Bleeding During Pregnancy

Bleeding during pregnancy can be a frightening experience unless you know the exact cause of the bleeding. Up to 20-30% of women have vaginal bleeding at some time during their pregnancy, especially in the first trimester. Many women with bleeding in pregnancy have minor conditions that need no treatment. At other times, bleeding can be a sign of a serious problem.

Vaginal bleeding during pregnancy can indicate a serious risk to you and/or your baby, or it may not be a significant problem at all.  It is important to inform your health care provider immediately if you experience any amount of vaginal bleeding during pregnancy.

Bleeding during the first trimester (12 weeks) occurs in many women and can be a sign of miscarriage, but does not mean that miscarriage is imminent. Studies show that anywhere from 20-30% of women experience some degree of bleeding in early pregnancy. Approximately half of pregnant women who bleed do not have miscarriages. Approximately 15-20% of all pregnancies result in a miscarriage, and the majority occur during the first 12 weeks.

To help prevent a miscarriage or other problems during pregnancy, avoid smoking and the use of drugs of any kind, including alcohol. Eat a well-balanced diet and nutritional diet, and obtain prenatal care and regular medical checkups. Any vaginal bleeding at any point in pregnancy should always be reported to your health care provider.

Several of the major reasons why bleeding may occur in pregnant women, adapted from the websites listed at the bottom of the page, are discussed below.  Remember, anytime vaginal bleeding occurs during pregnancy, whether early pregnancy or late pregnancy, it should be reported to your health care provider.  If you pass anything you think is fetal tissue be sure to take it to your health care provider for examination.

Common Causes of vaginal bleeding

1) Bleeding can also occur in early pregnancy due to some type of infection in the pelvic cavity or urinary tract, after intercourse due to the fact that the cervix is very tender and sensitive, and as the result of the implantation of the fertilized egg.

2) Miscarriage can occur at any time during the first half of pregnancy. Most occur during the first 12 weeks. Miscarriage occurs in about 15 percent to 20 percent of pregnancies. Bleeding does not mean that miscarriage is certain, but it can occur.  Most miscarriages cannot be prevented. They are often the body's way of dealing with a pregnancy that was not normal.

3) An ectopic pregnancy, in which the embryo becomes implanted outside the uterus, is often accompanied by unexpected vaginal bleeding and severe abdominal pain.  An ectopic pregnancy occurs when the fertilized egg implants itself in one of the fallopian tubes. This is often called a "tubal pregnancy."  Ectopic pregnancy is much less common than miscarriage occurring in about one out of every 60 pregnancies.

4)A rare cause of early bleeding is molar pregnancy. It is also called gestational trophoblastic disease (GTD) or simply a "mole." It is the growth of abnormal tissue instead of an embryo.

5) Heavy vaginal bleeding usually involves a problem with the placenta. The two most common causes of bleeding in late pregnancy are placental abruption and placenta previa.

Placental Abruption is when the placenta may detach from the uterine wall before or during labor. This may cause vaginal bleeding. Only 1% of pregnant women have this problem. It usually occurs during the last 12 weeks of pregnancy. Stomach pain often occurs, even if there is no obvious bleeding.

Placenta Previa is when the placenta lies low in the uterus, it may partly or completely cover the cervix. It may cause vaginal bleeding. Placenta previa is serious and requires prompt care. Placenta previa occurs in one woman in 200.

6) Late in pregnancy, vaginal bleeding may be a sign of labor.  A plug that covers the opening of the uterus during pregnancy is passed just before or at the start of labor. A small amount of mucus and blood is passed from the cervix. This is called "bloody show." It is common. It is not a problem if it happens within a few weeks of your due date.

Taking Action

Any bleeding during pregnancy should be evaluated by your health care provider. For a threatened miscarriage, follow your health care providers orders. Bed rest is often recommended to stabilize the pregnancy. Medication is usually not necessary. Do not take any medication without consulting the doctor or midwife. Avoid sexual intercourse until the outcome of the bleeding is known. Drink only fluids if the bleeding and cramping is severe.