Bleeding During Pregnancy – What‘s Normal?

Vaginal bleeding during pregnancy isn’t common. However, it can happen for different reasons. It can be the result of something serious or non-serious.

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Vaginal bleeding can happen at any stage of a pregnancy, from conception to delivery. Light bleeding is commonly called spotting. With spotting, you may see just a few drops of blood in your underwear. Heavy bleeding is more noticeable. It will require a sanitary pad to protect your clothing.

While some spotting is normal during the first 12 weeks of pregnancy (first trimester), you should always call your doctor whenever you experience bleeding of any kind. You should call your doctor if you have vaginal bleeding or spotting, even if an ultrasound test (where a technician moves a wand around your stomach to see an image of the baby) has confirmed your pregnancy is normal.

Non-serious reasons for bleeding early in your pregnancy can include:

  • implantation (as the egg settles in your uterus the first 6-12 days)
  • sex
  • infection
  • hormones.

More serious causes of vaginal bleeding during the early part of pregnancy can include:

  • An ectopic pregnancy (a pregnancy that starts outside the uterus and will not survive).
  • A miscarriage (losing the baby early in a pregnancy).
  • A molar pregnancy (a fertilized egg that implants in the uterus that does not live).

In later pregnancy, the following medical conditions can cause vaginal bleeding:

  • Placental abruption (the placenta detaches from the wall of the uterus during birth).
  • Placenta previa (the placenta is lying too low in the uterus and nearly covers the cervix).
  • Placenta accreta (when the placenta invades and doesn’t separate from the uterine wall).
  • Preterm labor (labor that starts before completing 37 of 40 weeks of pregnancy). Bleeding may be just one sign of preterm labor. It also can include vaginal discharge, pressure in your pelvis or abdomen (lower stomach), a dull backache, cramps, contractions, and your water breaking.

If your bleeding is not serious, your doctor may treat it by recommending that you rest, relax, stay off your feet, and not have sex. Also, when you are pregnant, you should never douche (use vaginal cleansing products) or use tampons. Serious bleeding may need to be treated with a long-term bed rest, hospitalization, or surgery.

Things to consider

If you experience bleeding or spotting at any time during your pregnancy, your doctor will want to collect as much information as possible. That will include:

  • How far along is your pregnancy?
  • Have you had bleeding at any other time during your pregnancy?
  • When did the bleeding start?
  • Is the bleeding heavy or spotting?
  • Does it start and stop?
  • How much blood is there?
  • What color is the blood (bright red or dark brown)?
  • Does the blood have an odor?
  • Do you have cramps or pain?
  • Do you feel weak, tired, faint, or dizzy?
  • Have you experienced vomiting, nausea, or diarrhea?
  • Do you have a fever?
  • Were you recently injured (such as a fall or car accident)?
  • Have you engaged in any physical activity?
  • Are you under extra stress?
  • When did you last have sex? Did you bleed afterward?
  • Do you have a bleeding disorder? Women with bleeding disorders are at risk of complications during and after pregnancy. This includes iron-deficiency anemia, bleeding during pregnancy, and serious bleeding after delivery (postpartum hemorrhage). Talk to your doctor before getting pregnant if you have a bleeding disorder. Also, bleeding disorders are genetic.
  • What is your blood type? If your blood type is Rh negative, you will need treatment with a medicine called Rho(D) immune globulin. This prevents complications with future pregnancies.

Vaginal bleeding is usually blood without clots or tissue. If you see something other than blood, call your doctor immediately. Try to collect the discharge in a container and bring it with you when you see your doctor. It may mean you have miscarried. If that is the case, your doctor will provide additional care.

Questions to ask your doctor

  • Can certain foods (such as spicy foods) cause bleeding?
  • Is it best to avoid having sex throughout your entire pregnancy?
  • Is spotting during later pregnancy normal?

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