During pregnancy, your body changes. A lot. And in early pregnancy, you may deal with some pretty substantial hormonal shifts. Between mood swings, exhaustion and morning sickness, you might not feel your best. But there’s another symptom that can happen in early pregnancy that you might not be thinking about — bleeding or spotting. Show
“Bleeding in early pregnancy happens to 20 to 40% of women,” says Deidre Heber, DO, OB-GYN at Geisinger. “Most of the time, it’s nothing to worry about.” Potential causes of first trimester bleedingBleeding during the first trimester can look different for everyone. The amount can range from light to heavy. For some, it can be intermittent. Others may have more constant bleeding or spotting. And it may or may not be painful. Here are a few things that might be behind it. Implantation bleedingEarly in pregnancy (sometimes before you know you’re pregnant), you may have some spotting when your period is due. This common occurrence is called implantation bleeding. “It happens between 6 and 12 days after conception as the fertilized egg implants into your uterus,” Dr. Heber says. This bleeding is typically light and may last for a few days. Cervical changesDuring pregnancy, there’s increased blood flow to your cervix. Having sex or getting a Pap smear, which cause contact with the cervix, can trigger light bleeding. Other cervical changes that can trigger bleeding include:
HormonesIn the early weeks of pregnancy, your body starts making the hormones you need to sustain a pregnancy. This change can cause your progestin levels to drop. That drop may lead to spotting or light bleeding. MiscarriageSince miscarriages are most common during the first trimester, worrying about bleeding is normal. Light bleeding or spotting doesn’t automatically mean you’re miscarrying. But if your bleeding is heavy, bright red or you’re passing clots and in pain, contact your healthcare provider. They can explain next steps. Most women who miscarry go on to have healthy pregnancies. But having a miscarriage is a loss that families may need help handling. Don’t rush the grieving process, and find a support group or counselor if you feel you need it. Ectopic pregnancyAn ectopic pregnancy happens when a fertilized egg implants outside the uterus, like in your fallopian tube. When that happens, it can lead to heavy bleeding, pain and other serious symptoms. “An ectopic pregnancy is an emergency,” says Dr. Heber. “If you have symptoms, contact your provider immediately.” When to call the doctor about bleedingCall 911 or go to the nearest emergency room if you have any of these symptoms:
If you’re pregnant and bleeding heavily, don’t use a tampon. Wear a pad instead. “Doctors need to know how much you’re bleeding to gauge the severity,” says Dr. Heber. And if you’re passing tissue, consider bringing it in for testing. Your doctor may use an ultrasound to determine the cause of your bleeding. Once they find the cause, they’ll work with you on a treatment plan. Healthy parent, healthy babyBuilding good habits now can help you have the healthiest pregnancy possible. Dr. Heber makes these suggestions to help you (and your baby) feel your best.
Next steps:Meet Deidre Heber, DO Bleeding during pregnancy is common, especially during the first trimester, and usually it's no cause for alarm. But because bleeding can sometimes be a sign of something serious, it's important to know the
possible causes, and get checked out by your doctor to make sure you and your baby are healthy. About 20% of women have some bleeding during the first 12 weeks of pregnancy. Possible causes of first trimester bleeding include: Implantation bleeding. You may experience some
normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus. Some women don't realize they are pregnant because they mistake this bleeding for a light period. Usually the bleeding is very light and lasts from a few hours to a few days. Miscarriage. Because miscarriage is most common during the first 12 weeks of pregnancy, it tends to be one of the biggest concerns with first trimester bleeding. However, first
trimester bleeding does not necessarily mean that you’ve miscarried or will miscarry. In fact, if a heartbeat is seen on ultrasound, over 90% of women who experience first trimester vaginal bleeding will not miscarry. Other symptoms of miscarriage are strong
cramps in the lower abdomen and tissue passing through the vagina. Ectopic pregnancy. In an ectopic pregnancy, the fertilized embryo implants outside of the uterus, usually in the fallopian tube. If the embryo keeps growing, it can cause the fallopian tube to burst, which can be life-threatening to the mother. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies. Other symptoms of ectopic pregnancy
are strong cramps or pain in the lower abdomen, and lightheadedness. Molar pregnancy (also called gestational trophoblastic disease). This is a very rare condition in which abnormal tissue grows inside the uterus instead of a baby. In rare cases, the tissue is cancerous and can spread to other parts of the body. Other symptoms of molar pregnancy are severe
nausea and vomiting, and rapid enlargement of the uterus. Additional causes of bleeding in early pregnancy include:
Abnormal bleeding in late pregnancy may be more
serious because it can signal a problem with the mother or baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester. Possible causes of bleeding in late pregnancy include: Placenta previa. This condition occurs when the
placenta sits low in the uterus and partially or completely covers the opening of the birth canal. Placenta previa is very rare in the late third trimester, occurring in only one in 200 pregnancies. A bleeding placenta previa, which can be painless, is an emergency requiring immediate medical attention. Placental abruption. In about 1% of pregnancies, the placenta detaches from the wall of the uterus before or during labor and
blood pools between the placenta and uterus. Placental abruption can be very dangerous to both the mother and baby. Other signs and symptoms of placental abruption are abdominal pain, clots from the vagina, tender uterus, and
back pain. Uterine rupture. In rare cases, a scar from a previous C-section can tear open during pregnancy. Uterine rupture can be life-threatening, and requires an emergency C-section. Other symptoms of uterine rupture are pain and tenderness in the abdomen. Vasa previa. In this very rare condition, the developing baby's blood
vessels in the umbilical cord or placenta cross the opening to the birth canal. Vasa previa can be very dangerous to the baby because the blood vessels can tear open, causing the baby to bleed severely and lose oxygen. Other signs of vasa previa include abnormal fetal heart rate and excessive bleeding. Premature labor. Vaginal bleeding late in pregnancy may just be a sign that your body is getting ready to deliver. A few days or weeks before labor begins, the mucus plug that covers the opening of the uterus will pass out of the vagina, and it will usually have small amounts of blood in it (this is known as "bloody show"). If bleeding and symptoms of labor begin before the 37th week of pregnancy, contact your doctor right away because you might be in preterm labor. Other symptoms of preterm labor include contractions, vaginal discharge, abdominal pressure, and ache in the lower back. Additional causes of bleeding in late pregnancy are:
What to Do If You Have Abnormal Bleeding During PregnancyBecause vaginal bleeding in any trimester can be a sign of a problem, call your doctor. Wear a pad so that you can keep track of how much you're bleeding, and record the type of blood (for example, pink, brown, or red; smooth or full of clots). Bring any tissue that passes through the vagina to your doctor for testing. Don't use a tampon or have sex while you are still bleeding. Your doctor might recommend that you rest as much as you can and avoid exercise and travel. You should expect to receive an ultrasound to identify what the underlying cause of your bleeding may be. Vaginal and abdominal ultrasounds are often performed together as part of a full evaluation. Go to the emergency room or call 911 right away if you have any of the following symptoms, which could be signs of a miscarriage or other serious problem:
Can you bleed at 6 weeks and not miscarry?If you bleed in early pregnancy it does not always mean that you are having a miscarriage; in fact it is quite common. One in four women will bleed in early pregnancy, many of whom go on to have a healthy baby.
Why am I bleeding while pregnant but no pain?Implantation bleeding
In early pregnancy, you might get some harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due.
Does bleeding with no pain mean miscarriage?Pregnancy Bleeding Does Not Always Mean Miscarriage
Beyond abdominal cramping and passing tissues (the placenta and the gestational sac) through the vagina, one of the most common symptoms of miscarriage is vaginal bleeding. That said, bleeding in early pregnancy does not always mean miscarriage.
How much bleeding is normal for 6 weeks pregnant?It's not unusual to see some spotting at six weeks, but it should be light, not even enough to cover a small pantyliner. This implantation bleeding is normal, but if you see a lot of blood, if the spotting lasts longer than two days, or you have any concerns, be sure to see your doctor right away. Cramping.
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Bleeding at 6 weeks pregnant with no pain
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