Bleeding during pregnancy
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Vaginal bleeding during the early stages of pregnancy is more common than you may think and it doesn't always mean that something is wrong. We look into early pregnancy bleeding, such as implantation bleeding, as well as what to do if you start bleeding later on during your pregnancy.
Bleeding during early pregnancy
‘Bleeding in the first 12 weeks is common and although it's frightening, it doesn't always mean your pregnancy is failing,’ says Netmums’ official midwife, Leah Hazard.
In fact, one study quoted by the Miscarriage Association showed that half of all women who visited an Early Pregnancy Unit (EPU) because of first-trimester bleeding went on to have healthy pregnancies.
Here are some of the main reasons for bleeding in early pregnancy:
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- implantation bleeding
- breakthrough bleeding
- bleeding after sex
- ectopic pregnancy (when a fertilised egg implants itself outside of the womb)
- miscarriage
- molar pregnancy (where a foetus doesn't form properly in the womb)
What is implantation bleeding?
While it's only natural to fear the worst when it comes to bleeding in pregnancy, implantation bleeding actually means good news.
‘As implantation bleeding happens when the developing embryo implants into the lining of the uterus, this light bleeding or spotting is a sign that you are pregnant,’ says Leah.
As it normally happens around the time your period would have been due lots of women who are TTC see it is a sign that they're getting their period and therefore aren't pregnant, only to do another test a few days or weeks later to find out that they are.
Read more about implantation bleeding and more very early signs of pregnancy here.
Here's what an implantation bleed could look like in the early stages of pregnancy:
Can you still get periods during pregnancy?
No. But some women mistake very early signs of pregnancy such as brown discharge, spotting or implantation bleeding for a period when, in actual fact, it's a sign that you're pregnant.
Alternatively, ‘light bleeding or spotting around the time your period is due, could also be what's known as breakthrough bleeding,’ says Leah.
Experts aren't entirely sure what causes it but because it happens around the time of their period, some expectant mums think they are still having periods.
Although it can be a one-off bleed, it can happen around your 'time of the month' throughout the first trimester. It's very rare to last throughout your pregnancy and isn't a sign that anything is wrong with the baby.
‘Make sure you tell your GP and midwife though so you can be monitored throughout your pregnancy, just to be on the safe side,’ adds Leah.
Will bleeding after sex harm my baby?
If you are pregnant and notice bleeding, make sure you tell your midwife if you spotted it after having sex. Bleeding after sex is common in pregnancy, particularly in the later stages. It's caused by changes to your cervix during pregnancy and doesn't mean there is any danger to your baby.
Read more about sex in pregnancy here.
Am I having a miscarriage?
Sadly, around one in five pregnancies will end in miscarriage with the majority of these happening in the first 12 weeks. While early pregnancy bleeding isn't always serious, it is the most common sign of miscarriage.
Bleeding with a miscarriage isn't always heavy or continuous – it can come and go over the course of several days. Other symptoms that may indicate a problem include:
- cramping and pain, which may be like period pains or stronger
- a discharge of fluid or tissue from the vagina
- pregnancy symptoms (such as nausea and sore boobs) disappearing.
Often early miscarriages happen if there is a problem with the developing embryo. They can also be caused by hormonal problems or issues with clotting.
‘The only way to tell for sure if you're miscarrying is to see your midwife or visit your nearest EPU. They'll be able to run some tests and scans to confirm what's going on. If you're in the early weeks of pregnancy, this may be an internal scan, where a probe is inserted into your vagina,’ says Leah.
You can find more information as well as help coping with miscarriage here.
Is bleeding a sign of ectopic pregnancy?
An ectopic pregnancy is where the embryo implants outside the uterus, usually in one of your fallopian tubes. It's pretty rare, affecting one in every 80-90 pregnancies, but it can be extremely dangerous if ignored.
Ectopic pregnancies are most common between weeks 4 and 12 of your pregnancy and, as well as bleeding, can be accompanied by pain and feeling unwell.
The symptoms of ectopic pregnancy are:
- pain in the abdomen, usually on one side, which may be persistent and severe
- bleeding, which could be dark or bright red, and may stop and start (usually beginning after you've started experiencing pain)
- pain in the tip of your shoulder
- diarrhoea and vomiting
- fainting or feeling faint.
‘An ectopic pregnancy is a medical emergency as it can cause life-threatening internal bleeding. If you have symptoms of an ectopic pregnancy, you should go to A&E immediately, or if you can't get there yourself, call an ambulance,’ says Leah.
What is a molar pregnancy?
A molar pregnancy is a rare complication of pregnancy where abnormal cells grow instead of a healthy foetus. Symptoms can include vaginal bleeding or a dark, lumpy discharge within the first 6-12 weeks of being pregnant.
An ultrasound will confirm if your bleeding is caused by a molar pregnancy. Read here for more on molar pregnancies.
What to do if you're bleeding
‘If you have any bleeding during pregnancy, no matter how light, contact your GP, your midwife if you've already been in touch with her, or the EPU at your local hospital. They'll be able to tell you what to do next,’ says Leah.
You're likely to want the reassurance of a scan, but this won't always be offered. If you're in the very early stages or the bleeding is light, your GP might advise you just to wait and see what happens. This can be very hard to accept.
If your GP or midwife won't send you for a scan, you can try contacting your nearest EPU directly. Some will accept patients who refer themselves. Otherwise, you could book a private scan at a reputable clinic for reassurance.
Bleeding during the later stages of pregnancy
‘Bleeding can happen at any stage of pregnancy, and some mums-to-be experience intermittent bleeding throughout their whole nine months,’ says Leah.
It's not always possible to find a cause, but there are a number of reasons why bleeding might happen during the second and third trimesters.
These include:
- Changes in your cervix during pregnancy can lead to bleeding, especially after sex.
- Vaginal infections.
- A 'show,' when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is becoming ready for labour to start. It may happen a few days before your contractions start or during labour itself.
- Placental abruption: a serious condition where the placenta starts to come away from the wall of the uterus. This usually causes pain as well. Factors that increase risk of placental abruption include injury to the abdominal area and high blood pressure. Your baby will need to be born straight away if near due date, but if not and the abruption is minor, you may be monitored in hospital.
- Low-lying placenta (placenta praevia), where the placenta is attached in the lower part of the uterus, 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 usually a caesarean will be recommended.
- Late miscarriage – although miscarriages are more common in the first trimester, they can still happen in later pregnancy. Miscarriages that happen between weeks 12 and 24 are known as late miscarriages but they are quite a rare occurrence, affecting between 1-2% of pregnancies.
- Vasa praevia – this is a rare condition where the baby's blood vessels run through the membranes covering the cervix. Normally, the blood vessels would be protected within the umbilical cord and placenta. When your waters break, these vessels may be torn and cause vaginal bleeding. It's very difficult to diagnose vasa praevia, although it's occasionally picked up by a scan. It should be suspected if there is bleeding and your baby's heart rate changes suddenly after your waters break.
If you experience any bleeding at any stage of your pregnancy, call your midwife immediately for advice.
Related stories
Vaginal discharge in pregnancy
CHAT: bleeding in pregnancy (my story)
Sources
- NHS. 2018. Vaginal bleeding in pregnancy
- RCOG. 2016. Bleeding and/or pain in early pregnancy
- NICE. 2018. Miscarriage – Clinical Knowledge Summary
- NHS. 2017. Molar pregnancy
- NHS. 2018. Ectopic pregnancy
