Before 12 Weeks Pregnant
If you feel generally well and the bleeding is not heavy, then you can call your GP or midwife for an appointment who can then assess if they need to refer to the local Early Pregnancy Unit. Sometimes, you can self-refer to a local Early Pregnancy Unit depending on your history and where you live. If you call your local GP surgery they should be able to advise you.
You can also call NHS 111 if you feel you need urgent medical help but it is not an emergency.
Go to your local A& E if you are experiencing bleeding and:
- it is during the night or at the weekend when a GP is unavailable
- the bleeding is heavy
- your medical history
- any previous pregnancies
- the date that your last period started .
Then, they may ask you to provide a urine sample to confirm that you are pregnant, or you may have an ultrasound scan.
They may also do an internal scan, where a small probe is inserted through your vagina to get a clearer picture. This is helpful if you are very early on in your pregnancy. It is not possible to do an abdominal scan as the pregnancy sac is tucked deep inside the uterus, in the pelvis, so a vaginal scan is the only option this early in the pregnancy.
Ultrasound scans are safe to have and do not carry any risk of causing a miscarriage.
Its unlikely that they will be able to see a heartbeat if youre not around 6-7 weeks pregnant yet. Instead, they will be checking the size of the pregnancy sac and that it is in the womb. This helps to rule out an ectopic pregnancy.
Bleeding And Pain In Early Pregnancy
Any amount of vaginal bleeding or abdominal pain in early pregnancy can cause concern that something is wrong with your pregnancy. However, up to one in three women have these symptoms during the first twelve weeks of their pregnancy and it does not necessarily indicate a problem such as a miscarriage. If you have a scan showing a pregnancy in the womb with a heartbeat there is a 95% chance that your pregnancy will continue provided the bleeding settles down.
Second And Third Trimester Bleeding
In some cases, vaginal bleeding in the second or third trimester is not serious. Nonetheless, a dangerous condition must always be ruled out through an evaluation by your doctor.
See your doctor right away if you experience bleeding in your second or third trimester. Heavy or bright red blood that is accompanied by other symptoms like abdominal pain or contractions must be addressed immediately.
Light bleeding or spotting can happen later in pregnancy due to many of the same reasons as first trimester bleeding, such as slight irritation of the cervix after sexual intercourse, a medical exam, or growths on the cervix. Make an appointment with your doctor right away to pinpoint the cause and rule out a serious condition, such as:
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What Causes Vaginal Bleeding
Bleeding in the 1st trimester is not always a problem. It may be caused by:
- Having sex.
- The fertilized egg implanting in the uterus.
- Hormone changes.
- Other factors that will not harm the woman or baby.
- A threatened miscarriage. Many threatened miscarriages do not progress to pregnancy loss.
More serious causes of first-trimester bleeding include:
- A miscarriage, which is the loss of the pregnancy before the embryo or fetus can live on its own outside the uterus. Almost all women who miscarry will have bleeding before a miscarriage.
- An ectopic pregnancy, which may cause bleeding and cramping.
- A molar pregnancy, in which a fertilized egg implants in the uterus that will not come to term.
Serious Causes Of Bleeding
In some cases, bleeding after having sex can point to a more serious problem. However, know that having sex likely did not cause any of these complications.
If you experience heavy bleeding, this is not normal and should warrant getting immediate medical attention.
Here are some more serious causes of bleeding in pregnancy.
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Bleeding During Early Pregnancy And Taking Care Of Yourself At Home
You may feel a range of emotions over this time. Guilt is a normal feeling, but dont blame yourself, as you have done nothing wrong. Your body will be going through changes in hormone levels and this can make you feel very emotional. It may help to talk to family or friends.While there is no specific treatment to prevent a miscarriage, things you can do that may help include:
- Getting plenty of rest.
- Using pads rather than tampons while you are bleeding.
- Avoiding sex while you are bleeding. Sex can resume once the bleeding has stopped.
- Taking mild pain relief medication, such as paracetamol, if needed.
- Reporting any changes in your condition to your doctor.
If you are finding your mood remains low for an extended period of time, you may be experiencing depression and require the assistance of a professional.
Intercourse Or A Physical Exam
Speaking of pelvic exams, keep in mind that anything that might poke at or near the cervix can also irritate it and cause bleeding. Yes, this includes sex! This happens because pregnancy hormones may make your cervix along with many other things more sensitive than normal.
You might see bright red blood on your underwear shortly after sex or a physical checkup. Dont fret! The bleeding usually happens once and then goes away on its own.
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Tests For Bleeding Problems During Later Pregnancy
Both placenta previa and placental abruption can cause heavy bleeding of bright red blood from the vagina.A vaginal examination is often used to help diagnose placental abruption, but could trigger heavier bleeding in the case of placenta previa. Therefore, an ultrasound scan should always be taken first, and digital vaginal examinations should be strictly avoided in the case of placenta previa.Tests used to diagnose placenta previa include:
- Medical history
- Ultrasound scan
- Feeling the mothers belly to establish the babys position
- Very gentle speculum vaginal examination .
Having ruled out placenta previa using the tests above, a digital vaginal examination may be used to identify placental abruption.
Vaginal Bleeding During Pregnancy
Vaginal bleeding is any loss or discharge of blood from the vagina. It can happen any time from when the egg is fertilized to the end of your pregnancy.
To help you access more information about bleeding or spotting during pregnancy, you might like to readSpotting During Pregnancy How Much Spotting Is OK?
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Potential Causes Of Bleeding During The First Trimester
You may experience some spotting when you expect to get your period. This is called implantation bleeding and it happens around 6 to 12 days after conception as the fertilized egg implants itself in your womb. This bleeding should be light perhaps lasting for a couple of days, but its perfectly normal.
Since miscarriages are most common during the first trimester, its normal to worry about bleeding early in your pregnancy. But as Dr. Alexis Svokos, an OBGYN at Geisinger explains, Once a heartbeat is seen on an ultrasound, more than 90 percent of women who experience first trimester vaginal bleeding do not miscarry.
During pregnancy, extra blood is flowing to the cervix. Intercourse or a Pap test, which cause contact with the cervix, can trigger light bleeding.
Why See Our Specialists At Uc Davis Health
Our specialists can evaluate you quickly in an office setting. Any laboratory testing or ultrasound examinations that need to be done can be performed easily and conveniently. We perform our own ultrasound examination in the office and can share the results with you immediately.
If we do confirm you have a miscarriage, we can discuss expectant management or treatment options with you immediately. Should you need blood testing to evaluate the pregnancy, the laboratory is in the same building as our office.
If you are having very heavy vaginal bleeding or are feeling very sick, you should go to the Emergency Room to see our physicians.
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How Much Bleeding Is Normal During Pregnancy
Vaginal bleeding during the first three months of pregnancy is relatively common and usually is a cause of concern for the mother. Women wonder how much bleeding during early pregnancy is normal. While early bleeding may indicate the presence of a serious problem, this is frequently not the case. In fact, approximately 20% of pregnant women experience light bleeding or spotting during the first trimester of pregnancy. Most women go on to have uncomplicated pregnancies and ultimately deliver a healthy baby.
Spotting: Spotting usually refers to a few drops of blood that would not cover a pad or panty liner. Bleeding refers to blood flow that is heavy enough to require wearing a pad. If bleeding occurs during the first trimester, wear a panty liner or pad so that you are able to get an idea of the amount of bleeding that is occurring and can tell the health care professional. However, you should not use a tampon in the vagina or douche during pregnancy.
Treatment For Vaginal Bleeding
Most of the time, the treatment for bleeding is rest. It is important to see your provider and have testing done to find the cause of your bleeding. Your provider may advise you to:
- Take time off work
- Stay off your feet
- Not have sex
- Not douche
- Not use tampons
Very heavy bleeding may require a hospital stay or surgical procedure.
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Be Prepared For These Questions
If you experience bleeding during pregnancy, be ready to answer these questions when you call or visit your doctor:
- How far along are you?
- When did you first have a positive pregnancy test?
- Have you had an ultrasound, and if so, what did it show?
- When did the bleeding start?
- Were there any obvious causes? For example, have you recently had intercourse or a vaginal exam?
- How heavy has the bleeding been?
- Have you had any pain or other symptoms with the bleeding?
If you are asked to make an appointment, your doctor is likely to check your cervix with a speculum. You might have an ultrasound or other testing to help learn the cause of the bleeding.
Many factors can cause spotting and bleeding during pregnancy. Because of that, its best to talk with your doctor if you have any bleeding. The bottom line is, if youre thinking about it, call your doctor.Thats what were here for, says Dr. McKenna.
What If I Discharge More Than Blood
If something other than blood comes out, call your provider right away. Put the discharge in a jar or a plastic bag and bring it with you to your appointment.
Your provider will check to see if you are still pregnant. You will be closely watched with blood tests to see if you are still pregnant.
If you are no longer pregnant, you may need more care from your provider, such as medicine or possibly surgery.
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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.
How Heavy Can Implantation Bleeding Be
Implantation bleeding in early pregnancy is generally only a light spotting of blood that appears when you wipe or that needs a light pad or panty liner. It may also look like a light flow of blood, but it is different from the typical flow of normal periods. Typical implantation bleeding in the early stages of pregnancy is pink- or brown-colored discharge.
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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.
When Should I Go To The Doctor For Spotting Or Bleeding During Pregnancy
If youre at all concerned, don’t hesitate to talk to your physician. Heavy bleeding at any point in pregnancy should be reported to the doctor immediately, but spotting or light vaginal bleeding during the first trimester that goes away in a day or so can be brought up at your next prenatal checkup.
At this appointment, your doctor may order a blood test to check hCG levels or perform an ultrasound to check and see that your pregnancy is progressing.
But bleeding during the second trimester, even if its not much to see, should be discussed with your health care provider the day it happens. And if you spy blood during the third trimester, get in touch with your doctor right away.
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What Does Implantation Bleeding Look Like
Implantation bleeding looks like light spotting that appears when you wipe. It may also look like a consistent, light flow of blood that needs a light pad or panty liner. The blood may look orange, pink, or brown. There are usually no clots in implantation bleeding in the early stages of pregnancy. It may last from a few hours up to several days.
What Causes Bleeding In Early Pregnancy
In most cases we do not find a reason for the bleeding and the pregnancy continues with no effect on the baby.
However these are some reasons why vaginal bleeding may occur:
Implantation site bleeding
As part of the normal development the pregnancy attaches itself to the lining of your uterus . This can cause some of the blood vessels from your womb to bleed. This does not harm you or your baby and there is nothing that you need to do differently.
Haematoma or small area of bruising
This is also referred to as extrachorionic haemorrhage . This is seen on an ultrasound scan as a small area of bleeding near the pregnancy. If your scan shows one it will either be reabsorbed by your body or come away naturally as mild vaginal bleeding for a few weeks until it stops altogether. It does not harm you or your pregnancy.
You do not need a repeat scan in early pregnancy to check on it. You do not need to do anything differently although avoiding heavy lifting may settle your symptoms sooner.
During pregnancy an area on the neck of your womb can develop which is soft and rich in blood supply. This is a normal process but may cause bleeding. This area may be found during an internal examination.
It is not harmful to you or your baby and you do not need to do anything differently although you may find that sexual intercourse and vigorous exercise may cause bleeding.
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After Treatment For A Miscarriage
Bleeding may continue for several weeks after a miscarriage but tends to be much lighter with a suction aspiration. Any bleeding may change in color from bright red to pink or brown. Lower abdominal cramping in the few days after treatment is also common. You should contact a doctor right away if the bleeding gets heavier after the miscarriage instead of lighter, if a fever develops, or if vaginal discharge or a strange or unpleasant vaginal odor occurs. Avoid intercourse, douching, or using tampons for one week. Regular activities can be resumed right away, based on how you feel. Importantly, if you want to delay getting pregnant after the miscarriage, it will be very important to start an effective method of contraception.