four or more times a day, you may have a condition called hyperemesis gravidarum (HG). Aside from excessive vomiting, you may also experience constant dizziness or lightheadedness, weight loss, constipation, dehydration, and an inability to consume and hold down adequate amounts of food or drink.

Constant vomiting can strain the esophagus, the tube that connects your mouth to your stomach. When the lining becomes irritated, it can bleed. However, if it ruptures due to injury such as violent vomiting, which is called a Mallory-Weiss tear, you will need to seek medical attention immediately. Bleeding from the tears can cause anemia or other complications.

Signs of a ruptured esophagus include:

• Nausea
• Blood in vomit (usually a large amount)
• Fever
• Rapid breathing
  

Management of hyperemesis gravidarum may include:

• Staying hydrated
• Prescription for antiemetic or steroid, which controls nausea and vomiting
• Acupuncture or hypnosis
• Diet and lifestyle changes
• IV fluids

Pregnancy gingivitis

Thanks to fluctuating levels of estrogen and progesterone hormones during pregnancy, you may experience unpleasant symptoms of swollen and bleeding gums. This is known as pregnancy gingivitis, which is a form of gum disease.

Your teeth may have a slight build of plaque due to improper brushing, and during pregnancy, changing hormones can make your gums vulnerable to the effects of plaque and gingivitis. In one study by the University of Alabama at Birmingham School of Dentistry, researchers found that up to 80% of pregnant people are likely to experience moderate to severe gingivitis.

It is common for gums to bleed with this condition, which could lead to spotting blood in your vomit.

Signs of pregnancy gingivitis include:

• Swollen gums
• Bleeding gums, especially when flossing or brushing
• Tenderness

Treatment for pregnancy gingivitis may include:

• Your doctor may recommend seeing a dentist
• Regular brushing and flossing
  

Bloody nose

During pregnancy, your blood volume will increase to help support a growing uterus, placenta, and fetus—and this includes the blood vessels in your nose. Since the vessels in your nose are so thin -walled, however, they may not always be able to accommodate the increased blood volume, which can sometimes lead to bursting. But don't worry, pregnancy nose bleeds are very common; one in five pregnant people will get a nosebleed at some point during their nine months.

If you are experiencing bloody noses, you may also notice blood in your vomit. When you lay your head back during a nose bleed, some blood may drip from your nasal cavity down into your throat, where it can collect. Later, when you throw up, the blood will be carried along with vomit.

Treatment for pregnancy nose bleeding:

• Drink plenty of fluids to stay hydrated
• Use a humidifier, especially when you sleep
• Don't pick your nose
• Apply a saline gel or spray

Does Throwing Up Blood During Pregnancy Mean Miscarriage?

An old wives tale says that if you experience morning sickness, then you won't have a miscarriage. While not having morning sickness isn't a cause for concern, a study published in JAMA Internal Medicine found that symptoms of morning sickness (nausea and vomiting) in early pregnancy appeared to be linked to a lowered risk of a miscarriage by up to 75%.

Signs of a miscarriage include:

• Bleeding that accelerates to heavy bleeding
• Cramping
• Belly or abdomen pain
• Back pain
• An accompanied fever
• Passing tissue, blood, fluids, mucus

If you believe you are having a miscarriage, it is important to contact a health care provider immediately.