During pregnancy, your body changes. A lot. And in early pregnancy, you may deal with some pretty substantial hormonal shifts. Between mood swings, exhaustion and morning sickness, you might not feel your best. But there’s another symptom that can happen in early pregnancy that you might not be thinking about — bleeding or spotting. Show
“Bleeding in early pregnancy happens to 20 to 40% of women,” says Deidre Heber, DO, OB-GYN at Geisinger. “Most of the time, it’s nothing to worry about.” Potential causes of first trimester bleedingBleeding during the first trimester can look different for everyone. The amount can range from light to heavy. For some, it can be intermittent. Others may have more constant bleeding or spotting. And it may or may not be painful. Here are a few things that might be behind it. Implantation bleedingEarly in pregnancy (sometimes before you know you’re pregnant), you may have some spotting when your period is due. This common occurrence is called implantation bleeding. “It happens between 6 and 12 days after conception as the fertilized egg implants into your uterus,” Dr. Heber says. This bleeding is typically light and may last for a few days. Cervical changesDuring pregnancy, there’s increased blood flow to your cervix. Having sex or getting a Pap smear, which cause contact with the cervix, can trigger light bleeding. Other cervical changes that can trigger bleeding include:
HormonesIn the early weeks of pregnancy, your body starts making the hormones you need to sustain a pregnancy. This change can cause your progestin levels to drop. That drop may lead to spotting or light bleeding. MiscarriageSince miscarriages are most common during the first trimester, worrying about bleeding is normal. Light bleeding or spotting doesn’t automatically mean you’re miscarrying. But if your bleeding is heavy, bright red or you’re passing clots and in pain, contact your healthcare provider. They can explain next steps. Most women who miscarry go on to have healthy pregnancies. But having a miscarriage is a loss that families may need help handling. Don’t rush the grieving process, and find a support group or counselor if you feel you need it. Ectopic pregnancyAn ectopic pregnancy happens when a fertilized egg implants outside the uterus, like in your fallopian tube. When that happens, it can lead to heavy bleeding, pain and other serious symptoms. “An ectopic pregnancy is an emergency,” says Dr. Heber. “If you have symptoms, contact your provider immediately.” When to call the doctor about bleedingCall 911 or go to the nearest emergency room if you have any of these symptoms:
If you’re pregnant and bleeding heavily, don’t use a tampon. Wear a pad instead. “Doctors need to know how much you’re bleeding to gauge the severity,” says Dr. Heber. And if you’re passing tissue, consider bringing it in for testing. Your doctor may use an ultrasound to determine the cause of your bleeding. Once they find the cause, they’ll work with you on a treatment plan. Healthy parent, healthy babyBuilding good habits now can help you have the healthiest pregnancy possible. Dr. Heber makes these suggestions to help you (and your baby) feel your best.
Next steps:Meet Deidre Heber, DO Bleeding during pregnancy is relatively common and does not always mean there's a problem – but it can be a dangerous sign. Urgent advice: Call your midwife or GP immediately if:
Coronavirus (COVID-19) updateIf you're well, it's really important you go to all your appointments and scans for the health of you and your baby. If you're pregnant, hospitals and clinics are making sure it's safe for you to go to appointments. If you get symptoms of COVID-19, or you're unwell with something other than COVID-19, speak to your midwife or maternity team. They will advise you what to do. Find out more about pregnancy and COVID-19 Causes of bleeding in early pregnancyImplantation bleedingIn early pregnancy, you might get some harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due. Cervical changesPregnancy can cause changes to the cervix, and this may sometimes cause bleeding – after sex, for example. Miscarriage or ectopic pregnancyDuring the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy. However, if you bleed at this stage of pregnancy it's likely you will go on to have normal and successful pregnancies. MiscarriageIf a pregnancy ends before the 24th week, it's called a miscarriage. Around 1 in 5 pregnancies ends this way. Many early miscarriages (before 14 weeks) happen because there is something wrong with the baby. There can also be other causes of miscarriage, such as hormone or blood clotting problems. Most miscarriages occur during the first 12 weeks (3 months) of pregnancy and, sadly, most cannot be prevented. Other symptoms of miscarriage include:
If you have bleeding or any of the symptoms above, contact your midwife or GP straightaway. Ectopic pregnancyAn ectopic pregnancy is when a fertilised egg implants outside the womb – for example, in the fallopian tube. It can cause bleeding and is dangerous because the fertilised egg cannot develop properly outside the womb. The egg has to be removed, which can be done through an operation or with medicines. Symptoms of an ectopic pregnancy tend to develop in the 6th week of pregnancy but can happen later. Other signs of ectopic pregnancy can include:
Call 111 if you have symptoms of an ectopic pregnancy. Causes of bleeding in later pregnancyCervical changesThese can lead to bleeding, particularly after sex. Vaginal infectionsYour midwife or doctor can discuss tests and treatment with you. A 'show'This is when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is getting ready for labour to start. It may happen a few days before contractions start or during labour itself. Find out about the signs of labour and what happens in labour. Placental abruptionThis is a serious condition in which the placenta starts to come away from the womb wall. Placental abruption usually causes stomach pain, and this may occur even if there is no bleeding. Low-lying placenta (placenta praevia)This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and put you and your baby at risk. You may be advised to go into hospital for emergency treatment, and a caesarean section will usually be recommended. The Royal College of Obstetricians and Gynaecologists has more information on placenta praevia. Vasa praeviaThis is a rare condition where the baby's blood vessels run through the membranes covering the cervix. When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can lose a life-threatening amount of blood. Finding out the cause of bleeding in pregnancyTo work out what is causing the bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels. Your doctor will also ask you about other symptoms, such as cramp, pain and dizziness. Sometimes it might not be possible to find out what caused the bleeding. If your symptoms are not severe and your baby is not due for a while, you'll be monitored and, in some cases, kept in hospital for observation. How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are. Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems. Find the answers to common health problems in pregnancy Video: What should I do if I start bleeding during early pregnancy?In this video, a midwife tells you what to do if you start to bleed during early pregnancy. Media last reviewed: 20 March 2020 How much bleeding in early pregnancy is normal?Implantation bleeding
“It happens between 6 and 12 days after conception as the fertilized egg implants into your uterus,” Dr. Heber says. This bleeding is typically light and may last for a few days.
Can you bleed like a period in early pregnancy?Spotting or bleeding may occur shortly after conception, this is known as an implantation bleed. It is caused by the fertilised egg embedding itself in the lining of the womb. This bleeding is often mistaken for a period, and it may occur around the time your period is due.
How long can you bleed while pregnant?Vaginal bleeding during pregnancy can be scary. However, it isn't always a sign of trouble. Bleeding in the first trimester (weeks one through 12) might occur, and most women who experience bleeding during pregnancy go on to deliver healthy babies.
How does pregnancy bleeding look like?You may see a range of colors depending on how long the blood has taken to exit the body: A fresher bleed will appear as a shade of light or dark red. Blood may look pink or orange if it's mixed with other vaginal discharge. Older blood may look brown due to oxidation.
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Can a woman still bleed while pregnant
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