Bleeding During Pregnancy: What’s Normal and What’s Not

Early in your pregnancy, you may experience light vaginal bleeding. It usually isn’t serious. It can happen during the first 20 weeks for a variety of reasons. 

Continuous bleeding during pregnancy isn’t normal. If you are bleeding profusely or later in your pregnancy, contact your doctor right away. 

Here at Glendale Obstetrics and Gynecology, board-certified OB/GYN Diana Heard, MD, offers a full spectrum of women’s health services. Dr. Heard provides top-quality prenatal care and is delighted to share this joyous occasion with you and your growing family.

Let’s discuss bleeding during pregnancy and when you should contact us at Glendale Obstetrics and Gynecology. 

Is it spotting or bleeding?

Light vaginal bleeding, or spotting, is not the same as moderate or heavy vaginal bleeding. Before we get into the various causes of pregnancy bleeding, it's important to understand the distinction between the two. 

Spotting usually appears as a few small blood spots. While the color can range from light pink to bright red or even dark brown, the spotting is light and brief enough that you don't need to wear a pad or liner. 

To put it another way, it's similar to the type of bleeding you might experience at the start or end of your period.

Moderate to heavy bleeding results in a much heavier flow, similar to what you normally experience in the middle of your period, when your flow is at its peak.

If you start bleeding during your pregnancy, wear a sanitary napkin so you can keep track of how much and what kind of bleeding you're having. Avoid having sex or inserting anything into your vagina, including tampons, until you receive the all-clear.

When you have bleeding during early pregnancy

Within two weeks of conception, most women experience a day or two of light bleeding before realizing they're pregnant. That's when the fertilized egg burrows, or implants, into the uterine lining, causing perfectly normal light spotting known as implantation bleeding.

As the first trimester progresses, changing hormone levels stimulate the formation of new blood vessels and an increase in blood flow to your uterus, cervix, and vagina, all of which can result in normal spotting or light bleeding after sexual activity, strenuous exercise, or a routine pelvic exam.

The following are some of the most common causes of abnormal and potentially problematic vaginal bleeding during early pregnancy.

Ectopic pregnancy

An ectopic pregnancy occurs when an embryo implants outside of the uterus. Early first trimester bleeding is sometimes indicative of an ectopic pregnancy. This type of bleeding is frequently accompanied by abdominal, pelvic, or even shoulder pain, but you might not experience any pain.

Because an ectopic pregnancy can be fatal, you should contact us if you experience any bleeding or pain during your first trimester.

Miscarriage 

Bleeding during the first trimester, especially when accompanied by abdominal pain or cramping, can also be the first sign of a miscarriage. Approximately 10% of known pregnancies end in miscarriage, and about half of all women who experience unusual bleeding in early pregnancy eventually miscarry. 

Most miscarriages are unavoidable; they usually happen when an unhealthy pregnancy doesn't develop properly.

When you have bleeding later in pregnancy

While harmless spotting is possible during your second and third trimesters, especially after intercourse or a routine pelvic exam, late pregnancy bleeding of any kind is cause for concern and requires an immediate call to an obstetrician like Dr. Heard.

Heavy bleeding, in particular, can indicate a serious pregnancy complication, such as:

Issues with the placenta

Late-pregnancy bleeding can indicate a problem with the placenta, or the vascular tissue that nourishes and maintains your baby in utero.

Placental abruption, which occurs when the placenta separates from the uterus, frequently causes heavy bleeding, cramping, and back pain. Placenta previa, which occurs when the placenta partially or completely covers your cervix, usually results in painless bleeding.

Preterm labor

Spotting or bleeding that occurs during your second or third trimester but before your 37th week of pregnancy can be an indication of preterm labor.

Changes in vaginal discharge, increased pelvic pressure, abdominal cramping, lower back pain, and contractions are also signs of preterm labor.

Comprehensive obstetric care

Dr. Heard is dedicated to making sure all of our expectant moms have the healthiest pregnancy possible. You can always get in touch with Dr. Heard for prompt advice if you experience spotting or bleeding during any trimester or have any other questions or concerns.

To learn more, call our Glendale, Arizona, office, or use our easy online tool to schedule a visit today.