Vaginal bleeding during pregnancy

Vaginal bleeding at any point can be distressing, but during pregnancy, it can be even more so. Bleeding isn’t uncommon during pregnancy and it often isn’t harmful, but it’s important for pregnant women to report any vaginal bleeding to their healthcare provider as this can indicate a serious complication. Your provider can determine if the situation calls for further attention.

The difference between spotting and bleeding

Spotting is very light bleeding that leaves only spots of blood on underwear and can’t fill a panty liner. Vaginal bleeding involves a significantly heavier flow.

Causes of vaginal bleeding early in pregnancy

Light bleeding is not uncommon in early pregnancy. It’s believed that nearly 20% of pregnant women notice light bleeding in the first trimester of their pregnancy. This can be caused by a few things, and some less serious causes are:

  • Implantation bleeding: This is when the fertilized egg attaches to the uterine lining. The amount of bleeding can seem like spotting or even like a light period, which can confuse women who don’t yet know that they’re pregnant
  • Subchorionic bleeding: This type of bleeding occurs when blood collects between the uterus and the chorion, a membrane surrounding the fetus, causing a subchorionic hematoma. This is the most common form of bleeding in the first trimester, and it usually resolves on it’s own
  • Cervical polyps: These aren’t necessarily harmful, but they will bleed more during pregnancy due to the body’s fluctuating hormones. Sometimes sexual intercourse will make them bleed, and your healthcare provider may advise you to stop having intercourse during early pregnancy if it causes bleeding
  • Certain infections in the urinary tract or pelvis

Some more serious causes of vaginal bleeding in early pregnancy include:

  • Ectopic pregnancy, when the fertilized egg implants somewhere besides the uterus
  • Molar pregnancy, which involves tissue forming in the womb in place of a fetus
  • Miscarriage. Vaginal bleeding often accompanies a miscarriage

Causes of vaginal bleeding later in pregnancy

Vaginal bleeding in the second half of pregnancy has different causes than bleeding in the first half. Again, some are serious and some are not as serious. They include:

  • An inflamed cervix
  • A growth on the cervix

Some serious causes of vaginal bleeding later on in pregnancy are:

  • Placental abruption, a rare but serious condition in which the placenta separates from the uterine wall
  • Placenta previa, another serious condition in which the placenta lies low in the uterus or completely covers the cervical opening
  • Labor, especially if it comes before 3 weeks of your due date. This would be accompanied by the bloody show (mucus and blood-tinged discharge), pelvic pressure, cramps, or a low, dull backache

Vaginal bleeding: the bloody show?

Many women wonder if vaginal bleeding during the later stages of pregnancy is in fact the bloody show. If you see blood in the second half of pregnancy but before 37 weeks, make sure to assess the amount of blood and any symptoms that you feel. The bloody show is usually described as light bleeding or mucus that has slight traces of blood in it, and is often accompanied by stomach cramps. You will want to call your healthcare provider immediately if you notice what appears to be the bloody show at this stage in pregnancy.

If you see light blood and feel cramping within 3 weeks of your due date, this could be the bloody show and is a normal sign that labor is approaching.

Vaginal bleeding in pregnancy: what to do

It’s best to call your healthcare provider to report any bleeding that you notice. Try to wear a panty liner or pad so that you can see how much blood there is. Don’t put in a tampon, have sex, or use anything that would block the flow or introduce bacteria into the vagina. And try to pay attention to how you’re feeling – for example, if you feel dizzy or have cramps. These are important symptoms that your healthcare provider will want to know about.

Your healthcare provider may determine that tests need to be done. These could include a pelvic exam or measuring your levels of hCG, a hormone released in the body during pregnancy.

Vaginal bleeding during pregnancy shouldn’t be an immediate cause for panic. It is, however, important to know some of the common causes of vaginal bleeding and what you should do if you notice any blood at specific stages of your pregnancy. Vaginal bleeding during pregnancy can sometimes indicate serious conditions, so you’ll want to be aware of any changes as early as possible.

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