Bleeding During Pregnancy: What’s Normal and What’s Not

No one tells first-time moms-to-be, but some spotting during pregnancy is common. Research has shown that as many as 25% of women may experience spotting in the early stages (first trimester) of their pregnancy, and it’s often nothing to worry about. However, bleeding can also occur for concerning medical issues such as infections or tears to the vaginal wall.

My passion as an OB/GYN specialist in Burbank, California is to offer women the best healthcare possible for their unique needs, and that includes education regarding the issues they may experiences while pregnant. That’s why I take time to discuss the possibility of spotting with my patients.

Because bleeding during pregnancy can signal a serious medical condition, I urge you to contact your obstetrician right away if you notice even minor spotting.

What causes bleeding during pregnancy?

Common causes of bleeding during the first 12 weeks of pregnancy include issues such as implantation bleeding. This temporary, and normal, bleeding occurs when an embryo “implants” or attaches to your uterine lining.

Implantation typically happens 6-12 days after the egg is fertilized and may cause slight bleeding that lasts for a few hours to a few days. You may even mistake this bleeding for a light period and assume you’re not pregnant.

Cervical changes can also cause spotting during pregnancy. The cervix is the rigid structure at the neck of your uterus where it connects with the vagina. It’ shaped something like a donut and normally has a very small hole in the center that allows sperm to pass through to the uterus.

When you become pregnant, the cervix enlarges and softens as blood flow to the region increases. It also forms a mucus plug that closes off the opening until it’s time to deliver. Sexual intercourse, a Pap test, or other forms of external contact with the cervix can cause light bleeding.

Yeast infections, which are common during pregnancy, may also cause spotting as your vaginal tissue becomes inflamed and irritated as it reacts to the infection. Bacterial infections such as those from gonorrhea and other sexually transmitted diseases can cause bleeding during early pregnancy as well.

Does an ectopic pregnancy cause bleeding?

With an ectopic pregnancy, the embryo implants outside of the uterus, usually in one of your fallopian tubes. If the embryo continues to grow, it eventually ruptures the fallopian tube, which can cause internal bleeding.

Vaginal bleeding is sometimes the only sign of an ectopic pregnancy. You may also experience one-sided abdominal or pelvic pain that can come and go or remain constant. Weakness, dizziness, or fainting can also occur due to blood loss.

The symptoms of an ectopic pregnancy might start before you realize you’re pregnant but can also occur following a positive pregnancy test. The pregnancy cannot survive if the embryo implants outside the uterus, and you require immediate medical care to help prevent the sometimes life-threatening complications associated with an ectopic pregnancy.

What are the symptoms of a miscarriage?

Miscarriage is more likely to occur during the first trimester and may be the possibility women fear most when they notice vaginal bleeding during pregnancy. It’s important to note that not all vaginal bleeding indicates you’re having a miscarriage, but it is one of the symptoms.

Other symptoms that may accompany a miscarriage include cramping lower abdominal pain and clumps of tissue noted in the vaginal blood. Regardless of the severity of your bleeding or accompanying symptoms, it’s important to contact your OB/GYN at the first sign of any bleeding or spotting during pregnancy.

What causes bleeding later in pregnancy?

Bleeding later in pregnancy is sometimes caused by problems with the placenta, the organ that connects your baby to the uterine wall. It may also signal preterm labor. If you’re near your due date, a bloody discharge may signal the release of the cervical mucus plug and your body’s preparation for labor and delivery. I instruct my patients to call me immediately or go to the hospital if necessary for any bleeding that occurs late in pregnancy.

What problems with the placenta cause bleeding during pregnancy?

Placental abruption is one issue that may cause bleeding and is caused when the placenta detaches from the uterine wall before or during birth. Symptoms of placental abruption often include vaginal bleeding and lower back and abdominal pain.

Placenta previa can cause vaginal bleeding that often occurs without pain. Placenta previa happens when the placenta lies low in the uterus and partially or completely covers the cervix. This condition sometimes resolves on its own by 32–35 weeks of pregnancy. If it does not, you may require early delivery with a cesarean section.

Regardless of the reason for bleeding during pregnancy, your best source of information and treatment is your OB/GYN. When the cause of your bleeding isn’t worrisome, a visit with your provider can allay your fears and ease your emotional stress. Even when your bleeding is due to a more troublesome issue, early care can often result in a healthy pregnancy and delivery.

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