Vomiting Blood During Pregnancy: What Is Normal And When To See A Doctor

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Morning sickness during pregnancy characterized by nausea and vomiting is common. However, blood in vomit during pregnancy, also known as hematemesis, may indicate an underlying problem.

The condition may be caused due to different reasons, such as a tear in the food pipe, peptic ulcer, irritated esophageal lining, and others. If you experience hematemesis, it is important to seek prompt medical attention.

Read the post for more information on the causes of hematemesis, the symptoms accompanying it, its diagnosis, complications, treatments, and things you can do at home to relieve the symptoms.

What Is Hematemesis (Vomiting Blood)?

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Hematemesis refers to vomit that has a significant amount of bright red or gritty coffee ground blood. Usually, the bright red blood indicates any bleeding from the upper gastrointestinal tractⁱAlimentary or digestive tract. , mostly from the esophagus, stomach, or duodenumⁱFirst part of the small intestine. . Coffee-ground hematemesis occurs when the stomach acids convert hemoglobinⁱA protein found in red blood cells. to hematinⁱA discolored coffee-brown form of hemoglobin caused by gastric hydrochloric acid. (1).

Is It Normal To Vomit Blood During Pregnancy?

Vomiting blood during pregnancy is not normal, and you should see a doctor in case you are vomiting chunks of blood. It may happen when you have severe morning sickness that irritates the esophageal lining, thus leading to bleeding (2). Gastrointestinal infections or other severe diseases may also lead to blood in the vomit. Should you see blood in your vomit, visit your doctor immediately for a proper diagnosis and remedy.

Vicina Lucinda, a mother of two, talks about her experience of vomiting blood while she was pregnant, “The nausea was quite intense, and I couldn’t sleep sometimes because of it. One day, I had to throw up, and I also threw up blood, and that scared me. I called my midwife the next day just to be sure, and she said that I had to keep an eye on it, but it was very common (ⅰ).’’

What Causes Hematemesis In Pregnancy?

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The causes of blood in the vomit in pregnant women are the same as that of the general population (3).

Common causes are likely to be:

• Severe gastritis or peptic ulcer: Gastritis (inflammation of the stomach lining) or peptic ulcers or stomach ulcers (painful sores in the inner stomach lining) cause a burning sensation in your tummy and damage the artery. This could lead to blood vomiting. Stomach ulcer during pregnancy is characterized by the erosion of the protective lining of the digestive system due to a bacterial infection.

• Esophageal varices: These are the enlarged veins in the lower esophagus (food pipe), which bleed but may not cause any pain. They could be caused due to elevated blood pressure (hypertension or preeclampsia) or alcoholic liver disease (liver is damaged due to long term alcohol exposure). If the doctor suspects this, that doctor may ask you to get admitted to the hospital immediately.

• Esophageal irritation: Prolonged retching can irritate the esophageal lining, resulting in bleeding that may appear in the vomit. Hyperemesis gravidarum (HG) is a medical condition that can lead to prolonged and intense retching. While rare, chronic and severe retching may lead to an esophageal rupture or tear. An esophageal tear occurs due to extreme pressure on the esophagus, which is not typically associated with HG. However, in extreme cases of vomiting, an esophageal tear may occur regardless of the underlying cause (4) (5).
• Gastro-esophageal reflux disease (GORD): GORD is a medical condition where stomach acids leak out from the stomach into the esophagus or food pipe. This is also known as acid reflux or reflux. Severe GORD can cause the esophageal lining to irritate and erode, resulting in bleeding (6). In expecting women, the growing uterus can increase pressure on the stomach and aggravate GORD symptoms, potentially leading to hematemesis.
• Nosebleeds: Blood volume during pregnancy increases by almost 50%, which puts pressure on the delicate blood vessels in the nose, increasing their susceptibility to rupture. Hormonal changes during pregnancy can cause nasal congestion, which can further increase the likelihood of nosebleeds. Swallowing blood from a nosebleed may result in vomiting blood during pregnancy (7) (8).
• Pregnancy gingivitis: During pregnancy, changes in estrogen and progesterone levels can make gums more sensitive to bacteria in plaque, leading to red, swollen, or bleeding gums. If a pregnant woman swallows this blood, it is possible that some of this swallowed blood appears as a part of the vomit during an episode of regurgitation (8) (9).
• Mouth and throat irritation: Frequent or excessive vomiting can irritate the lining of the mouth or throat, resulting in minor bleeding, which may show up as traces of blood in the vomit (8) (10). If you notice streaks of fresh blood or dark, dried blood in your vomit, it might be due to bleeding in your throat or mouth.

Less common causes are likely to be:

• Swallowing poisons such as arsenic or corrosive acids
• Cancer of the stomach or esophagus
• Blood conditions such as thrombocytopeniaⁱA condition in which the platelet count is lower than normal, i.e., 150000/microliter (for adults). , hemophiliaⁱA bleeding disorder in which the blood does not clot properly. , leukemiaⁱA form of blood cancer that begins in the bone marrow. , and anemia

Quick fact

Some medications, such as aspirin, anti-inflammatory painkillers, and anticoagulantsⁱA drug also known as blood thinner that helps prevent and treat blood clots. , may cause blood vomiting (3).

Signs And Symptoms That May Accompany Blood Vomiting

Along with blood in the vomit, you may experience some other symptoms depending on the cause of the bleeding. They could be (11):

• Nausea
• Rapid heartbeat
• Blurred vision
• Dizziness
• Confusion
• Fainting
• Clammy skin
• Reduced urine output
• Pain in upper abdomen

If any of these symptoms develop or worsen over time, reach out to your doctor to ensure timely treatment and prevent complications.

Diagnosis For Blood Vomiting During Pregnancy

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According to experts, the presence of blood in vomit during pregnancy warrants prompt medical attention. It is because self-diagnosing its precise cause is not possible, and leaving the condition unattended holds potential risks. So, it is vital to see your healthcare provider if you notice blood in your vomit.

During the examination, your doctor may ask about the color of the blood and the history of any injuries you have had in the present or past. Diagnostic tests performed during pregnancy are similar to tests performed on non-pregnant women. Only your doctor can suggest the required imaging test to diagnose the actual cause.

Some of the imaging tests you may be recommended include:

• Ultrasound scan
• X-ray
• MRI scan
• Endoscopy
• Nuclear medicine scan
• Blood tests

Did You Know?

The diagnosis of blood vomiting may also involve rectal examination, which helps evaluate hemorrhoidsⁱThe veins around the anus or lower rectum become swollen, also known as piles. , anorectal mass, stool examination, and anal fissures (12).

Complications Of Vomiting Blood

Some of the common complications of blood vomiting could be (12) (15):

• Choking is when the blood collects in the lungs and impairs your ability to breathe effectively.

• Aspiration, where vomited blood is again drawn in through airways.

• Anemia, a deficiency of red blood cells may develop when there is rapid blood loss through vomiting.

• Dehydration, where essential fluids and electrolytes are lost from the body.

To avoid these complications, pay attention when you are vomiting to check if there is blood, especially when you experience some of the symptoms mentioned above.

Treatment Of Hematemesis During Pregnancy

Management will depend on the severity of the vomiting.

In case of minimal blood loss, your doctor may prescribe medications. If there is significant blood loss, you might need a blood transfusion or a drip. In severe life-threatening cases, emergency resuscitation or a blood transfusion may be needed.

Treatment usually depends on the cause of blood vomiting. It may involve endoscopy to stop the bleeding by sealing an internal wound or emergency surgery to control severe bleeding (8).

Can You Prevent Throwing Up Blood While Pregnant?

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Nausea and vomiting are common during pregnancy, but you can take a few measures to prevent them from becoming severe (a condition called hyperemesis gravidarum) and resulting in blood vomits (13).

• Maintain personal hygiene by washing your hands frequently before handling food, after using the toilet, or after handling trash or contaminated surfaces.
• Avoid being in contact with anyone who has gastroenteritisⁱSwelling of the stomach and intestines, which results in vomiting and diarrhea. .
• It’s important to restrict the consumption of specific medications like painkillers and aspirin, as they can lead to stomach inflammation and elevate the risk of bleeding (14).
• Do not prepare or handle food if you have GI infections.
• Avoid public pools if you have infections
• Avoid raw foods and cook meat thoroughly.
• Avoid spicy foods that cause stomach irritation or acid reflux.
• Quit smoking and alcohol
• Avoid overeating
• Avoid inducing vomiting when you have too much nausea

Home Remedies To Deal With Blood Vomiting

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Vomiting blood during pregnancy may warrant strict medical supervision. Loss of blood makes your body weak, which is not good for your baby’s health. Moreover, bloody vomit also leaves an unpleasant feeling in your mouth.

Here are a few helpful remedies that might relieve you from the nauseous state in pregnancy:

1. Saline water: Your body may be depleted of fluids or undergo dehydration after recurrent vomiting. You may have to get intravenous fluids or ORS (oral rehydration solutions) that have electrolytes to gain the lost fluids and recover.

2. Drink lots of water: Consider drinking more water, fruit juices, and electrolyte solutions to recover from dehydration.

3. Eat a well-balanced diet: A proper diet gives you the right amounts of essential nutrients and minerals to keep you healthy and avoid nutritional deficiencies. You may feel nauseated when you wake up in the morning. Eating a toast or cracker might mitigate the feeling and could also offer energy.

4. Avoid oily food, eat less: Stay away from fatty or spicy foods that could trigger bouts of vomiting during pregnancy. It is better to have boiled and somewhat bland foods. Eat small portions throughout the day and avoid eating large quantities before sleeping.

5. Rest enough: Nausea due to vomiting can create stress, lack of sleep, and fatigue. Rest as much as you can and avoid stress as it could help in healthy fetal growth too (15).

Point to consider

Doctors may recommend including ginger in your diet and taking vitamin B6 supplements to reduce nausea and vomiting. Eating high-protein snacks and avoiding sensory triggers can also help (16).

Is Vomiting Blood A Sign Of Miscarriage?

Vomiting blood is not a sign of miscarriage. Vaginal bleeding, discharge, cramping, and a feeling of weakness are the usual symptoms you may experience in case of a miscarriage (17).

Infographic: Reasons Why You Might Vomit Blood While Pregnant

There are several weird pregnancy-related complications, including nausea and vomiting throughout gestation. But, if you notice blood in the vomit (hematemesis), it could indicate an underlying issue. Look at the infographic below to learn about all the possible causes that may lead to blood vomiting while pregnant.

Illustration: Momjunction Design Team

Illustration: Vomiting Blood During Pregnancy: Causes And Treatment

Image: Stable Diffusion/MomJunction Design Team

Vomiting blood during pregnancy can be a scary experience. Learn what it means, its causes and how to manage this condition, in this video.

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Reviewer Author Editor Fact Checker

Dr. Sangeeta AgrawalFRCOG, MD, DNB, DGO

Dr. Sangeeta Agrawal is an obstetrician and gynecologist with around 29 years of experience in the field. She worked in Royal London, St. Bartholomew’s, North Middlesex, and Barnet General hospitals in London and currently runs her clinic in Mumbai.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Swati PatwalM.Sc. (Food & Nutrition), MBA

Swati Patwal is a clinical nutritionist, a Certified Diabetes Educator (CDE) and a toddler mom with more than a decade of experience in diverse fields of nutrition. She started her career as a CSR project coordinator for a healthy eating and active lifestyle project catering to school children.

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Dr. Joyani DasM.Pharm, PhD

Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

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