Any mom-to-be will tell you that one of the scariest things to happen during pregnancy is to notice bleeding or spotting. And while spotting during pregnancy isn’t technically abnormal, it’s unexpected and terrifying, especially as a first-time mom. Vaginal bleeding is more common during the first trimester, but can be a sign of a complication if it’s during the second and third trimesters. Here’s a guide to the causes of bleeding during pregnancy, how to tell when it’s serious and when to call your doctor.
Bleeding During Pregnancy: First Half
Bleeding that can occur during the first half of your pregnancy is very common and due to several different factors. In fact, the American Pregnancy Association (APA) says that between 20-30 percent of women experience bleeding during early pregnancy. This type of spotting often carries no threat to the mom or baby. The APA says there are a number of possible causes of this type of bleeding, which include:
Implantation bleeding – you may experience bleeding or spotting when the egg gets implanted into the wall of your uterus. This usually occurs around four weeks into your pregnancy. If you notice a small amount of bleeding shortly after conception, implantation is the likely cause.
Sexual intercourse – as pregnancy progresses, your cervix becomes swollen because there is an increase of blood supply in that area. It’s completely common and normal to experience spotting as a result of sexual intercourse
Infection – cervical bleeding can happen for some women and it’s usually due to some type of infection or sexually transmitted disease (such as chlamydia).
Internal exam – sometimes it’s possible for a pregnant woman to bleed after a Pap smear or pelvic exam, typically done between six and 12 weeks of pregnancy. It’s nothing to worry about and usually goes away within a day.
More serious causes of bleeding that occur during the first half include: bleeding around the placenta, a chemical pregnancy, miscarriage, ectopic pregnancy or molar pregnancy.
Bleeding During Pregnancy: Second Half
Early complications and the risk of miscarriage greatly diminish or are no longer a factor after the first 20 weeks or pregnancy. But because bleeding during the second half of your pregnancy is not as common it should be taken more seriously. Causes for this type of bleeding include:
Sexual intercourse – it’s somewhat abnormal for this to still be occurring by the second half of your pregnancy.
Cervical checks – these do happen more frequently during the third trimester and can cause spotting
Placenta trivia – this is when the placenta covers the cervix, can be either partially or completely
Placental abruption – this condition is very life-threatening to both mom and baby as it results in the placenta tearing away from the wall of the uterus. According to the American Academy of Family Physicians, this is the most common cause of serious bleeding during the second half of pregnancy and only affects one percent of all pregnancies.
Preterm labor – if you experience vaginal bleeding and cramping, back pain or contractions all before 37 weeks, it could be preterm labor.
Bleeding During Pregnancy: When it’s Serious
While light bleeding or spotting is pretty normal, vaginal bleeding is not nearly as common. There are many factors to consider when trying to decide the cause: heavy or light, how long it lasts, the color and when it occurs during pregnancy. Warning signs it could be something serious include heavy bleeding (think menstrual bleeding), bleeding with cramps, a fever or bleeding that results in some tissue. You also definitely want to pay attention to the color: Bright red blood is a cause for worry.
Bleeding During Pregnancy: When to Call Your Doctor
It doesn’t matter when it occurs, if you’re experiencing vaginal bleeding (even a dime sized amount) call your doctor or midwife right away to be safe. You’ll want to pay close attention to how you feel and how much blood you’ve lost. If the bleeding causes you to feel faint or is enough to bleed through a sanitary pad, or if it doesn’t stop and causes pain or a fever, your practitioner will want to see you right away. An ultrasound is common for these types of scenarios. If the bleeding is due to a miscarriage, unfortunately there isn’t anything that can be done. But if it’s due to preterm labor or placenta previa, your doctor may place you on bed rest to prevent these complications from getting any more serious.
The old adage of “when in doubt, have it checked out” most certainly applies to bleeding during pregnancy. While the vast majority of cases can be attributed to a normal cause that comes and goes, often there are serious complications that need to be addressed. At any point of your pregnancy it’s better to be safe than sorry, and knowing the cause can ease your worried mind so that you can focus on safely delivering your baby.