Contrary to how it may seem, bleeding during pregnancy is actually common. About 25% of pregnant women experience some form of bleeding or spotting during pregnancy. This doesn’t always indicate there is an issue, but it should be monitored. This could be a sign of complications or a miscarriage before 20 weeks of pregnancy. Keeping in contact with your healthcare provider during this time will help you navigate bleeding during pregnancy.

Bleeding Vs Spotting: What’s the Difference?

Spotting is considered light bleeding. This might mean a few drops of blood at a time. Spotting during early pregnancy is normally not a concern. However, if the blood is heavy enough to cover a panty liner, that is considered ‘bleeding’. This type of flow is usually heavy enough to soak your clothes. Talk to your healthcare provider about heavier bleeding. They may want to set up an exam or perform an ultrasound to determine if the cause is something underlying. 

Why Do You Bleed During Pregnancy?

Bleeding during pregnancy can be an indicator of a lot of things. At some point during your pregnancy, you may experience bleeding or spotting. This happens for many reasons – commonly in the first trimester. Although, bleeding can also be a sign of an underlying issue or complication. If you are experiencing any symptoms of the sort, it’s a good idea to share them with your healthcare provider so they can help you determine if this is something to look into. But! No reason to panic, many women experience bleeding during pregnancy and go on to have a seamless birth and healthy baby. 

If you start to experience any kind of bleeding during pregnancy, call your healthcare provider. In the meantime here are a few to help your healthcare provider have the most information about the situation:

• Check the color of the blood. Blood can vary in color. Take note if you are experiencing bright red, dark or brown blood. 
• Keep track of how heavy the flow is. Does it fluctuate between heavy and light? How many pads or panty liners have you used?
• Make sure to avoid tampons, douches and intercourse when you are bleeding during pregnancy. 

If you start to experience any of the following, call your healthcare provider immediately or go to the emergency room:

• Bleeding with pain or cramping
• Very heavy bleeding
• Pain in your abdomen or pelvis
• Bleeding and dizziness

Bleeding and Spotting In The First Trimester

Spotting or bleeding in the first trimester is fairly common and normally doesn’t indicate a major issue. There are many reasons you might experience this in the first trimester. Some of those reasons could be: 

• Implantation – this means the fertilized egg is starting to attach itself to the lining of the uterus to begin growing
• Hormone fluctuations
• Intercourse
• Changes in the cervix
• An Infection – infections such as gonorrhea, chlamydia, UTIs, and other STIs can cause light bleeding and need to be treated by your healthcare provider
• Problems in relation to smoking. Smoking should be avoided during pregnancy
• Certain tests during pregnancy. CVS and amniocentesis for example. These tests are done to check for genetic abnormalities in your baby that affect the baby’s genetics. Some genetic abnormalities passed down to the baby from mom or dad can cause health problems.
• Cervical polyps – a benign growth on the cervix that can bleed during pregnancy. Normally due to increased estrogen levels

Other times, bleeding can be a symptom of a much larger problem. Some of those issues can be:

 

• Ectopic pregnancy: this is when a pregnancy starts to form outside of the uterus, for instance, the fallopian tubes. This can not only be serious, but life-threatening. An ectopic pregnancy cannot result in the birth of the baby
• Molar pregnancy: this condition is rare but possible. This is when a fertilized egg implants in your uterus, but instead of a baby forming – it becomes a tumor/mass tissue
• Subchorionic hematoma: this is when one of the membranes that surround the embryo inside your uterus. This can also resolve on their own
• Miscarriage: this is the loss of pregnancy before 20 weeks. Miscarriages can start with light bleeding and then gets heavier over time accompanied by severe cramping.

Bleeding and Spotting in the Second or Third Trimester

Bleeding after the first trimester is often caused by a more serious condition. If you start to bleed in the second or third trimester, speak to your healthcare provider so they’re aware of your symptoms and can help you plan what to do next. 

Here are a few reasons that you might be bleeding during your second and third trimester:

Placental Abruption: this is a rare condition but can be very dangerous for both the mother and the fetus. This is when the placenta detaches from the wall of the uterus. 

Placenta Previa: this is another rare condition that is even more rare after 20 weeks of pregnancy. This is when the placenta covers all or part of your cervix.

Placenta Accreta: this happens when the placenta grows deep into the wall of the uterus

Uterine Rupture: this is a rare occurrence when the uterus tears during labor. This can happen if you have previous scarring from a poor c-section birth for instance. 

Incompetent Cervix: this is when the cervix opens too early and causes premature labor.

Preterm Labor: this can be defined by other symptoms other than bleeding like, cramping, contraction or rupturing membranes. In addition, bleeding can be a sign of premature labor which is defined as labor occuring earlier than 37 weeks. 

Bloody Show: this means the bleeding is mixed with mucus. This normally happens at the end of the pregnancy and is a sign that the body is preparing for labor.

Miscarriage: however, a miscarriage after the 20th week of pregnancy is normally labeled a stillbirth.

How Much Bleeding Is Normal In Pregnancy?

Early on in pregnancy, spotting is often a normal symptom and nothing to be overly concerned with. Regardless of how common it is, it’s important to let your healthcare provider know and ensure there isn’t more to take into consideration. 

Although spotting or bleeding can look different for everyone, if, at any time during your pregnancy you start to experience bleeding that resembles menstruation contact your healthcare provider right away. Menstruation type bleeding meaning: a steady flow of blood that lasts several days. At no point should that bleeding also be accompanied by pain. 

When talking to your healthcare provider, take note of what the blood looks like so they can help you evaluate your symptoms. Some details could include: 

• The consistency of your blood. Is it thick or more watery? Is the flow accompanied by clots?
• The color of your blood. Is the blood more pink or red? Maybe it’s more of a brown color?
• The amount of blood. Is it a few more drops than normal? Are you filling a panty liner or pad?

Details like these will help your healthcare provider figure out the level of care you might need at the time and how urgent your situation could be. 

Is Bleeding and Spotting Treated?

Treatment is entirely based on the situation. Depending on what caused the bleeding, and the symptoms surrounding the bleeding will all determine if treatment is necessary. At times, healthcare providers might use medical exams and tests to help determine their next recommendation. 

There are many times that the treatment recommended is just rest. Aside from rest, common treatments could also be:

• Medication to help protect the baby from Rh disease. A disease that means the baby and the mother’s blood are incompatible. 
• Time off work and bedrest
• Heavy bleeding may mean a hospital stay or surgery
• Avoiding douches, tampons and sex

When it comes to bleeding during pregnancy, it is best to follow the recommendations from your doctor. Try to avoid activities like rigorous movement and exercise and use a pad or panty liner to help contain the bleeding.

 

Bleeding During Pregnancy? Call Rosh Maternal and Fetal Medicine for Complete Access Obstetric Care

Here at Rosh Maternal & Fetal Medicine, we’re committed to making sure all our expectant moms can reach us any time of day and any day of the week to report potential problems, discuss pressing concerns, or ask a simple question.

As such, you can always get in touch with one of our experienced obstetricians for prompt advice if you happen to experience spotting or bleeding during any trimester.

To learn more, call our Manhattan, New York City office today, or use the easy online tool to schedule a visit with one of our board-certified obstetricians.