Is Bleeding Normal During Early Pregnancy

Intercourse Or A Physical Exam

How common is bleeding during first trimester(early pregnancy)? Is it normal? Dr. Sreeja Rani

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.

What Types Of Bleeding Occur During Early Pregnancy

  • Light pink discharge
  • Deep red bleeding
  • Haemorrhage involving tissue fragments

Many women bleed from time to time at the beginning of pregnancy the bleeding is usually very light and does not last longer than one or two days. In general, however, the type and strength of the bleeding is not a reliable indicator of whether it is harmless or dangerous.

A slight pink or brown discharge may also indicate a complication, so an immediate examination is essential. The colour of the discharge helps to determine how old and strong the bleeding is.

Light pink suggests very weak bleeding brown indicates older blood and light red indicates fresh blood. Heavy bleeding is usually dark red with or without tissue parts .

Bleeding during early pregnancy is not uncommon but should be medically clarified.

There are several possible causes.

  • In the first weeks of pregnancy, slight bleeding is usually caused by the so-called implantation bleeding.
  • Light, painless bleeding is often harmless, but like all bleeding that occurs in the course of pregnancy must always be clarified immediately by a gynecologist.
  • Early Pregnancy Implantation Bleeding

    One of the most common reasons for early pregnancy bleeding is implantation. Implantation happens when the fertilised egg settles into the blood rich uterus lining and begins the transformation into a fetus.

    When the egg burrows into the uterine lining, this causes some spotting or light bleeding. As implantation happens around week 3 of your cycle , implantation often happens around the time you expect your next period.

    Early pregnancy implantation bleeding is usually light pink to rusty brown and is spotting rather than a heavy flow.

    Find out more about implantation bleeding.

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    Seeing Your Gp About Spotting

    Your GP will ask you about your bleeding.

    They may ask you:

    • when your last period was
    • how many weeks pregnant you are
    • if it’s your first pregnancy
    • what the bleeding or spotting is like
    • if you have any other symptoms such as stomach pain or dizziness

    Be honest with your GP. There’s nothing to be embarrassed about. Tell them about the colour, any clotting, and how heavy the bleeding was. Be as graphic as you need to. Remember, your GP sees people with personal issues like bleeding all the time.

    How Quickly Should Bleeding In Pregnancy Be Clarified

    Bleeding dark red during pregnancy! !! Plz help

    In case of heavy bleeding or pain occurring at the same time, it is advisable to go to a clinic immediately. The respective gynecologist can clarify mild bleeding and spotting. How much bleeding is normal during early pregnancy? and How quickly bleeding should be defined also depends on its appearance.

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    Bleeding In The Second And Third Trimesters

    Abnormal bleeding in late pregnancy may be more serious because it can signal a problem with the mother or baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester.

    Possible causes of bleeding in late pregnancy include:

    Placenta previa. This condition occurs when the placenta sits low in the uterus and partially or completely covers the opening of the birth canal. Placenta previa is very rare in the late third trimester, occurring in only one in 200 pregnancies. A bleeding placenta previa, which can be painless, is an emergency requiring immediate medical attention.

    Placental abruption. In about 1% of pregnancies, the placenta detaches from the wall of the uterus before or during labor and blood pools between the placenta and uterus. Placental abruption can be very dangerous to both the mother and baby.

    Other signs and symptoms of placental abruption are abdominal pain, clots from the vagina, tender uterus, and back pain.

    Uterine rupture. In rare cases, a scar from a previous C-section can tear open during pregnancy. Uterine rupture can be life-threatening, and requires an emergency C-section.

    Other symptoms of uterine rupture are pain and tenderness in the abdomen.

    Other signs of vasa previa include abnormal fetal heart rate and excessive bleeding.

    Other symptoms of preterm labor include contractions, vaginal discharge, abdominal pressure, and ache in the lower back.

    Additional causes of bleeding in late pregnancy are:

    How Is It Treated

    It depends on the cause of the bleeding. No treatment is needed for a threatened miscarriage. Ectopic pregnancies need to be treated with medicine or surgery. After a miscarriage, the tissue may pass on its own. If not, you may need medicine or a procedure called aspiration to remove the tissue. Women with Rh-negative blood types may need a shot to help prevent problems in future pregnancies.

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    Cramps Later In Pregnancy

    As the uterus continues to grow larger, abdominal cramps can also occur later in pregnancy. You should experience the least amount of cramps during the second trimester. However, this is when your round ligamenta muscle that supports the uteruswill begin to stretch. During this time, it’s normal to feel sharp pains or dull aches in the lower abdomen.

    If you are pregnant with multiples, expect some soreness during the second trimester as your body makes extra room for the babies. This final growth spurt usually doesn’t occur in a single pregnancy until the third trimester.

    While some cramping is normal, be on the lookout for signs of preterm labor. These include dull backaches, intense pelvic pressure, blood or fluid from your vagina, or more than five contractions or cramps in an hour.

    Implantation Bleeding Or Streaking

    Is implantation bleeding normal in early pregnancy?

    When a fertilized egg implants in the uterine lining, it can result in light bleeding or streaking called implantation bleeding.

    Usually, it lasts a couple of days in the first trimester and occurs around the time of implantation or when your period would have been due.

    Some mothers mistakenly think they have simply had a light period and dont realize they are pregnant.

    For more information please read Implantation Bleeding Everything You Need To Know.

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    Should I Worry About Spotting

    Some spotting is normal very early in pregnancy. Still, it is a good idea to tell your provider about it.

    If you have had an ultrasound that confirms you have a normal pregnancy, call your provider the day you first see the spotting.

    If you have spotting and have not yet had an ultrasound, contact your provider right away. Spotting can be a sign of a pregnancy where the fertilized egg develops outside the uterus . An untreated ectopic pregnancy can be life-threatening for the woman.

    A Molar Pregnancy Or Hydatiform Mole

    This is a rare condition where the placenta is not normal and the pregnancy does not develop as it should. Abnormal cells develop in your womb.

    A molar pregnancy is usually treated by a simple procedure. This removes the abnormal cells from your womb. You may have appointments afterwards with your obstetrician for blood tests and/or ultrasound scans. These are to make sure all the cells have been removed.

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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.

    Can Certain Habits Cause Miscarriages

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    Usually, miscarriages occur for reasons beyond our control. But, there are some habits that increase the likelihood of miscarriages. Some of these include smoking, drinking alcohol, being too skinny or overweight, drinking too much caffeine, eating certain food or taking drugs. Sexual intercourse, mental health, stress, walking, and exercising do not increase the likelihood of miscarriages.

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    Causes Of Bleeding Or Spotting In The First 20 Weeks

    Doctors estimate that 25 to 40 percent of women will experience some vaginal bleeding during early pregnancy and more often than not the pregnancy will progress totally normally, Dr. Stephenson-Famy says. According to the American Pregnancy Association, there are a number of possible causes of innocuous spotting or bleeding in the first half of pregnancy, including:

    • Implantation bleeding: The implanting of the egg in the lining of the uterus occurs about 4 weeks into your pregnancy as the fertilized egg attaches to your uterine wall. If you notice a small amount of bleeding about a week to 10 days after conception, implantation bleeding is likely the cause and is nothing to worry about.
    • Sexual intercourse: During the second and third trimester, your cervix becomes swollen because of the increased blood supply in the area. As a result, vigorous intercourse may cause spotting during pregnancy.
    • Infections: Some women have cervical bleeding because of an infection, usually a sexually transmitted disease such as chlamydia. In this case, the underlying condition needs to be treated.
    • Internal exam done by your obstetrician or midwife: It’s not uncommon to bleed after a Pap smear or pelvic exam, which in many practices is conducted between the sixth and 12th week of pregnancy. Spotting may occur within 24 hours after the visit and usually goes away within a day.

    Related: What to Know About an Ectopic Pregnancy

    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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    When To Worry About Spotting During Pregnancy

    Spotting or bleeding during pregnancy is not expected and may be abnormal, but it is not always a cause for concern. However, it is important to contact your healthcare provider to discuss the symptoms you are experiencing. The good news is that 50% of women with bleeding during pregnancy go on to have a healthy pregnancy and a healthy baby.

    Any spotting or bleeding in the second or third trimesters should be reported to your healthcare provider immediately. In the first trimester, spotting is somewhat more common, but should also be reported to your doctor or midwife.

    Call your obstetrician especially if you notice heavy bleeding similar to a menstrual period to make sure the bleeding is not a result of pregnancy complications, such as an ectopic pregnancy. Abnormal bleeding in late pregnancy may be more serious because it can signal a complication with you or your baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester. Your healthcare provider will most likely check for cervical polyps, and make sure your cervix is closed.To help manage your spotting during pregnancy and to increase the probability of continuing with a healthy pregnancy, your healthcare provider may encourage you to do the following:

    Light Bleeding Early Pregnancy

    Bleeding in Early Pregnancy

    Seeing any blood in early pregnancy is worrisome. Remember light bleeding in early pregnancy happens in a quarter of pregnancies, and more than 50% of those women go on to have healthy babies.

    Light bleeding is generally what we call spotting that is smears of pink, red or brown blood and doesnt fill a panty liner.

    Benign causes of light bleeding in early pregnancy are usually implantation bleeding and dont cause other symptoms, such as clots or cramping severe enough to be painful.

    Any signs you are worried about with light bleeding, always seek the advice of your doctor.

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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.

    How Are Bleeding In Early Pregnancy Clarified

    A gynecological examination should always be carried to know How much bleeding is normal during early pregnancy? Ultrasound plays a significant role as a central diagnostic measure. The recording of pregnancy is possible from the 6th week of pregnancy. At this time, sometimes the heartbeat of the embryo is already visible.

    Besides, the measurement of the pregnancy hormone beta-hCG can be helpful in specific suspected diagnoses. Beta-hCG is produced approximately from the fifth day after fertilization and is responsible for maintaining the pregnancy in the first trimester.

    In a natural course of pregnancy, the beta-hCG levels in the blood double every two days and reach their maximum between the 8th and 10th week of pregnancy. After that, they fall off again slowly and continuously. If the cause of the bleeding is unclear, the course of the pregnancy can be monitored using regular beta-hCG determination and appropriate medical measures can be taken if necessary.

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    History And Physical Examination

    Vaginal bleeding in early pregnancy requires prompt attention. A review of the menstrual history and prior ultrasonography can help establish gestational dating and determine whether the pregnancy location is known. Patients should be asked about pain and the amount of bleeding. Bleeding equal to or heavier than a menstrual period and bleeding accompanied by pain are associated with an increased risk of early pregnancy loss.2,7 Patients should be assessed for signs and symptoms of hypovolemia. Vital signs indicating hemodynamic instability or peritoneal signs on physical examination require emergent evaluation. A speculum examination can help identify nonobstetric causes of bleeding, such as vaginitis, cervicitis, or a cervical polyp. If products of conception are visible on speculum examination, the diagnosis of incomplete abortion can be made and treatment offered. Further evaluation is needed unless a definitive nonobstetric cause of bleeding is found or products of conception are seen .8

    FIGURE 1.

    Evaluation of first trimester bleeding.

    Adapted with permission from Reproductive Health Access Project. First trimester bleeding algorithm. November 1, 2017. . Accessed November 10, 2017.

    FIGURE 1.

    Evaluation of first trimester bleeding.

    Bleeding During The Second Or Third Trimester

    What Is The Difference Between Menstrual Bleeding And ...

    Light bleeding later in the pregnancy can be a result of an inflamed cervix. Heavier bleeding is more likely to be a cause of concern. It can be a signal that youre going into preterm labor, which means you go into labor before 37 weeks of pregnancy.

    Heavy bleeding may also be a sign that there is a problem with the placenta. But if caught early, we can address these problems so can you go on to deliver a healthy baby.

    Placenta previa is when the babys placenta partially or totally covers the mothers cervix. Bleeding but no pain marks this condition. Placenta abruption, when the placenta detaches from the uterine wall before or during pregnancy, is a rare condition affecting only 1% of pregnant women.

    Lastly, if bleeding near the end of your pregnancy is mixed with mucus, can be a sign that your water has broken and youre going into labor. In all cases of bleeding, you should speak with your doctor for treatment or to rule out serious conditions.

    For more information about whats normal and whats not during your pregnancy, call the Center for Womens Health in Wichita, Kansas, or make an appointment online.

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    Bleeding From The Placenta

    A vaginal bleed without pain might be caused by an abnormally placed placenta. Its quite common to have a low-lying placenta in early pregnancy.

    Usually, by the third trimester, the placenta will have moved up as the uterus grows and is further away from the cervix. Sometimes, though, this doesnt happen.

    Here are three different placental problems that can result in a vaginal bleed:

    Placenta previa

    Placenta previa will usually result in a vaginal bleed at some point in your pregnancy usually after the 20-week mark.

    There are different degrees of severity, but all cases of placenta previa require repeat ultrasounds for an accurate diagnosis.

    If you have a placenta previa, to prevent risk to your baby, your doctor might recommend bed rest, induction, or c-section if the placenta remains over or too close to the cervix.

    This article about placenta previa has more information.

    Placental abruption

    Another cause of vaginal bleeding later in pregnancies is placental abruption. This is where the placenta partially or completely separates from the wall of the uterus.

    Symptoms include severe pain and bleeding.

    The blood might be visible or remain in the uterus, which will be tense, tight, hard to the touch and very painful.

    Contact your doctor or health care professional if you have any of these symptoms and go immediately to your nearest emergency department.

    Depending on the severity of the bleeding, you might be recommended bed rest, an induction, or even a c-section.

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