Bleeding during pregnancy: Everything you need to be aware of

Bleeding during pregnancy can be scary, but it is very common (especially during your first trimester) and is usually no cause for alarm.

However, while most women who experience vaginal bleeding during pregnancy go on to deliver healthy babies, it is important to take it seriously.

According to the NHS, the main causes of vaginal bleeding (or spotting) during pregnancy:

First trimester

**You may experience some normal (and harmless) spotting within the first six to 12 days after you conceive as the fertilised egg implants itself in the lining of the uterus. The bleeding is usually very light and lasts from a few hours to a few days.

**Any infection of the cervix, vagina, or a sexually transmitted infection (such as chlamydia, gonorrhea, or herpes) can cause bleeding in the first trimester.

**During pregnancy, extra blood flows to the cervix. Sexual intercourse or a Pap test, which cause contact with the cervix, can trigger bleeding. This type of bleeding isn't cause for concern.

**An ectopic pregnancy occurs when the fertilised egg implants itself somewhere other than the main cavity of the uterus. You may also experience shoulder pain, lightheadedness, fainting, or abdominal pain.

Ectopic pregnancies are much less common than miscarriages, affecting about one in 100 pregnancies.

**A rare occurrence in which an abnormal mass of cells — instead of a baby — forms inside the uterus after fertilisation. Bleeding will be dark brown to bright red, and you may also suffer nausea and vomiting.

**During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage. Most miscarriages occur during the first 12 weeks of pregnancy and, sadly, most cannot be prevented.

However, many women who bleed at this stage of pregnancy go on to have normal and successful pregnancies.

If you experience unusual vaginal bleeding in your first trimester, contact your midwife or GP immediately.

Second or third trimester

**During pregnancy, extra blood flows to the cervix. As mentioned before, sexual intercourse or a Pap test, which cause contact with the cervix, can trigger bleeding.

**A vaginal infection can cause bleeding or spotting.

**Light bleeding, often mixed with mucus, near the end of pregnancy could be a sign that labor is starting. Vaginal discharge that is pink or bloody is known as the bloody show.

**Preterm labor occurs when regular contractions begin to open your cervix before 37 weeks of pregnancy. If this is the cause of your bleeding, you will also experience regular or frequent contractions, backache, watery discharge, and pressure on the abdomen.

**This is a serious condition, in which the placenta starts to come away from the womb. if this is the case, you will experience stomach pain - even if there is no bleeding.

**This occurs when the placenta is attached to the lower part of your womb, causing potentially heavy bleeding and putting both you and your baby at risk. A caesarian and hospital treatment will usually be recommended. Find out more about this condition here.

**Bleeding in the later stages of pregnancy can be a symptom of miscarriage; however, miscarriages are very rare after the third month of pregnancy. Find out more at the RCOG website now.

**This is a rare condition, in which your baby’s blood vessels run through the membranes covering the cervix, rather than remaining protected within the umbilical cord and placenta. When your waters break, these vessels may be torn and cause vaginal bleeding, which can cause your baby to be put into a life-threatening position. It should be suspected if there is bleeding and your baby’s heart rate changes suddenly.

If you experience unusual vaginal bleeding in your second or third trimester, contact your midwife or GP immediately.

How to find out the cause of bleeding in pregnancy:

To work out what is causing your bleeding, you will be asked about your symptoms, such as cramp, pain, and dizziness.

A vaginal or pelvic examination (similar to a cervical screening test) may be carried out to work out where the bleeding is coming from.

You may also be asked for a urine and / or blood sample, to help to determine your pregnancy hormone levels.

Most women will also be offered a transvaginal scan (where a probe is gently inserted into the vagina) or a transabdominal scan (where the probe is placed over your abdomen), in a bid to work out where the bleeding is coming from. Both tests are safe and well not cause you to miscarry.

In some cases, the cause of bleeding cannot be found. if this is the case, doctors will decide on the best course of action.

If your symptoms are not severe and your baby is not due for a while, you will be monitored and, in some cases, kept in hospital for observation.

How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are. Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems.

**

REMEMBER: BLEEDING DURING PREGNANCY IS VERY COMMON AND USUALLY NO CAUSE FOR ALARM. HOWEVER IT IS ALWAYS BEST TO CONTACT YOUR MIDWIFE OR GP. **

THEY TREAT BLEEDING VERY SERIOUSLY, EVEN IF IT IS JUST A SPOT, SO NEVER BE CONCERNED THAT YOU ARE WASTING THEIR TIME.

Find out more about bleeding during pregnancy over at the NHS website now.

You can also download some information on bleeding and pain during website from the RCOG.org.uk here.