Bleeding Later In Pregnancy: Why It Happens
Weve already discussed why it isnt possible to have a period during pregnancy, and why some people may experience light bleeding or spotting during their first trimester. Bleeding during the second and third trimesters is possible, though not common, and it may be an indicator that something else is going on. If you experience bleeding later in your pregnancy, its important to see your health care provider.
Potential reasons for mid- or late-term pregnancy bleeding include:
Your Cervix Is More Sensitive During Pregnancy
As your cervix changes to prepare for a growing baby, it will also become increasingly sensitive to penetration, whether that happens during sex or a gynecological exam. This can cause light bleeding and is usually nothing to worry aboutunless the blood increases enough to warrant a pad or tampon. The American Pregnancy Association recommends that you avoid intercourse again until youve seen a doctor.
When To Call Your Doctor When Youre 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 youve lost and a description of how youre feeling overall, advises Laura Riley, M.D., author of Pregnancy: The Ultimate Week-by-Week Pregnancy Guide. Your practitioner will decide whether theres 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 whats 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.
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Should I Take A Pregnancy Test If I’m Spotting
Anyone who’s been sexually active in the previous month and could possibly be pregnant should take a pregnancy test after irregular bleeding of any kind, says Dr. Vyas.
Keep in mind that implantation bleeding will happen beforea missed period. If you experience bleeding that isn’t implantation- or period-related , it could be what’s known as the first trimester bleeding.
According to the American College of Obstetricians and Gynecologists , this common phenomenon occurs in 15% to 25% of people early in their pregnancy. “But it might also be the first sign of a pregnancy loss or even an ectopic pregnancy,” a potentially fatal condition where the embryo implants outside of the uterus, says Dr. Berman.
Those who experience abnormal first-trimester bleeding should see a health care provider. “There are pregnancies that bleed early on that do just fine,” says Dr. Patounakis, “but your health care provider needs to evaluate to make sure you’re safe.”
Bleeding During Early Pregnancy
If youve had bleeding early in your pregnancy, youre not alone. Many other pregnant women have early bleeding, too. And in most cases, nothing is wrong. But your healthcare provider still needs to know about it. They may want to do tests to find out why youre bleeding. Call your provider if you see bleeding during pregnancy. Tell your provider if your blood is Rh negative. Then they can figure out if you need anti-D immune globulin treatment.
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What Other Symptoms Can Be Early Signs Of Pregnancy
Every person and every pregnancy is different. So, if you are pregnant, youll likely experience a unique combination of common, not-so-common and sometimes overlapping symptoms. And, they may show up earlier or later than expected. Here are more than a dozen possible symptoms of early pregnancy.
1. Spotting or light bleeding
Many women are surprised to learn that spotting or light bleeding can be an early sign of pregnancy, but about one-third of women experience it. This is often called implantation bleeding because doctors believe it occurs as the fertilized egg attaches itself into the uterine lining. This is different from bleeding that could occur from something like a miscarriage which is usually heavier.
When does implantation bleeding occur?
Implantation bleeding typically occurs 10 to 14 days after conception, which is just before or right around the time your period is due. So, you may think youve gotten your period.
But implantation bleeding is a light flow, which may start and stop over a couple days. And while it can take on a range of colors, its more likely to be pink, brown or light red.
Your period, on the other hand, may start off light in flow and in color but after a couple days becomes heavier, changes to a crimson red color and lasts up to a week or so.
2. Lower abdominal pain or cramping
While cramps and lower-abdominal pain can signal a coming period, they can also be a sign of egg implantation.
What do implantation cramps feel like?
Preventing Miscarriage Next Time
Since most miscarriages are caused by genetic abnormalities or other health factors that are beyond anyones control, its important for women to understand that it isnt their fault, says Dr. Svokos. There isnt much you can do to prevent miscarriages. But staying healthy while trying to conceive and while pregnant is definitely the best approach. Her recommendations?
- Eat a nutritious, well-balanced diet
- Exercise regularly
- Avoid alcohol, recreational drugs and cigarettes
- Reduce caffeine intake to one cup a day
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What Is The Difference Between Period And Pregnancy Spotting
Period spotting is often heavier and lasts longer than implantation spotting. Pregnancy spotting is usually lighter in color and consistency than menstrual bleeding.
It may be pink, brown, or red, and its often accompanied by other pregnancy symptoms, such as nausea and breast tenderness. Menstrual bleeding, on the other hand, is usually heavier and lasts for several days.
There Are Complications With Your Pregnancy
In the first trimester, steady bleeding might occur with several different pregnancy complications:
- Miscarriage pregnancy loss up to 20 weeks of pregnancy
- Ectopic pregnancy when a pregnancy develops outside of the uterus, sometimes in the fallopian tubes
- Molar pregnancy a tumor that develops in the uterus at the beginning of pregnancy
While miscarriages occur in up to 20% of pregnancies, these other complications are rarer. Often, though not always, these conditions are accompanied by other symptoms, like abdominal pain. If you assumed you were getting your period but experience increased cramping that does not go away, see a doctorthese pregnancy complications can be life-threatening if left untreated.
In the second and third trimesters, bleeding of any amount can indicate the onset of labor or a complication with the uterus or placenta. Even if you have no other symptoms, call your doctor immediately if you are bleeding at this stage in pregnancy.
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Implantation Bleeding Vs Period Bleeding: How To Tell The Difference
Since implantation bleeding is a symptom that can often occur before you test positive on a pregnancy test, it can be hard to know whether light bleeding is an early sign of pregnancy or just normal spotting leading up to your period. And unfortunately, theres no conclusive way to find out.
The best way to know whether youre pregnant or not is to wait a few more days and take a pregnancy test. The timing of when you last had sex might also help you figure it out. If its been more than two weeks, its unlikely that any spotting you’re having is implantation bleeding.
About a third of women who report having experienced implantation bleeding often describe it as distinct from their usual premenstrual spotting some say the blood is darker and not as red compared with normal period blood. Others have mild cramping at the same time as the spotting.
But for many women, the two types of bleeding arent different at all. So youre not alone if you assume that some spotting is implantation bleeding and get your period a few days later, or if you assume that implantation bleeding is normal spotting and end up being pregnant!
Can The Exact Date Of Conception Be Determined Accurately
Many women have questions about the date of possible conception, and unfortunately figuring this out is not always so easy. The assumption is that if a woman has pretty regular menstrual cycles, then she will be ovulating during a certain time of the month.
Ovulation is the time when conception can take place because that is when an egg is made available. The problem is that most women do not ovulate on an exact date each month, and many women have a different ovulation day from month to month.
If you also take into account that sperm can live in the body 3-5 days after intercourse has taken place, this can make determining conception very difficult.
Most doctors use the first day of the last period and ultrasound measurements to gauge the gestational age of a baby and determine when the baby was conceived. But these are just tools used to estimate the datesit is very hard for anything to tell what the exact date of conception really is.
Most people do not realize that ultrasounds can be off up to 5-7 days in early pregnancy and up to a couple of weeks off if the first ultrasounds are done farther into the second trimester or beyond.
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Is It Normal To Bleed During Pregnancy
Bleeding during pregnancy, especially in the early stages, is quite common. About 1 in 4 women will experience vaginal spotting or bleeding during the first trimester. Many of these women will go on to have healthy pregnancies.
However, vaginal bleeding may be the first sign of a problem, so its important to contact your doctor or midwife if you experience vaginal bleeding at any stage of your pregnancy for advice on what to do next.
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.
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Does Every Woman Get Implantation Bleeding
No. Bleeding only happens in 15-25% of early pregnancies1. In most cases, spotting is a normal sign of implantation, but any bleeding should be checked out if youre worried, because it could still be a symptom of a miscarriage or an ectopic pregnancy.
Implantation bleeding is usually nothing to worry about. Chances are you may not even know youre pregnant when you notice it. If you notice any spotting around the date you would have your period, and you suspect you are pregnant take a pregnancy test. If you are pregnant, talk to your healthcare provider and mention any bleeding you have, just so any other factors can be ruled out.
When To Consult Your Healthcare Provider
Implantation bleeding is generally nothing to be concerned about, but itâs a good idea to talk to your healthcare provider about any bleeding you experience during pregnancy.
Although light bleeding in early pregnancy can be totally normal, there are some reasons for bleeding in early pregnancy that need to be addressed immediately. These can include infection, miscarriage, or ectopic pregnancy.
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What If I Notice Some Cramping During Pregnancy
Pregnant women may experience some light cramping early in pregnancy. The cramping is often like light menstrual cramps through the lower abdomen or on one side or the other. It is often a result of all the changes that are occurring in the uterus as the implanted egg begins to grow and develop. Also, a cyst, called the corpus luteum cyst, can develop on the ovary at ovulation.
This cyst forms in the spot on the ovary where the egg comes out before making its journey to the uterus. It then produces progesterone until the placenta has formed enough to begin producing its own progesterone. The cyst can cause some discomfort for women in early pregnancy.
Heres How To Figure Out When Implantation Happens
Other common signs of implantation can include: light cramping , mood swings, breast tenderness, nausea and pain in your lower back. Many of these symptoms result from the higher levels of progesterone circulating in your body, which increases to help support the pregnancy . Keep in mind, these symptoms can be similar to premenstrual syndrome or other symptoms that occur between ovulation and a period .
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How Are Bleeding And Spotting Treated
Your treatment depends on what caused your bleeding. You may need a medical exam and tests.
Most of the time, treatment for bleeding or spotting is rest. Your provider may also suggest treatments like:
- Take time off from work and stay off your feet for a little while
- You may need medicine to help protect your baby from Rh disease. Rh disease is when your blood and babys blood are incompatible . This disease can cause serious problems even death for your baby.
- If you have heavy bleeding, you may need a hospital stay or surgery
What Should I Do If I Bleed During Pregnancy
If you bleed during pregnancy, contact your doctor or midwife. Your antenatal care provider can give you advice about what to do next.
It can be helpful to note down details about what you have been experiencing. This may include:
- the amount and colour of any discharge
- whether you have passed any clots
- whether you have had any abdominal pain
If you are having heavy bleeding, its a good idea to keep your pads or stained clothes to show your doctor or midwife.
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Spotting During The Second Trimester
Light bleeding or spotting during the second trimester may be caused by irritation to the cervix, usually after sex or a cervical exam. This is common and not usually cause for concern.
A cervical polyp is another possible cause for bleeding in the second trimester. This is a harmless growth on the cervix. You may have spotting from the area around the cervix due to an increased number of blood vessels in the tissue there.
If you experience any vaginal bleeding thats heavy like a menstrual period, let your doctor know right away. Heavy bleeding in the second trimester may be a sign of a medical emergency, such as:
What Should I Do If I Have Heavy Bleeding While Pregnant
Inform your doctor. If due to miscarriage and the baby is alive, your doctor will encourage bed rest with ultrasound to monitor your pregnancy. If your baby is not alive, your doctor will evacuate products of conception to stop bleeding.
In addition, if your bleeding is severe, blood transfusion may be necessary to prevent anemia in pregnancy.
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What Are The Most Common Causes Of Bleeding In The First Trimester
Bleeding or spotting in the first trimester can be common and doesnt always mean there is something wrong. Try not to worry. Take notes of the type of bleeding you see and call your healthcare provider to let them know your symptoms.
Some causes of bleeding in the first part of pregnancy are:
- Implantation bleeding: This is when the fertilized egg implants in the wall of your uterus and causes light bleeding. Its considered a normal part of early pregnancy.
- Molar pregnancy: A rare condition when a fertilized egg implants in your uterus, but a tumor forms instead of a baby.
- Ectopic pregnancy: When a pregnancy forms outside of your uterus . It can be life-threatening.
- Subchorionic hematoma: Bleeding from one of the membranes that surround the embryo inside your uterus. Subchorionic hematomas usually resolve on their own.
- Cervical polyps: A noncancerous growth on your cervix that bleeds in pregnancy due to increased estrogen levels.
- Miscarriage: The loss of the pregnancy before 20 weeks. It usually starts as light bleeding and gets heavier. It can be accompanied by severe cramping.
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.
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