Bleeding during pregnancy is common, especially during the first trimester, and usually it’s no cause for alarm. However, bleeding that occurs in the second and third trimester of pregnancy can often be a sign of a possible complication.
Bleeding can be caused by a number of potential reasons.
Is it normal to have bleeding during pregnancy?
Light bleeding during pregnancy is common, especially in early pregnancy. Around 1 in 4 pregnant women have some light bleeding very early in the first trimester. But even if the bleeding seems to have stopped, call your healthcare provider right away, just to make sure everything is okay.
Bleeding is probably from something minor, but it could also be a sign of a serious problem, such as an ectopic pregnancy, a miscarriage, or problems with the placenta.
Causes of bleeding in early pregnancy
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Implantation bleeding:
Some women have spotting even before they know they’re pregnant, about a week or so after they ovulate. It’s called “implantation bleeding” because it happens when the fertilized egg burrows into the blood-rich lining of the uterus, a process that starts just six days after fertilization.
If you have a day or two of spotting in the week before your period is due, take a home pregnancy test. If the result is negative, wait a few days or a week. When your period doesn’t start when you expect it, try testing again.
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Miscarriage:
Because miscarriage is most common during the first 12 weeks of pregnancy, it tends to be one of the biggest concerns with first trimester bleeding. However, first trimester bleeding does not necessarily mean that you’ve lost the baby or going to miscarry. In fact, if a heartbeat is seen on ultrasound, over 90% of women who experience first trimester vaginal bleeding will not miscarry.
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Ectopic pregnancy:
Bleeding also can be a sign of an ectopic pregnancy – when the embryo implants outside the uterus, usually in one of the fallopian tubes. Sometimes bleeding is the only sign, but other common symptoms include abdominal, pelvic, or shoulder pain.
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Molar pregnancy:
Also called gestational trophoblastic disease is a very rare condition in which abnormal tissue grows inside the uterus instead of a baby. In rare cases, the tissue is cancerous and can spread to other parts of the body.
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Infection:
Any infection of the cervix, vagina, or a sexually transmitted infection (such as chlamydia, gonorrhea, or herpes) can cause bleeding in the first trimester.
Can having sex cause bleeding during pregnancy?
Yes, you might notice some spotting or light bleeding after sexual intercourse or a pelvic exam. More blood flows to your cervix during pregnancy, so it’s not unusual to notice spotting after intercourse, a Pap smear, or an internal exam. A cervical polyp (a benign growth on the cervix) can also cause spotting or bleeding after sex or an exam.
Causes of vaginal bleeding in Second & Third trimester
Placental Abruption:
Vaginal bleeding may be caused by the placenta detaching from the uterine wall before or during labor. Only 1% of pregnant women have this problem, and it usually occurs during the last 12 weeks of pregnancy.
Placenta Previa:
Placenta previa occurs when the placenta lies low in the uterus partly or completely covering the cervix. It is serious and requires immediate care. It occurs in 1 in 200 pregnancies. Bleeding usually occurs without pain.
Preterm Labor:
Vaginal bleeding may be a sign of labor. Up to a few weeks before labor begins, the mucus plug may pass. This is normally made up of a small amount of mucus and blood. If it occurs earlier, you could be entering preterm labor and should see your physician immediately.
What to Do If You Have Abnormal Bleeding During Pregnancy
Because vaginal bleeding in any trimester can be a sign of a problem, call your doctor. Wear a pad so that you can keep track of how much you’re bleeding, and record the type of blood (for example, pink, brown, or red; smooth or full of clots). Bring any tissue that passes through the vagina to your doctor for testing. Don’t have sex while you are still bleeding.
