Bleeding during pregnancy is common, especially in the first trimester. Most of the time, it is no cause for concern. However, since bleeding can sometimes be a sign of something serious, it is important to be aware of the possible causes and consult your doctor to ensure that both you and your baby are in good health.
Bleeding in the First Trimester
Is bleeding in the first trimester normal?
Up to 25% of women experience vaginal bleeding during the first 12 weeks of pregnancy. In most cases, this is normal and no cause for concern. Many women who experience bleeding during this period go on to have normal pregnancies and give birth to healthy babies.
Bleeding—or spotting—during pregnancy is generally not a cause for concern. However, heavier bleeding that soaks through a panty liner or sanitary pad is not normal. Call your doctor immediately to report any bleeding you experience during the first trimester. Your doctor will help fix the cause and guide you on the steps to take to maintain the health of both you and your baby.
What causes bleeding in the first trimester?
Likely causes of bleeding in the first trimester include the following:
Implantation bleeding. You may experience normal bleeding during the first 6 to 12 days after conception, as the fertilised egg implants in the coating of the uterus. Some women do not realise they are pregnant, as they mistake this bleeding for a light menstrual period. Often, the bleeding is very light and lasts anywhere from a few hours to a few days.
Miscarriage. Since miscarriage is most common during the first 12 weeks of pregnancy, it is often one of the biggest concerns during the first trimester. However, bleeding in the first trimester does not necessarily mean that you are having a miscarriage or that you are going to have one. According to research, if a fetal heartbeat is detected via ultrasound, the likelihood of experiencing a miscarriage is lower.
Other symptoms of a miscarriage include severe pain in the lower abdomen and the expulsion of tissue through the vagina.
Ectopic pregnancy. In an ectopic pregnancy, the fertilised embryo implants—or attaches itself—outside the uterus, typically in the fallopian tube. If the embryo remains to grow, it can cause the fallopian tube to disagreement, which can be serious to the mother. Although an ectopic pregnancy can be dangerous, it occurs in approximately 2% of pregnancies.
Other symptoms of an ectopic pregnancy comprise severe pain or hampering in the lower abdomen and dizziness.
Molar pregnancy. Similarly called gestational trophoblastic disease, this is a actual rare condition in which abnormal tissue grows inside the uterus in its place of a baby. In rare cases, the tissue is carcinogenic and can meal to other parts of the body.
Other symptoms of a molar pregnancy include severe nausea and vomiting. Your abdomen may also grow very rapidly as the size of the uterus increases.
Other causes of bleeding early in pregnancy include:
Cervical changes. During pregnancy, a greater volume of blood flows to the cervix. Sexual intercourse or a Pap smear—both of which involve contact with the cervix—can trigger bleeding. This type of bleeding is not a cause for concern.
Infection. Any infection of the cervix or vagina, or a sexually transmitted impurity (such as chlamydia, gonorrhoea, or herpes), can cause bleeding during the first trimester. You will need medical treatment if you have an infection.
Smoking. Smoking can cause abnormal bleeding during pregnancy. Talk to your doctor for support if you are pregnant and wish to quit smoking.
Subchorionic hematoma. This occurs when blood collects in the area where the baby’s amniotic sac attaches to the uterine wall. This blood collection usually resolves on its own without causing symptoms, although it can sometimes lead to mild bleeding.
Bleeding in the second and third trimesters
Abnormal bleeding later in pregnancy can be more serious, as it could indicate a problem related to you or your baby. Call your doctor as soon as possible if you experience any bleeding during the second or 3rd trimester.
What causes bleeding in the next and third trimesters?
Likely causes of bleeding later in pregnancy include:
Placenta previa. This disorder occurs when the placenta is positioned in the lower part of the uterus and partially or completely covers the initial of the birth canal. Placenta previa is very uncommon in the late third trimester, occurring in approximately 1 in 200 pregnancies. Bleeding caused by placenta previa—which may be painless—constitutes a medical emergency requiring immediate medical attention.
Placental Abruption. In approximately 1% of pregnancies, the placenta separates from the uterine wall before or during labour, causing blood to accumulate between the placenta and the uterus. Placental abruption can be very dangerous for both the mother and the baby.
Other signs and symptoms of placental abruption contain abdominal pain, vaginal bleeding, uterine pain, and back pain.
Uterine Rupture. In rare cases, a scar from a earlier cesarean section may tear during pregnancy. Uterine rupture can be life-threatening and needs an emergency cesarean section.
Other symptoms of uterine rupture include pain and abdominal tenderness.
Vasa Previa. In this very rare disorder, the developing baby’s blood vessels—located in the umbilical cord or placenta—cross over the opening to the birth canal. Vasa previa can be very dangerous for the baby, as the blood vessels may rupture, causing the baby to suffer severe haemorrhage and oxygen loss.
Other signs of vasa previa include an abnormal fetal heart rate and excessive bleeding.
Premature Labor. Vaginal bleeding in the late stages of pregnancy may be a sign that your body is preparing for labour. A few days or weeks before labour begins, the mucus plug covering the opening of the uterus will pass through the vagina; it often contains a small amount of blood (known as “passing the mucus plug” or “bloody show”). If bleeding and labour symptoms begin before the 37th week of pregnancy, contact your doctor immediately, as you may be experiencing premature labour.
Other symptoms of premature labour include contractions, vaginal discharge, abdominal pressure, and lower back pain.
Other causes of bleeding in the late stages of pregnancy include:
- Injuries to the cervix or vagina
- Polyps
- Cancer
What to Do if You Take Abnormal Bleeding During Pregnancy
Since vaginal bleeding in any trimester can be a sign of an underlying problem, call your doctor. Use a sanitary pad to help track the amount of bleeding, and observe the appearance of the blood (for example: pink, brown, or red; fluid or containing clots). Bring any tissue you pass through the vagina to your doctor for examination. Do not use tampons or have sexual intercourse while the bleeding persists.
Your doctor may recommend resting as much as likely and avoiding exercise and travel.
You will likely undergo an ultrasound to determine the underlying cause of your bleeding. Often, vaginal and abdominal ultrasounds are performed together as part of a comprehensive examination.
Heavy Bleeding During Pregnancy
Heavy bleeding during pregnancy is not normal. You can determine if you are bleeding heavily if you need to change your sanitary pad every 1 or 2 times, or if you pass blood clots the size of a sector or larger. Call your doctor directly if you experience heavy bleeding at any time during your pregnancy.
When to Go to the Emergency Room
Go immediately to the emergency room or call 911 if you experience any of the following symptoms, which could be signs of a miscarriage or another serious problem:
- Severe pain or intense cramping in the lower abdomen
- Heavy bleeding, with or without pain
- Vaginal discharge containing tissue
- Dizziness or fainting
- Fever of 100.4°F or advanced and/or chills
Takeaways
Bleeding during pregnancy does not always mean there is a problematic with you or your baby. Spotting or light bleeding throughout the first trimester is usually normal and resolves on its own. However, heavy bleeding—with or without other symptoms—could be a sign of a serious problem. Keep a record of the colour, amount, and duration of the bleeding. Call your doctor if you experience bleeding at any point throughout your pregnancy.
Frequently Asked Questions About Bleeding During Pregnancy
How much bleeding is considered normal early in pregnancy?
Spotting—or a few drops of blood that may not even be noticeable on a panty liner—is usually normal early in pregnancy. Light bleeding—which may cause you some concern—typically resolves on its own and is not a cause for worry. Always contact your doctor if you are concerned about the amount of vaginal bleeding you are experiencing.
Is bleeding during pregnancy an emergency?
Sometimes, but not always. Bleeding can be a sign of an alternative, especially if accompanied by other symptoms, such as abdominal pain, tenderness, passing blood clots or vaginal tissue, fever, dizziness, or collapsing. Call 911 or go to the emergency room if you are bleeding and experience any of these symptoms.
Is it possible to have heavy bleeding and still be pregnant?
Yes, it is possible to have heavy bleeding and still be pregnant. Heavy bleeding does not always mean you are having a miscarriage. It could be a sign of premature labour or another serious problem requiring instant medical attention to safeguard your health and that of your baby.
Can bleeding during pregnancy affect the baby?
Bleeding during pregnancy can distress the baby, depending on the underlying cause. Your doctor will examine you to regulate the source of the bleeding and provide the most appropriate care for you and your baby.
Can stress cause vaginal bleeding?
More research is needed to confirm this with certainty. However, stress during pregnancy can cause problems such as high blood pressure, premature birth (birth before 37 weeks), or the baby being born with low birth weight (fewer than 5 pounds, 8 ounces). Talk to your doctor if you feel stressed. Managing stress during pregnancy can help keep both you and your baby healthy.