Any type of bleeding while pregnant is terrifying, even for the most level-headed mom-to-be. The good news: Spotting, or light bleeding in early pregnancy that's not heavy like your menstrual period, occurs for nearly one-third of all moms-to-be and often poses no threat to mom or baby. It's common for a small percentage of pregnant women to have spotting after intercourse, for example, and others may have bleeding for reasons that have nothing to do with pregnancy, such as infections or tears to the vaginal wall. "The vast majority of spotting is harmless," says Alyssa Stephenson-Famy, M.D., Maternal-Fetal Medicine Specialist at the University of Washington, Seattle. But bleeding, no matter how scant, can be indicative of a variety of complications, including miscarriage, ectopic pregnancy, and placenta previa, and thus should never be ignored. Here are the various reasons you may experience bleeding while pregnant, when to know whether you should call your doctor, and tips for effectively communicating your symptoms to your healthcare provider.
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:
Sometimes bleeding during the first half of your pregnancy can be a sign of a more serious condition, however, such as:
Although the risk of miscarriage (known as a stillbirth after the first 20 weeks) diminishes greatly after the first trimester, and many of the early complications are no longer a factor (such as ectopic and molar pregnancies), bleeding during the second half of pregnancy should be taken very seriously, especially if it's ongoing, Dr. Stephenson-Famy says. Causes for bleeding in the second half of pregnancy include:
Vaginal bleeding during pregnancy is not uncommon, but it's also usually not normal. It can indicate many things, depending on whether it's heavy or light, how long it lasts, what color it is, and at what point in the pregnancy it occurs. Signs that bleeding is due to serious conditions such as miscarriage, problems with the placenta, or preterm labor, include heavy bleeding (similar to menstrual bleeding), bleeding in conjunction with cramps and/or fever, or bleeding and passing some tissue. The color of the blood is also important: Blood that's bright red is usually more worrisome than blood that's brownish.
No matter when it occurs, even if you have less than a dime-size spot of blood, call your doctors or midwife immediately to be safe, as any vaginal bleeding during pregnancy can be a symptom of a larger problem. Be prepared to answer detailed questions about the amount of blood you've lost and a description of how you're feeling overall, advises Laura Riley, M.D., author of Pregnancy: The Ultimate Week-by-Week Pregnancy Guide. Your practitioner will decide whether there's a cause for concern. If this is the case, she may want to monitor the situation by having you stay off your feet for a few hours and call back, or have you to come in immediately. She may also order an ultrasound to see what's going on with the fetus. Dr. Riley says you should insist on being seen if you have any vaginal bleeding that makes you feel faint or soaks through a sanitary pad. You should also be seen if the bleeding is persistent or accompanied by pain or a fever.
Unfortunately, if the bleeding is due to a miscarriage, there's nothing that can be done.
If the bleeding is a sign of preterm labor, your doctor will take steps to prevent it, possibly recommending bed rest or medication.
If the bleeding is due to placenta previa—a condition in which the placenta covers the mouth of the uterus—then your doctor may put you on modified bed rest. She'll probably avoid conducting an internal vaginal exam, and will probably recommend that you have a c-section when your baby is ready to be born. A scheduled c-section is usually done at 38 or 39 weeks, but women with placenta previa often bleed in the third trimester. If this is the case, the c-section may be done earlier.