Vaginal bleeding isn't uncommon during pregnancy and it can occur anytime from the time an egg is fertilized until the end of the pregnancy. Although it can occur at any time, many women experience spotting or bleeding during the first 20 weeks of their pregnancy.
While bleeding in pregnancy can be scary for most women, it doesn't necessarily mean you are having a miscarriage. However, bleeding can be an indication that there is a serious problem and you should be checked by your doctor.
Bleeding in Early Pregnancy, Is It Serious?
Although it can be worrisome, bleeding during pregnancy is common, especially during the first trimester. Doctors estimate that 25 to 40 percent of women will experience some vaginal bleeding during the first three months of their pregnancy. Bleeding usually occurs about the same time that your period would have been due and it usually lasts for only a day or two. Even though some women experience vaginal bleeding, most of their pregnancies progress normally.
What Causes Bleeding in Early Pregnancy?
It can be frightening to experience vaginal bleeding or spotting during pregnancy, while it could sometimes indicate a serious problem, most causes of vaginal bleeding are not serious at all.
Common but Not Serious Causes
Implantation Bleeding
This type of vaginal bleeding is often one of the early indications of a pregnancy and it can affect 1 out of every 3 women. Implantation bleeding occurs after a fertilized egg has attached itself to the wall within the uterus, which occurs about 6 to 12 days after conception. While the bleeding is usually light, some women do have a good deal of spotting. Along with bleeding, some women may have cramps, but they are usually milder than those associated with their period.
Breakthrough Bleeding
A few pregnant women experience bleeding about the same time their menstrual cycle is usually due, which is referred to as breakthrough bleeding. They will experience many of the same period symptoms as well, including cramps, backaches and a bloated feeling. Breakthrough bleeding can continue to occur throughout the first trimester, but it can also continue throughout the entire pregnancy for some women, who then go on to have healthy babies.
Bleeding After Sex
The bleeding is caused by more blood in the cervix, along with its softening. Although you should always report bleeding during your pregnancy, one of the first questions you will be asked by your healthcare provider will be "have you had sex?" Always answer the question honestly so it can be noted during an examination. Sex during pregnancy is normally safe and your doctor or midwife can answer any of your concerns about it.
Other Common Causes of Bleeding in Early Pregnancy
- Fibroids, which are harmless growths in the uterus, can cause bleeding when the placenta embeds where fibroids are present.
- Cervical polyps, which are harmless growths in the cervix
- Cervical or vaginal infections
- Von Willebrand Disease, which is a genetic disorder that makes it difficult for blood to clot
- Pap smears or vaginal exams may cause some minor bleeding during pregnancy.
Serious Causes of Vaginal Bleeding
While most of the time bleeding in early pregnancy isn't a cause for concern, there are some serious problems that will lead to bleeding. These problems include:
Threatened or Actual Miscarriage
Studies have found that during the first 12 weeks of pregnancy, about one out of every three pregnancies end in miscarriage. However, many of these miscarriages occur before a woman even knows she is pregnant. Aside from vaginal bleeding, indications of a miscarriage include mild to severe cramps, back pain, the cessation of pregnancy symptoms like nausea and passing tissue or blood clots.
Ectopic Pregnancy
An ectopic pregnancy occurs when the fertilized egg implants outside of the uterus, most commonly in a fallopian tube. Ectopic pregnancies are much less common than miscarriages, occurring in about one out of every 100 pregnancies. Bleeding is one of the symptoms with this type of pregnancy and others include pain in the abdomen on one side, feeling faint and being nauseous. The pain usually stops if the fallopian tube ruptures. However, it will reappear and it may be worse than before. If you know you are pregnant and experience pain in your abdomen, you should contact your doctor.
Molar Pregnancy
A molar pregnancy occurs when there is a problem with fertilization and there is abnormal cell growth within the placenta. This is a very rare occurrence, taking place only one to three times out of every 1,000 pregnancies. When this type of pregnancy occurs, women will usually have typical pregnancy symptoms early on, but they will have spotting or bleeding 6 to 12 weeks into the pregnancy.
When to Worry
It is recommended that you report any bleeding in early pregnancy to your doctor or midwife. They may ask you to describe the amount of bleeding you experienced, what it looked like and whether any clots or tissue were included.
During the first trimester, which is week 1 to 12 of a pregnancy, you should:
- Inform your doctor of any spotting or light bleeding that stops after a day.
- Contact your doctor if you have vaginal bleeding that lasts longer than 24 hours.
- Contact your doctor if you have moderate to heavy bleeding, pass tissue or have vaginal bleeding that is occupied by cramps, abdominal pain, fever or chills.
Even though you may experience vaginal bleeding early in pregnancy, most of the time the spotting or bleeding is normal and there is no cause to be concerned. It is also important to remember that most pregnancies will full-term and you can have a healthy baby.