Bleeding During Pregnancy

Why am I bleeding during pregnancy?

It’s common to have bleeding or spotting (light bleeding) during pregnancy. This is especially true in the first trimester. Bleeding during pregnancy can happen for many reasons. It doesn’t mean something is wrong or that you should panic. But it could be a sign of something more serious. That’s why it’s always a good idea to contact your pregnancy care provider if you have vaginal bleeding at any time during pregnancy. They’re the best person to determine if the bleeding is normal or if you need further tests. In the meantime, try to stay calm until you talk to your provider. Many people who experience bleeding during pregnancy have healthy pregnancies and deliver healthy babies.

Bleeding vs. spotting in pregnancy

Spotting is when you notice a few drops of pink, red or dark brown blood. You see it in your underwear or on toilet paper when you wipe. If you put a panty liner on, the blood won’t fill it. Spotting during pregnancy, especially in the first trimester, is usually not concerning.

Bleeding describes a flow of blood that’s greater than a drop here and there. The amount of blood requires you to wear a pad or panty liner to keep it from ruining your underwear.

You should call your pregnancy care provider either way and tell them about it. They may want to schedule an appointment to confirm everything is OK.

What are the most common causes of bleeding in the first trimester?

Bleeding or spotting in the first trimester is common. Between 15% and 25% of all pregnant women experience bleeding or spotting in the first 12 weeks of pregnancy. Even though it’s common, you should still call your healthcare provider to let them know.

Some causes of bleeding in the first trimester of pregnancy are:

• Implantation bleeding: This is when the fertilized egg implants in the wall of your uterus and causes light bleeding.
• Hormonal changes: The extra hormones you need for pregnancy can sometimes lead to spotting.
• Changes to your cervix: Your cervix may be more sensitive as it changes and prepares for pregnancy. This could lead to bleeding more easily.
• Ectopic pregnancy: When a pregnancy forms outside of your uterus (like in your fallopian tubes). It can be life-threatening without treatment.
• Molar pregnancy: A rare condition when a fertilized egg implants in your uterus, but a tumor forms instead of a fetus.
• Subchorionic hematoma: Blood forms between the amniotic sac and your uterine wall. It typically goes away without causing complications.
• Cervical polyps: A noncancerous growth on your cervix that bleeds in pregnancy due to higher estrogen levels.
• Infection: Chlamydia, gonorrhea and other sexually transmitted infections (STIs), or urinary tract infections (UTIs) can cause light bleeding. Your healthcare provider will prescribe antibiotics to treat these infections.
• Miscarriage: The loss of the pregnancy before 20 weeks. It usually starts as light bleeding and gets heavier. Most people also experience strong cramping.

What are the most common causes of bleeding in the second or third trimester?

Bleeding in the second or third trimesters is less common and may be a sign of a more serious condition. Contact your healthcare provider immediately so they’re aware of your symptoms.

Some conditions that can cause bleeding in the second and third trimesters are:

• Placenta previa: When the placenta covers all or part of your cervix.
• Placental abruption: A rare condition where the placenta detaches from the wall of your uterus. This can be dangerous for both you and the fetus.
• Preterm labor: Going into labor earlier than 37 weeks of pregnancy. Other symptoms of preterm labor are contractions, cramping or your water breaking.
• Labor: Going into labor after 37 weeks can cause you to bleed, too.
• Incompetent cervix: When the cervix opens (dilates) too early.
• Bloody show: Light bleeding mixed with mucus that occurs toward the end of your pregnancy. It can be a sign of labor.
• Miscarriage: A loss of the pregnancy before 20 weeks. A stillbirth occurs when you lose the pregnancy after 20 weeks.

What are other causes of bleeding during pregnancy?

Other causes of bleeding during pregnancy that aren’t related to health conditions are:

• Sex: Some people experience light bleeding after sexual intercourse. This is due to the blood vessels in your cervix receiving more blood flow and being more fragile.
• Pelvic exam or ultrasound: Your cervix can bleed after a pelvic exam or transvaginal ultrasound.
• Pap test: Your pregnancy care provider may perform a Pap smear in your first trimester of pregnancy. This can cause you to bleed a little bit afterward.
• Injury or trauma: Falling or taking a blow to your abdomen could cause placental abruption.

How much bleeding is normal in early pregnancy?

Bleeding in early pregnancy is common, but it usually doesn’t mean anything is wrong. However, you should still let your healthcare provider know, especially if you’re unsure if it’s spotting or bleeding. There are several causes of spotting that aren’t worrisome, but some are.

Can you bleed in early pregnancy and not miscarry?

Yes. Many causes of bleeding in early pregnancy don’t cause a miscarriage.

Is period-like bleeding during pregnancy normal?

Bleeding that resembles your period isn’t typical during pregnancy. Bleeding isn’t always a sign that something is wrong, but heavy bleeding may mean there’s a complication.

What does vaginal bleeding during pregnancy look like?

Bleeding during pregnancy can look different for everyone. Your pregnancy care provider will want to know what your blood looks like. Some details you’ll want to track include:

• The color of your blood: Is your blood brown, pink or bright red?
• The consistency of your blood: Is it smooth, thick or watery? Does it contain clots or mucus?
• How much blood there is: Did you see a few drops? Does it happen only when you wipe? Or are you filling a pad?

These details can help your provider determine the level of care you need and how urgent your symptoms are. It’s always a good idea to call your provider so they can determine if the bleeding is serious.

How is bleeding during pregnancy treated?

Your pregnancy care provider may want to perform an ultrasound and physical exam to determine the cause of the bleeding. They may order blood tests, too.

Some treatments for vaginal bleeding during pregnancy can include:

• Relaxing and staying off your feet.
• Drinking lots of water.
• Avoiding sex.
• Avoiding travel.
• Staying in the hospital if the bleeding is severe.

It’s always best to follow the recommendations of your healthcare provider. In most cases, they’ll recommend more rest. Avoiding things like vigorous exercise or lifting heavy objects can also help. You should use a panty liner or pad to contain the bleeding.

When does spotting stop in pregnancy?

Spotting during pregnancy is most common in the first trimester, but it’s possible to spot in the second and third trimesters, too.

When should bleeding during pregnancy be treated by a doctor?

Your pregnancy care provider should know of any bleeding or spotting during pregnancy. Even if it’s not serious at that moment in your pregnancy, they’ll want to take notes of your symptoms.

Call your provider right away if you experience any of the following, more serious symptoms:

• Heavy bleeding. This means you’re filling a pad every few hours.
• Cramping or contractions.
• Pelvic pain or pain in your abdomen.
• Dizziness or fainting.
• Fever or chills.
• Other signs of preterm labor like your water breaking.

If your provider’s office is closed, you should go to the nearest emergency room (ER).

What questions should I ask my provider about bleeding during pregnancy?

Bleeding during pregnancy can be scary. It’s natural to have questions for your healthcare provider. Some questions to ask your provider are:

• When should I be concerned about bleeding?
• How do I know if I’m bleeding too much?
• Should I avoid having sex if I’m bleeding?
• Do I need to reduce my activity if I’m bleeding?
• When should I go to the ER?

What questions will my provider ask me about bleeding during pregnancy?

Your healthcare provider may ask you several questions to find the cause of your vaginal bleeding. Some questions you may need to answer are:

• Have you had vaginal bleeding in prior pregnancies?
• Have you had prior surgeries on your uterus or cervix?
• How heavy is your bleeding?
• Does the blood fill a panty liner?
• What color is the blood?
• Does the blood contain clots or tissue?
• Do you have any pain or cramping?
• Have you been exercising or standing more?
• Have you fallen lately?
• When did you last have sex? Did you bleed afterward?