Bleeding During Pregnancy: What's Normal?

Bleeding During Pregnancy: What's Normal?

Most moms-to-be can agree that one of the incidental perks of pregnancy is not having to deal with a regular menstrual cycle. No unexpected early starts, no heavy bleeding, no expensive feminine hygiene products — in short, it’s a something of a dream come true.  

But even though you won’t have to bother with your period for nine whole months, you may be one of the many pregnant women who experience vaginal spotting or light bleeding from time to time.

Vaginal bleeding during pregnancy is relatively common, especially in the first trimester. In fact, it’s estimated that up to 30% of women experience spotting or light bleeding within the first 12 weeks of pregnancy.

Although any amount of vaginal bleeding can be alarming when you’re expecting, it isn’t necessarily a sign that something’s wrong. But even if you only experience light bleeding that stops soon after it starts, give us a call so we can make sure all is well.  

Spotting versus bleeding

Spotting, or very light bleeding, usually appears as a few small spots of blood. It may be light pink, bright red, or dark brown, and doesn’t require a pad or liner. It’s similar to the type of bleeding you may experience at the very beginning or tail end of your period.

Bleeding, on the other hand, is a heavier flow of blood that calls for a panty liner or pad to prevent it from soaking through your clothes. It’s similar to the kind of bleeding you have in the middle of your period, during peak flow.

If you begin bleeding when you’re pregnant, wear a panty liner or pad so you can keep track of how much and what type of bleeding you’re experiencing. Avoid sexual intercourse, douching, or inserting anything into your vagina, including tampons.

Early pregnancy spotting or bleeding

The first type of spotting or bleeding that may occur in early pregnancy takes place one or two weeks after conception when the fertilized egg burrows into the lining of your uterus. This implantation process, which starts just six days after fertilization, can lead to one or two days of light spotting known as “implantation bleeding.”

As the days go on and your pregnancy begins changing your hormone levels and increasing the blood flow to your uterus, cervix, and vagina, you may experience spotting or light bleeding following sexual intercourse, vigorous exercise, or a routine pelvic exam. This type of bleeding is normal and isn’t usually a cause for concern.

Other bleeding early on in a pregnancy can be a sign of something serious, including:

Ectopic pregnancy

Early first trimester spotting or bleeding can be a sign of an ectopic pregnancy, which occurs when the embryo implants itself somewhere outside your uterus, usually in one of the fallopian tubes.

This type of bleeding may be accompanied by abdominal, pelvic, or shoulder pain as well. Because an ectopic pregnancy can be life-threatening, you should give us a call any time you experience bleeding or pain in your first trimester.

Miscarriage

First trimester spotting or bleeding — especially when accompanied by abdominal pain or cramping — can also be an early indication of miscarriage. About 10% of known pregnancies end in miscarriage, and roughly half of all women who experience bleeding in early pregnancy go on to miscarry.

Even so, it’s important to keep in mind that your chances of continuing a healthy pregnancy are greater than 90% if your ultrasound between 7 and 11 weeks shows your baby has a normal heartbeat.

Infection

First trimester spotting can be the result of a condition unrelated to pregnancy, such as bacterial vaginosis, a yeast infection, or some other type of vaginal infection. It can also be caused by trichomoniasis, gonorrhea, chlamydia, or other sexually transmitted disease that irritates or inflames your cervix.  

Late pregnancy spotting or bleeding

Although it’s still possible to experience harmless intervals of spotting during your second and third trimesters, late pregnancy bleeding can be far more worrisome, and warrants an immediate call to our office.

As your pregnancy progresses, heavy bleeding may indicate a more serious problem, including:

Placental abruption

Heavy bleeding accompanied by abdominal or back pain can be a sign of placental abruption, which occurs when the placenta detaches from the wall of your uterus. If it isn’t discovered early enough, placental abruption can lead to serious complications for you and your baby.

Placenta previa

Placenta previa, which is often diagnosed during a routine ultrasound, occurs when your placenta is situated low in your uterus, where it partly or completely covers your cervix. Bleeding related to placenta previa isn’t usually accompanied by pain or discomfort.

Placenta accreta

Placenta accreta, which occurs when some or all of your placenta invades the wall of your uterus, is also usually discovered during a routine ultrasound. Besides causing bleeding in late pregnancy, this problem can lead to severe blood loss during delivery if it goes undetected.

Preterm labor

Bleeding that occurs late in pregnancy, but before 37 weeks, can also indicate the start of preterm labor. Other signs of premature labor include changes in the amount or consistency of your vaginal discharge, pressure in your pelvis or lower abdomen, lower back or abdominal pain, cramping, or contractions.

Complete-access care you can trust

At our practice, we take pride in making sure all of our moms-to-be can call Dr. Weyhrich any time of day and any day of the week to report or discuss pressing questions or concerns.

As such, you can virtually always get in touch with him if you experience any spotting or bleeding. He can give you an immediate recommendation about whether you should seek immediate medical care or simply schedule a prompt appointment.

To learn more, call our office or schedule an appointment online with board-certified OB/GYN Dr. Darin L. Weyhrich.