Its it normal to bleed during pregnancy

Bleeding and spotting from the vagina during pregnancy

Bleeding and spotting from the vagina during pregnancy are common

If you bleed or spot during pregnancy, it doesn’t always mean there’s a problem but in some cases they may be signs of a problem for you or your baby’s health

If you have heavy bleeding, call your health care provider right away

Tell your provider about any bleeding or spotting you have during pregnancy

Bleeding and spotting from the vagina during pregnancy are common. Up to 1 out of 4 (up to 25%) of all pregnant women have some bleeding or spotting during their pregnancy.

Bleeding and spotting in pregnancy don’t always mean there’s a problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.

Call your health care provider if you have any bleeding or spotting, even if it stops. It may not be caused by anything serious, but your provider needs to find out what’s causing it.

What’s the difference between bleeding and spotting?

Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Spotting is light bleeding. It happens when you have a few drops of blood on your underwear. Spotting is so light that the blood wouldn’t cover a panty liner. Bleeding is when the blood flow is heavier, enough that you need a panty liner or pad to keep the blood from soaking your underwear and clothes.

What should you do if you have bleeding or spotting during pregnancy?

Call your health care provider if you have any kind of bleeding during pregnancy and do these things:

Keep track of how heavy your bleeding is, if it gets heavier or lighter, and how many pads you are using.
Check the color of the blood. Your provider may want to know. It can be different colors, like brown, dark or bright red.
Don’t use a tampon, douche or have sex when you’re bleeding.

Call your health care provider right away at any time during pregnancy or go to the emergency room if you have:

Heavy bleeding
Bleeding with pain or cramping
Dizziness and bleeding
Pain in your belly or pelvis

What causes bleeding or spotting early in pregnancy?

It’s normal to have some spotting or bleeding early in pregnancy. Bleeding or spotting in the first trimester may not be a problem. It can be caused by:

Having sex
An infection
Implantation. When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow.
Hormone changes. Hormones are chemicals made by the body.
Changes in your cervix. The cervix is opening to the uterus that sits at the top of the vagina.
Certain types of testing during pregnancy like an amniocentesis or Chorionic villus sampling (CVS). These are tests that are done to check for genetic abnormalities in your baby. Genetic abnormalities are changes in the genes that are passed down to a baby from mom or dad. These genetic changes can cause health problems for a baby.
Problems related to smoking. If you smoke, it’s best to stop before pregnancy or as soon as you know you’re pregnant.

Sometimes bleeding or spotting in the first trimester is a sign of a serious problem, like:

Miscarriage. Almost all women who miscarry have bleeding or spotting before the miscarriage.
Ectopic pregnancy. This is when a fertilized egg implants itself outside of the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. It can cause serious, dangerous problems for the pregnant woman.
Molar pregnancy. This is when a mass of tissue forms inside the womb, instead of a baby. Molar pregnancy is rare.

What causes bleeding or spotting later in pregnancy?

Bleeding or spotting later in pregnancy may be caused by:

Labor
Having sex
An internal exam by your health care provider
Problems with the cervix, like an infection, growths, inflammation or cervical insufficiency. This is when a woman’s cervix opens too early. Inflammation of the cervix is when it may be painful, swollen, red or irritated.

Bleeding or spotting later in pregnancy may be a sign of a serious problem, like:

Preterm labor. This is labor that happens too early, before 37 weeks of pregnancy.
Placenta previa. This is when the placenta lies very low in the uterus and covers all or part of the cervix.
Placenta accreta. This is when the placenta grows into the wall of the uterus too deeply.
Placental abruption. This is when the placenta separates from the wall of the uterus before birth.
Uterine rupture. This is when the uterus tears during labor. This happens very rarely. It can happen if you have a scar in the uterus from a prior cesarean birth (also called c-section) or another kind of surgery on the uterus. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.

How are bleeding and spotting treated?
Your treatment depends on what caused your bleeding. You may need a medical exam and tests.

Most of the time, treatment for bleeding or spotting is rest. Your provider may also suggest treatments like:

Take time off from work and stay off your feet for a little while
You may need medicine to help protect your baby from Rh disease. Rh disease is when your blood and baby’s blood are incompatible (can’t be together). This disease can cause serious problems — even death — for your baby.
Don’t have sex, douche or use tampons
If you have heavy bleeding, you may need a hospital stay or surgery

Last reviewed April 2020

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Contact your doctor or midwife if you notice bleeding from your vagina at any time during your pregnancy. If you have very heavy bleeding, strong pain or feel very unwell, call triple zero (000) immediately and ask for an ambulance.

Is it normal to bleed during pregnancy?

Bleeding during pregnancy, especially in the early stages, is quite common. About 1 in 4 women will experience vaginal spotting or bleeding during the first trimester. Many of these women will go on to have healthy pregnancies.

However, vaginal bleeding may be the first sign of a problem, so it’s important to contact your doctor or midwife if you experience vaginal bleeding at any stage of your pregnancy for advice on what to do next.

What are the causes of bleeding during pregnancy?

The causes of bleeding during pregnancy are generally divided into two categories — bleeding before 20 weeks and bleeding after 20 weeks gestation.

Before 20 weeks gestation, causes of bleeding may include:

Implantation bleeding — in very early pregnancy (4 to 5 weeks gestation) some women may experience bleeding when the pregnancy implants itself in the lining of the uterus (womb).
Miscarriage — bleeding may be the first sign of a miscarriage. About 1 in 15 women who experience bleeding in early pregnancy end up having a miscarriage.
Ectopic pregnancy — a rare but serious cause of bleeding when a fertilised egg starts growing outside the uterus (womb). An ectopic pregnancy can rupture (burst) and cause heavy bleeding, and may be life-threatening.

Bleeding in later pregnancy (after 20 weeks) is usually caused by problems with the placenta such as:

Placenta previa — also known as a 'low lying placenta', when the placenta implants close to the cervix (neck of the uterus). If the cervix starts to open or the uterus contracts, this can cause bleeding.
Placental abruption — when the placenta starts to separate from the uterus during pregnancy but before birth, causing bleeding from the place where the placenta has peeled away. Bleeding caused by placental abruption is usually associated with sudden, severe abdominal pain.

Less common causes of bleeding, which may happen at any stage of pregnancy, may include:

genital tract infections
injuries to the genital tract
growths or tumours of the reproductive system
bleeding from vulvovaginal varicosities (varicose veins in the vulva or vagina)

What should I do if I bleed during pregnancy?

If you bleed during pregnancy, contact your doctor or midwife. Your antenatal care provider can give you advice about what to do next.

It can be helpful to note down details about what you have been experiencing. This may include:

the amount and colour of any discharge
whether you have passed any clots
whether you have had any abdominal pain

If you are having heavy bleeding, it’s a good idea to keep your pads or stained clothes to show your doctor or midwife.

How will my doctor or midwife diagnose the cause of my bleeding?

Your doctor or midwife will ask you questions about the bleeding, any other symptoms you have been having and about your pregnancy and general health. Your doctor or midwife may also perform a vaginal examination to check the bleeding and look for any visible cause.

You may be referred for a blood test to check your human chorionic gonadotropin (hCG) level. hCG is a hormone made by the placenta that can be found in your blood and urine. Your hCG level can give your doctor important information about how your pregnancy is progressing.

You may also be referred for an ultrasound scan, which may be used to:

check your baby’s heartbeat
check for signs of a miscarriage
look for signs of an ectopic pregnancy
check the position and health of the placenta

It may take some time to work out what is causing your bleeding. You may need to have several blood tests or ultrasound scans over a few days or weeks. This can be a stressful time, so consider seeking support from your partner or someone else you trust.

In some situations, your bleeding may resolve on its own without your doctor or midwife finding a cause.

When should I seek medical attention?

If you have bleeding at any stage of pregnancy, contact your doctor or midwife for advice and support.

You should contact your doctor urgently, or visit the nearest emergency department, if:

your bleeding becomes very heavy
you have strong pains
you feel dizzy or faint
you feel short of breath

If you have very heavy bleeding, strong pain or feel very unwell, call triple zero (000) immediately and ask for an ambulance.

Does bleeding mean I am having a miscarriage or might lose my baby?

Bleeding in early pregnancy is very common and does not necessarily mean you are having a miscarriage. Many women who experience bleeding in early pregnancy go on to have healthy babies.

In some cases, bleeding can be the first sign of a miscarriage. If you are experiencing bleeding in early pregnancy, contact your doctor or midwife for advice.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

The Royal Women's Hospital (Bleeding in early pregnancy), Safer Care Victoria (Bleeding in early pregnancy), Royal Women's Hospital (Placenta problems), Safer Care Victoria (Antepartum haemorrhage: assessment and management), Australian Family Physician (Early pregnancy bleeding)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: June 2022

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Bloody discharge during pregnancy ᐈ Blood during early pregnancy

Seeing bloody discharge, a pregnant woman is always frightened. They are considered a symptom of miscarriage and other equally serious pathologies. At the same time, in some cases, the appearance of a small amount of blood is considered the norm and does not pose a threat to the life and health of the fetus or the expectant mother.

In early pregnancy, bloody discharge occurs in 25% of women. In most cases, they are associated with the implantation of the fetal egg to the wall of the uterus. Also, scanty spotting may appear on the dates of the expected menstruation. If they end quickly, are not accompanied by pain, and the woman has not had miscarriages or pregnancy complications before, most likely she has nothing to worry about. However, it is necessary to consult an obstetrician-gynecologist and undergo an examination. nine0003
Why bloody discharge can appear and when it is dangerous, said Elena Petrovna Domnich, obstetrician-gynecologist of the highest category, gynecologist-endocrinologist, ultrasound specialist of the ADONIS medical center.

Elena Nikolaevna, tell me, can a woman have periods during pregnancy?

- Sometimes during pregnancy, a woman may experience spotting, but this should not be interpreted as menstruation. Menstruation occurs at the end of the menstrual cycle, during which the endometrium changes, first proliferative, then secretory. During the cycle, the endometrium prepares for pregnancy, and if it does not occur, then menstruation begins. nine0003
In the event of pregnancy, menstruation is not possible, although bleeding may occur at the expected time. Because of this, some women do not immediately know that they are pregnant. However, when the obstetrician-gynecologist at the reception asks them about the nature of the discharge, it always turns out that they are different from menstrual. As a rule, they are more scarce, pass faster and are not accompanied by other symptoms. Sometimes a woman says that her period was very recent, but at the time of examination and examination, we find that she is already 8 or 12 weeks pregnant. nine0003

How often does this happen? Is spotting during pregnancy an exception or a fairly common occurrence?

- Bloody discharge is not common in pregnant women, but still it cannot be said that these are exceptional cases.

Tell me, if a woman is planning to conceive a child, and during the expected period she has atypical discharge, should she take a pregnancy test? nine0012

– Yes, but it is better to visit an obstetrician-gynecologist. There are cases when a woman is pregnant, but the test strip shows a negative result. To accurately determine whether there is a pregnancy, allows a blood test for the level of hCG.

So bleeding during pregnancy is not menstruation, but bleeding? Why can it appear and why is it dangerous?

- Yes, that's right. This is bleeding, not menstruation. It can be a symptom of a miscarriage, ectopic pregnancy, or other pathology. For diagnosis, you must consult a doctor. nine0003

Tell me more, if a woman has a discharge and thinks she is menstruating, but a previous pregnancy test came back positive, could it be wrong?

- A pregnancy test is sometimes positive even if it is not. This happens if a woman has formed luteal cysts or developed a thyroid disease.

Bloody discharge during pregnancy requires contacting the antenatal clinic or the medical center where the woman was registered for pregnancy management. Sometimes they may not be dangerous, but without diagnosis, it cannot be ruled out that this is a symptom of a serious disorder. nine0003

Bleeding may occur with:

threatened miscarriage;

ectopic pregnancy;

infectious diseases of the reproductive system;

cysts;

myomas;

cervical erosion;

placental abruption;

threatened preterm birth.

You can watch the video version of Elena Petrovna Domnich's interview here. More helpful videos on our YouTube channel. nine0003
Pathological and physiological causes of bleeding during early pregnancy

The gestation period is a complex process that does not always go well. Every second woman has various complications. Most often, women go to the doctor with complaints of spotting. Why does bleeding occur during early pregnancy, how dangerous is it?

Causes of bleeding in pregnancy

Blood in the first trimester of pregnancy in the vaginal secretion is observed in 30% of expectant mothers. Bleeding can be weak, spotting, plentiful. nine0003
Most often, blood during pregnancy in the early stages is observed during implantation of the fetal egg. When the egg is attached, the vessels are often damaged, which leads to the appearance of blood secretions. They are similar to menstruation, last 1-2 days. This process is considered natural, does not indicate any pathologies.

Any spotting during early pregnancy is a reason for an urgent appeal to a gynecologist. Even if there is no additional discomfort. At a remote consultation, our doctor will collect an anamnesis, draw up a clinical picture in order to identify the cause of bleeding. And he will select effective methods to eliminate the problem. nine0003
Blood during pregnancy - other common causes

In addition to the main ones, there are some other reasons why pathology can develop.

No.

Cause

one nine0003

Excessive exercise, deep penetration during intercourse. If the cervix is damaged, slight red discharge occurs, which disappears within two hours.

2

Progesterone deficiency. With a low level of the hormone, the body starts the process of menstruation. Bloody discharge during pregnancy appears when the uterine mucosa is exfoliated. The situation may adversely affect the implantation of the fetal egg. nine0003

3

Miscarriage - occurs in 2-8% of pregnant women. It is characterized by pain in the lower abdomen, which is rapidly increasing, bloody discharge at the beginning of pregnancy. The causes of the pathological condition can be different - infectious diseases, fetal malformations that are incompatible with life, dehydration, abdominal trauma, taking certain drugs.
nine0114

4

Ectopic pregnancy. Dangerous condition, urgent hospitalization is required.

five

A failed miscarriage. Blood discharge during pregnancy, abdominal pain are the main manifestations of intrauterine development of the fetus.
nine0114

6

Infections. To avoid dangerous complications, it is necessary to treat diseases. Parents of both sexes should be tested.

7

Full or partial hydatidiform mole. Pathology of the chorion, in which the size of the villi increases, bubble expansions form. The risk group includes women with ovarian dysfunction, inflammatory diseases of the reproductive system, and a history of cystic mole. Bleeding is profuse and constant, characteristic blisters are present. The symptoms of early toxicosis are very pronounced, the size of the uterus, the hCG indicators do not correspond to the gestational age. nine0003

eight

Cervical cancer. Pregnant women are rarely diagnosed. The risk group includes women with a large number of abortions and childbirth, often changing sexual partners.

nine

Subchorionic hematoma. Hemorrhage around the placenta most often resolves on its own. But it increases the risk of preterm birth and other complications. nine0003

10

Cervical erosion. Detected in 50% of women. For pregnant women, the disease is not dangerous, but constant medical supervision is needed.

Bleeding in the first trimester can be caused by causes that appear at any gestational age. These are fibroids, polyps in the uterus and cervical canal, cardiovascular pathologies that are associated with a weakening of the endothelium. nine0003
Physiological or pathological bleeding during gestation - differences

Clinical manifestations of bleeding in pregnant women depend on the causes of occurrence. Physiological discharge of blood from the genital tract in the early stages of gestation proceeds without deterioration in well-being. With bleeding caused by erosion, fibroids and polyps, there are also no additional discomfort. In this case, only a few drops of blood are released, it bleeds for a short time. nine0003
Abundant bleeding, similar to menstruation, against the background of a general satisfactory condition, occurs with a deficiency of progesterone.

Bleeding with spontaneous interruption is accompanied by constant or periodic pain in the lumbar region, abdomen. Disturbed by nausea, bouts of dizziness, slightly increased body temperature. Bleeding can be weak or intense, and clots are often observed in the discharge.
nine0002 When a fertilized egg is fixed outside the uterus, internal bleeding often occurs, and discharge from the genital tract may appear much later. Characteristic manifestations - acute pain in the abdomen radiates to the anal region, right or left side, blood pressure decreases, cold sweat appears, fainting is possible. Significant blood loss leads to the development of a state of shock with a high probability of death.

Learn more about implantation bleeding

Why does it bleed at the initial stages of gestation? Most often, the appearance of spotting during pregnancy is associated with the implantation of the embryo. They occur 6-12 days after conception and are often one of the first signs of conception.

Usually, the appearance of spotting at the beginning of pregnancy coincides with the time of the onset of menstruation, if the cycle is regular. But discharge in pregnant women is not as abundant as menstrual bleeding. Duration - from several hours to three, with the first pregnancy up to 5 days. nine0003
How does implantation bleeding manifest?

weak, pulling pain in the lower abdomen;

headache, dizziness;

sudden change of mood;

bouts of nausea;

increased sensitivity, swelling of the mammary glands;

fatigue, drowsiness.

Important! When the embryo is implanted, little blood is released, usually these are small specks. The discharge may be pink, brown, orange, and there should be no clots. nine0003
Possible causes of early bleeding by week

The first months of pregnancy are the most difficult and dangerous. It is in the early stages that various pathologies and complications often appear.

Why blood may appear in the early stages during pregnancy:

At the 4th week of pregnancy, discharge with an admixture of blood may appear - this is implantation bleeding. Heavy bleeding is a dangerous sign, most often indicates a miscarriage. Spontaneous abortion can be caused by exercise, fever, infections, drugs or alcohol. Such bleeding is profuse, painful, blood clots are present. nine0068
The appearance of sanious discharge at the 5th week of pregnancy may be a sign of a missed pregnancy. The reasons are overwork, Rh conflict, bad habits, bacterial and viral diseases of the reproductive system, genetic disorders in the embryo. Symptoms - causeless fever, severe pain in the lower back and lower abdomen, the disappearance of signs of toxicosis.

Blood in the discharge at the 6th week of pregnancy appears with an ectopic attachment of the fetal egg, fetal fading, Rhesus conflict. Discharge with blood at 6 weeks of pregnancy is a reason for an urgent visit to the gynecologist. nine0068
At the 7th week of pregnancy, discharge with blood is not the norm. May indicate a miscarriage, missed or ectopic pregnancy.

From the 8th week of pregnancy, one of the most dangerous periods of pregnancy begins. The formation of the placenta begins, the hormonal background changes. Bloody discharge appears with the threat of miscarriage or spontaneous abortion. Pregnancy is often not saved.

Pay attention! nine0258 In the second trimester, bleeding occurs only in 5-10% of women. Most often this is due to late spontaneous abortion, isthmic-cervical insufficiency. The appearance of blood in the third trimester mainly occurs with presentation, placental abruption.

Early bleeding after IVF

The appearance of blood discharge during pregnancy on the 8-10th day after IVF is not considered a pathology, provided that the woman feels normal. After the introduction of the embryo into the uterine cavity, minor damage to the small uterine vessels often occurs. Brown, dark cream, pale pink, odorless discharge most often indicates a successful transplant, pregnancy. nine0003
If spotting after IVF is observed for 1-2 days, slight pulling pains in the lower abdomen are disturbing, this may be due to a progesterone deficiency. After the examination, the doctor will adjust the hormonal maintenance therapy.

Pink discharge on the 16th day after the transfer is a dangerous symptom. It may be a sign of detachment of the fetal egg, the threat of termination of pregnancy.

According to studies, uterine bleeding in the first trimester is a common occurrence in pregnancy after IVF. Discharge does not affect the incidence of adverse reproductive outcomes. The number of embryo rejections in women with and without uterine bleeding is approximately the same. Consult with our doctors by phone for more details. nine0003
Diagnostics

If blood has gone from the genitals of a pregnant woman, the doctor conducts an external and gynecological examination.

Analyzes and examinations:

general and biochemical blood test;

general urine analysis;

tests for hCG, other hormones;

Ultrasound of the pelvic organs;
nine0067 CTG is performed to assess the vital activity of the fetus.

Treatment

Methods of treatment depend on the results of the examination.

Bloody discharge in the first trimester - causes and therapeutic measures:
nine0119 nine0111
hormone therapy.

Causes

Treatment

Miscarriage

Cleansing the uterus.

Ectopic pregnancy

Diagnostic laparoscopy, removal of residual fetal tissues, antibiotic therapy.

Risk of miscarriage nine0003

Hospitalization, bed rest, prescribing drugs to maintain pregnancy, sedatives and tocolytics to reduce uterine tone.

bubble skid

Curettage of the uterine cavity.

Cervical cancer nine0003

Operational intervention.

Polyp injury, cervical erosion

Expectant management, if the condition does not worsen, removal and cauterization is carried out after childbirth.

progesterone deficiency

Damage to the uterus

Complete bed rest.

Infectious pathologies

Depending on the type of pathogen - antibiotics, antiviral or antifungal drugs. nine0003

Complications and consequences

It is impossible to ignore bloody impurities in vaginal discharge during pregnancy. Without proper and timely assistance, the following complications may occur:

miscarriage;

intrauterine fetal death;

the development of an infectious process, sepsis due to the remainder of dead tissues in the uterine cavity;

profuse blood loss can lead to death. nine0068

Important! Urgent medical attention is needed in case of heavy bleeding, bright scarlet blood, presence of blood clots in the discharge. In life-threatening and fetal conditions, severe pain in the abdomen, lower back, convulsions, profuse cold sweat, and loss of consciousness are disturbing.

Methods of prevention

If there is blood in the first trimester, it is important to remain calm. Stress and anxiety will only exacerbate the situation. But any health problem is easier to prevent than to treat. nine0003
How to avoid bleeding during childbearing - recommendations from a gynecologist:

eat right and balanced, give up junk and junk food, eat more fresh vegetables and fruits;

observe the drinking regime;

in the absence of contraindications, moderate physical activity is indicated - yoga, swimming, special gymnastics for pregnant women;

more time to walk in the fresh air; nine0068
avoid stress, overwork, observe the daily routine, get enough sleep;

give up bad habits, do not be in smoky rooms;

timely visit a gynecologist;

according to the doctor's prescription, take vitamin complexes for pregnant women;

do not self-medicate.

The prognosis for bleeding during gestation depends on the causes and timely visit to the doctor. Properly provided medical care can save the life of the fetus and the woman. nine0003
FAQ

Why is there blood from the genital tract during gestation?

+

The causes of bleeding in early pregnancy are different. Most often, spotting appears when the fetal egg is fixed, progesterone deficiency, with erosion of the cervix and polyps. Dangerous causes - ectopic, molar, miscarriage, miscarriage.

What to do if there is bleeding during pregnancy? nine0003
+

Much depends on the amount of blood released, general well-being. If the bleeding is not strong, not for long, the general condition is normal, it is enough to lie down and rest. Write down the date of the attack, inform the doctor at the next visit. But if even slight spotting during early pregnancy lasts more than 72 hours, is accompanied by cramping or acute pain, fever, you should immediately visit a gynecologist or call an ambulance. nine0003
How can you recognize a miscarriage?

+

With the threat of interruption, spotting is scanty, pain in the lower abdomen is absent or may be dull, aching. The condition is considered reversible, with timely treatment, pregnancy can be saved. If a miscarriage has begun, bleeding intensifies, cramping pain appears. The general condition is satisfactory. Urgent hospitalization is required, the probability of maintaining pregnancy is decided on an individual basis. nine0003
Expert opinion:

Bleeding during pregnancy is a dangerous symptom. Sometimes spotting can be caused by physiological reasons. But often such a symptom appears in life-threatening conditions for the woman and the fetus.

We publish only verified information

Article author nine0003
Menshikova Maria Viktorovna obstetrician-gynecologist

Experience 38 years

Consultations 1816

Articles 46

Specialist with extensive practical experience.
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