Spotting While Pregnant: What’s Normal What’s Not
While bleeding or spotting during pregnancy is not abnormal, it’s certainly unexpectedand unnerving. Learn the causes of bleeding during pregnancy, how to tell when it’s serious, and what you should do it if happens to you.
Any type of bleeding while pregnant is terrifying, even for the most level-headed mom-to-be. The good news: Spotting, or light bleeding in early pregnancy that’s not heavy like your menstrual period, occurs for nearly one-third of all moms-to-be and often poses no threat to mom or baby. It’s common for a small percentage of pregnant women to have spotting after intercourse, for example, and others may have bleeding for reasons that have nothing to do with pregnancy, such as infections or tears to the vaginal wall. “The vast majority of spotting is harmless,” says Alyssa Stephenson-Famy, M.D., Maternal-Fetal Medicine Specialist at the University of Washington, Seattle. But bleeding, no matter how scant, can be indicative of a variety of complications, including miscarriage, ectopic pregnancy, and placenta previa, and thus should never be ignored. Here are the various reasons you may experience bleeding while pregnant, when to know whether you should call your doctor, and tips for effectively communicating your symptoms to your healthcare provider.
Does Spotting Mean Miscarriage
Many people fear that spotting in early pregnancy is a sign of miscarriage, but this isn’t always the case. Roughly half of women who experience spotting in early pregnancy do miscarry. This means that half of women who spot in early pregnancy do not miscarry. Spotting later in pregnancy is often less serious, but there are times when it is very serious.
Between 10% and 30% of women who deliver full-term, healthy babies report that they had spotting at some point during pregnancy. Anyone who experiences spotting during their second or third trimester should contact their doctor right away.
Why You Might Experience A Period During Your First Trimester
Though people stop getting their period during pregnancy, its possible that they may still experience some bleeding. This bleeding does not necessarily indicate an underlying issue, but its important to understand the cause of it and whether its time to see a health care provider.
Bleeding tends to occur more often during the first trimester of pregnancy than the second or third. Estimates suggest that about 25 to 30 percent of pregnant people experience spotting at some point during their first trimester. There are a number of reasons for this bleeding.
Implantation bleeding: This refers to the light spotting that occurs about 10 to 14 days after conception, around the time when your period is due. Many people havent yet taken a pregnancy test at this point, so its easy to mistake the spotting for a period. This bleeding is lighter than a normal period, however, and only lasts for a couple of days. It occurs due to the implantation of the fertilized egg into the uterine lining.
Cervical changes: Spotting can occur shortly after you get pregnant due to cervical changes, and particularly after having sexual intercourse. As long as no infection is present, theres no need to be concerned about this.
Other causes: Heavier bleeding that more closely resembles a period during the first trimester of pregnancy can indicate something more serious, including:
- Back pain
- Severe abdominal pain or cramps
- Loss of consciousness or faintness
- Fatigue
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Can I Take Pain Relief Medication During Pregnancy
If you find that you need to take pain relief medication to relieve any pain, it is safest to use something simple such as paracetamol. Drugs such as aspirin and ibuprofen should be avoided. If you find that you need a stronger pain relief medication, you must always check with your doctor, nurse or midwife first.
Difference Between Spotting And Bleeding
Spotting is another word for light bleeding, ACOG says, and thats definitely different from having a heavy flow. But spotting is technically still bleeding. Your cervix may bleed more easily during pregnancy because more blood vessels are developing in this area. ACOG specifically says that its not uncommon to have spotting or light bleeding after sex, a Pap test, or pelvic exam when youre pregnant. If youre soaking through less than one pad or tampon in three hours, thats generally considered mild bleeding or spotting and is likely no big deal, Sherry Ross, M.D., an ob-gyn and womens health expert at Providence Saint Johns Health Center in Santa Monica, California, tells SELF. Still, if youre concerned or it continues, thats certainly worth bringing up with your doctor, midwife, or care provider.
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What Is Implantation Bleeding
Implantation bleeding is light bleeding from the vagina that happens in some women 10 to 14 days after conceiving a baby.
You may think its just a light period, but its an early sign of pregnancy. Its not dangerous, and you dont need treatment.
But heavy bleeding can be a sign of a problem. Call your doctor if you bleed a lot, with or without fever, chills, or have cramps that get worse.
What Will The Scan Tell Us
A scan can only tell us how your pregnancy is at that particular time. Unfortunately it is no guarantee that your pregnancy will continue successfully. If your symptoms persist or become worse, you must contact EPAU, midwife or your GP.
In later pregnancy ultrasound scanning is used to look more closely at the anatomy and organs of the developing baby. This is usually done between 18 21 weeks.
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How Can I Know Whats Happening
If you have vaginal bleeding or spotting at any time during your pregnancy, it is worth talking first to your GP. S/he may refer you to hospital for an ultrasound scan to try to see whether the pregnancy is developing as it should.
During the coronavirus pandemic, many GP practices are under severe strain, so you might need to contact 111 rather than your GP.
Many hospitals now have a specialist Early Pregnancy Unit or Emergency Gynaecology Unit . They usually require a GP referral but you might also be able to contact them direct for advice. You can find information about your nearest Early Pregnancy Unit here or you could just contact the nearest hospital that has maternity facilities.During the coronavirus pandemic, most early pregnancy or emergency gynaecology units are assessing patients by phone to begin with, to reduce the number of people coming to hospital. Be clear and honest in describing your symptoms so they can give you the best advice on coming in or not.
If you have acute, sharp abdominal pain, pain in your shoulders and/or pain on moving your bowels, contact your GP, EPU or midwife or if necessary, go to A& E . Tell them that you are pregnant and describe your symptoms so they can arrange an emergency scan.
If you have previously had an ectopic pregnancy, ask your GP or EPU for an early scan to make sure the baby is in the right place.
My Gp Wont Refer Me For A Scan
If your GP wont refer you for a scan, it might be because it is too early to be able to see even a healthy pregnancy on scan . It might be due to restrictions on scans during the coronavirus pandemic. But it might be that s/he takes a wait and see approach and advises you to stay home and put your feet up, or to stay in bed or just to go about your normal routine.
You might find this very frustrating and even frightening, especially if you are feeling very anxious:
- If its your first pregnancy, you may worry because you dont know what is normal and what isnt.
- If you have had a previous healthy pregnancy, you may worry because this pregnancy is not progressing in the same way.
- And if you have previously lost a baby, you are likely to be particularly anxious because of what happened last time.
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When To Call Your Doctor When You’re Spotting Or Bleeding During Pregnancy
No matter when it occurs, even if you have less than a dime-size spot of blood, call your doctors or midwife immediately to be safe, as any vaginal bleeding during pregnancy can be a symptom of a larger problem. Be prepared to answer detailed questions about the amount of blood you’ve lost and a description of how you’re feeling overall, advises Laura Riley, M.D., author of Pregnancy: The Ultimate Week-by-Week Pregnancy Guide. Your practitioner will decide whether there’s a cause for concern. If this is the case, she may want to monitor the situation by having you stay off your feet for a few hours and call back, or have you to come in immediately. She may also order an ultrasound to see what’s going on with the fetus. Dr. Riley says you should insist on being seen if you have any vaginal bleeding that makes you feel faint or soaks through a sanitary pad. You should also be seen if the bleeding is persistent or accompanied by pain or a fever.
When To Should I Call My Doctor If I Am Pregnant And Have Vaginal Bleeding
If you begin to bleed during early pregnancy call your OB or midwife to be seen. Until you have been seen by a medical professional for bleeding during pregnancy, and they have given you different instructions, you should take it easy. There is no way to stop bleeding during pregnancy, so you should rest and contact your healthcare provider. Rest and relax, do not undertake heavy lifting or strenuous exercise, and abstain from sex, tampon use, or douching. Drink plenty of water and try to avoid against dehydration. Remember to keep track of the number of pads used and if the bleeding is increasing or decreasing.
Bleeding is not normal at any time during pregnancy. Report any vaginal bleeding during pregnancy to your healthcare professional. Be prepared to give information about the amount of blood loss and a description of how you are feeling overall. If your bleeding is light and you have no pain, your evaluation may be in the doctor’s office.
There is no home care for late-pregnancy bleeding. You must see a health care professional immediately.
Go to a hospital’s emergency department if the following conditions develop:
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What Should I Do If I Experience Bleeding During Pregnancy
If you experience bleeding, it is wise to have this checked out. If you have been seen in the Early Pregnancy Assessment Unit during your pregnancy, you may contact us directly, up to 15 weeks + 6 days of pregnancy. Your GP or midwife can also help you.
If you have been seen in the EPAU and you then experience more bleeding contact the EPAU. Depending on how much bleeding and for how long the nursing staff will decide if you need to be seen again. A rescan is not always necessary. Sometimes the nurse will advise that you monitor this bleeding at home. A rescan will only be performed if bleeding heavy with clots. If there is a significant change in your symptoms then the nurse will make an appointment to come to EPAU and be either rescanned or to be assessed by the doctor. If bleeding unmanageable then the nurse may advise to be assessed on ward 30 or the Emergency department depending on your symptoms.
Early Pregnancy Loss Or Miscarriage
Most miscarriages occur in the first 13 weeks of pregnancy. If you know youre pregnant and experience brown or bright red bleeding with or without cramps, speak with your doctor.
With a miscarriage, you may also notice the following symptoms:
- mild to severe back pain
- weight loss
- tissue with clot-like material passing from the vagina
- a sudden decrease in pregnancy symptoms
Once a miscarriage has started, theres very little that can be done to save the pregnancy. You should still call your doctor, though, so they may rule out ectopic pregnancy or another complication.
Your doctor will likely do two or more blood tests to check your pregnancy hormone levels. This hormone is called human chorionic gonadotropin .
The tests will be 24 to 48 hours apart. The reason youll need more than one blood test is so your doctor can determine if your hCG levels are declining. A decline in hCG levels indicates a pregnancy loss.
Having a miscarriage doesnt mean youll have difficulties getting pregnant in the future. It also doesnt necessarily increase your risk for future miscarriages, though it may if youve already had multiple miscarriages. Its important to note that a miscarriage is also generally not caused by something you did or didnt do.
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Causes Of Bleeding Or Spotting Past 20 Weeks
Although the risk of miscarriage diminishes greatly after the first trimester, and many of the early complications are no longer a factor , bleeding during the second half of pregnancy should be taken very seriously, especially if it’s ongoing, Dr. Stephenson-Famy says. Causes for bleeding in the second half of pregnancy include:
- Sexual intercourse
- Cervical checks, especially late in the third trimester when they become more frequent
- Placenta previa, which is when the placenta covers the cervix either partially or completely
- Placental abruption, in which the placenta tears away from the wall of the uterus, can cause severe vaginal bleeding and is life-threatening to both Mom and Baby. According to the American Academy of Family Physicians, a placental abruption is the most common cause of serious bleeding during late pregnancy. The condition is rare, and occurs only in about one percent of all pregnancies.
- Preterm labor, in which vaginal bleeding is accompanied by cramping or contractions, diarrhea, pelvic pressure, or back pain before 37 weeks, could have serious repercussions for the baby if not managed. After 37 weeks, these symptoms could be a normal start to labor.
Tests For Bleeding Problems During Early Pregnancy
It can take some time for your doctor to be sure of what the bleeding means. You may need a number of tests, which could include:
- Vaginal examination to check the size of your uterus and the amount of bleeding. This examination lasts a few minutes and may be a bit uncomfortable.
- Blood tests to check your blood type and, sometimes, the levels of pregnancy hormones in your blood.
- Ultrasound scan gel is rubbed on your abdomen. A hand-held scanner uses sound waves to provide pictures of the pregnancy. In very early pregnancy, more information is gained by placing a small, slender scanner in the vagina. You will need to have a full bladder before the scan. An ultrasound scan takes around 15 to 20 minutes. If an ultrasound is needed, it can be arranged through the emergency department of your nearest hospital or your local doctor.
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Can You Bleed Heavy And Still Be Pregnant
Its best to follow up with your healthcare provider about any unusual uterine bleeding, especially if its on the heavier side or is accompanied by clots. If youre already pregnant and experiencing what seems like implantation bleeding, you may just be experiencing a fairly common symptom in early pregnancy.
Bleeding In The First Trimester
About 20% of women have some bleeding during the first 12 weeks of pregnancy. Possible causes of first trimester bleeding include:
Implantation bleeding. You may experience some normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus. Some women don’t realize they are pregnant because they mistake this bleeding for a light period. Usually the bleeding is very light and lasts from a few hours to a few days.
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 youve 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.
Other symptoms of miscarriage are strong cramps in the lower abdomen and tissue passing through the vagina.
Ectopic pregnancy. In an ectopic pregnancy, the fertilized embryo implants outside of the uterus, usually in the fallopian tube. If the embryo keeps growing, it can cause the fallopian tube to burst, which can be life-threatening to the mother. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies.
Other symptoms of ectopic pregnancy are strong cramps or pain in the lower abdomen, and lightheadedness.
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What Is Spotting And What Causes It
Generally speaking, spotting refers to the light vaginal bleeding that can sometimes occur between periods. However, it can also occur during early pregnancy. Although the sight of blood early in your pregnancy can be unnerving , it’s helpful to know that this is quite common and doesn’t usually mean there’s a problem.
As many as one quarter of moms-to-be experience some spotting during early pregnancy. Two common causes are described here.
Scanning In Early Pregnancy
An ultrasound scan is used during pregnancy for a number of reasons. In the first three months of pregnancy it can be used to check the presence of the babys heartbeat, which can be reassuring if you have experienced a problem, such as vaginal bleeding or pain. A scan will also be used to check to see if the pregnancy is in the correct place and to accurately predict the estimated date of delivery by measuring the end points of the embryo or fetus.
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