Pregnancy Bleeding: What’s Normal, What’s Not?

With your body going through so many changes during pregnancy, it’s no surprise that most women are constantly reaching for the phone to give their doctor a call. It can be difficult to know what’s serious and what’s just another symptom, so keep reading for everything you need to do about vaginal bleeding while pregnant—because it’s not all serious. 

Vaginal Bleeding in the First Trimester

During the first trimester, vaginal bleeding is actually pretty common—in fact, it occurs in about 20% of pregnancies, and most of those women go on to have perfectly healthy pregnancies. The most important thing to know is the difference between light and heavy bleeding, and when to call your doctor

For starters, there’s a big difference between spotting and bleeding. The term “spotting” refers to a few drops of blood—not enough to cover a pad or panty liner. You may already be familiar with spotting from your period days! Bleeding, on the other hand, means a blood flow that’s heavy enough to require wearing a pad. If actual bleeding occurs during your trimester, wear a panty liner or pad so you can get a clear idea of exactly how much you’re bleeding so you can tell your doctor. Remember that you shouldn’t use a tampon or douche while you’re pregnant. 

Causes of Vaginal Bleeding in the First Trimester

Implantation bleeding occurs when the fertilized egg implants in the lining of the uterus. This typically happens around the time of your expected period, so sometimes you don’t even know you’re pregnant yet. 

Hormone production during pregnancy can change and soften your cervix, making it more likely to bleed during pregnancy. You could also have a cervical polyp, or benign overgrowth of tissue, that can bleed easily. You could experience some spotting or light bleeding after sexual intercourse, or after a pelvic examination. A vaginal infection could cause some vaginal bleeding as well, and is usually accompanied by an abnormal vaginal discharge. 

Vaginal bleeding could also be a sign that you have an ectopic pregnancy, which occurs when the fertilized egg implants outside of the uterus, usually within one of the fallopian tubes, where the blood supply isn’t enough to sustain a normal pregnancy. About one in every 60 pregnancies is ectopic. The most common signs are increasing abdominal pain, the absence of menstrual periods, and spotting. About half of women with an ectopic pregnancy won’t have all three signs, so if you notice any of them it’s a good idea to talk to your doctor.

If you’re experiencing heavy vaginal bleeding during your first trimester, it could be something serious. Bleeding, abdominal pain, and back pain are all common signs of a miscarriage, which occurs in 15-20% of all pregnancies, usually during the first 12 weeks of gestation. A threatened miscarriage could also cause vaginal bleeding and milk cramping—the difference is that in a threatened miscarriage, the cervix remains closed and the fetus is still viable. In many women, the bleeding stops and they go on to have healthy pregnancies. Unfortunately for some, the bleeding doesn’t stop and a miscarriage occurs. 

A molar pregnancy, or gestational trophoblastic disease, is an abnormality of fertilization that results in the growth of abnormal tissue in the uterus. This tissue mimics the typical symptoms of early pregnancy, even though there’s no fetus. In a “partial mole,” the abnormal tissue is growing alongside the fetus, which results in severe birth defects. A molar pregnancy cannot result in a normal pregnancy, or a normal delivery. A sonogram or ultrasound is needed to diagnose a molar pregnancy. 

When blood collects between the gestational sac and the wall of the uterus, a subchorionic hemorrhage occurs. Your body frequently reabsorbs clots like these, but sometimes you may experience a passage of old, dark blood or even small clots from your vagina. 

While the causes of bleeding are varied in their severity, if your vaginal bleeding is heavy you should call 911, and go to the emergency room. 

Second and Third Trimester Vaginal Bleeding

While light vaginal bleeding is fairly common during your first trimester, it’s more serious in your second and third trimesters. Like the first trimester, however, sometimes having sex or a pelvic examination can cause light bleeding. Problems with your cervix, like cervix insufficiency or infection can also lead to bleeding. 

Some more serious causes of bleeding and heavy bleeding later in pregnancy include placenta previa, preterm labor, uterine rupture, or placental abruption. 

Any time you notice bleeding at any stage of pregnancy, it’s reasonable to call your doctor—even if it’s light bleeding, it could be a sign of some serious problems to come. If you’re experiencing heavy bleeding accompanied by pain or cramping, seek immediate medical attention. 

For more of what you need to know, call the maternity experts at RMC today.