Bleeding and Spotting During Pregnancy: What Does It Mean?

Here’s a guide to spotting and vaginal bleeding during pregnancy to help you know what’s going on and how to tell it’s serious.

When you are expecting, the last thing you would want to see is blood in your undies. The brown or red blood can instantaneously raise fears of a miscarriage. However, vaginal bleeding is relatively common during the first trimester and mostly is a cause of concern for the mothers.

Approximately 20% of women have reported to experience spotting during the first 12 weeks of pregnancy. Most women go on to deliver a healthy baby. According to the American College of Obstetrics and Gynecology, around 15 – 25% women experience bleeding or spotting during the first three weeks of pregnancy. Bleeding is less common and more concerning if it occurs during the second or third trimester.

bleeding pregnancy

What is the difference between vaginal bleeding and spotting?

Spotting is different from bleeding in terms if the amount of blood and its appearance.

  • Spotting during pregnancy is the coloured vaginal discharge, enough to leave some marks on a panty liner or pad. It is so light that blood will not cover a panty liner. It is irregular and is pink or dark brown in colour. It can be a sign of “threatened miscarriage”, which makes it important to inform your doctor.
  • Bleeding during pregnancy is heavier flow of blood. You would need a pad or liner to keep the blood from soaking your clothes. If it’s nothing like menstrual-like, there’s nothing to worry about. If you’re soaking through less than one pad in three hours, it is mild bleeding. If it’s more than one pad in three hours, then it’s moderate and if it’s more than that, it is heavy bleeding. Both moderate and heavy bleeding can be a cause of concern during pregnancy.

Whether you experience spotting or bleeding, it is best to contact your doctor and describe your experience. Keep a track of how heavy your bleeding is.

Is spotting during pregnancy normal?

Spotting or bleeding during first trimester is relatively common and generally not a cause of concern. About 20% women who experience spotting or vaginal bleeding during the first three months of pregnancy. In most of the cases, women go on to delivery a healthy baby and have uncomplicated journey.

Heavy bleeding, on the other hand, can be a cause of concern and must be checked immediately by the doctor.

What causes bleeding during first trimester?

Spotting or bleeding during first trimester can be cause by multiple factors like:

Implantation bleeding: One of the common causes of bleeding during pregnancy is implantation bleeding. It happens when the fertilized egg is attached to uterine lining, triggering light spotting or bleeding. Bleeding occurring after the day women is expecting her period is typically too late to be considered implantation bleeding and probably associated to pregnancy.

Cervical polyp which mostly bleeds during pregnancy because of high estrogen levels is another cause of spotting. In both cases, sexual intercourse or a pelvic examination may cause light bleeding or spotting.

Miscarriage: Miscarriage mostly happens during the first trimester of pregnancy. If you experience bleeding during first trimester, threatened miscarriage is one of the major concerns. While the fetus is inside the uterus, but the outcome of pregnancy is still unknown. However, bleeding in first trimester doesn’t necessarily mean, you’ve lost the baby. In fact, if a heartbeat is seen in the ultrasound, over 90% women do not miscarry.

Symptoms of miscarriage during first trimester include pain in lower abdomen and tissue passing through vagina.

Ectopic pregnancy: Ectopic pregnancy, also called a tubal pregnancy, occurs when fertilized egg implants somewhere else and not in uterus, which is mostly in a fallopian tube. It is a serious complication and must be addresses immediately since it can result in severe health complications. Make sure that you inform your doctor as soon as possible if you experience any of the symptom below:

  • Pain in the pelvis or abdomen muscles
  • Rectal pressure
  • Fainting or light-headedness
  • Pain in shoulders
  • Severe pain on one side of lower abdomen

Unidentified causes: As your body goes though many changes in the first trimester, it is possible to have bleeding for an unidentifiable reason. Hormonal changes or infection can be the causes for bleeding or spotting in first trimester of pregnancy. Applying strain to body like working out can cause spotting.

What causes bleeding during later stages of pregnancy?

Bleeding during the second or third trimester can be more serious and can be signal of something wrong with the baby or mother. Although the risk of miscarriage reduces after the first trimester and many early complications do not exist, bleeding during later stages should be taken seriously. You should immediately consult your doctor of you experience bleeding in second or third trimester.

Some of the possible causes of bleeding during second and third trimester include:

  • Placental abruption: In some cases, the placenta separates itself from the wall of the uterus during or before labor and blood pools between the uterus and placenta. This kind of abruption can be very risky for both the baby and the mother.
  • Placenta previa: In some pregnancies, he placenta sits low in the uterus and covers the opening of the birth canal. This condition can be painless and is very rare in late third trimester. However, it requires immediate medical attention if occurs.
  • Uterine rupture: In some rare pregnancy, a scar from earlier C-section can tear open during delivery. This kind of condition can be life-threatening and needs immediate emergency C-section.

Signs of a miscarriage?

spotting pregnancy

First Trimester

Most miscarriages happen within the first 13 weeks of pregnancy. If your spotting or vaginal bleeding doesn’t stop in few hours, make sure to inform your doctor. You may experience cramps in lower back or abdomen, or notice a tissue passing from your vagina along with the symptoms below:

  • contractions
  • sudden decrease in symptoms of pregnancy
  • weight loss
  • white-pink mucus

If you have experienced these symptoms in early weeks of first trimester, your body may expel the tissue on its own. In this case, no medical procedure is needed to miscarry. However, consult your doctor to make sure that all of the tissue has passed from your body.

cramps pregnancy

If these symptoms occur in later weeks of first trimester, or if there are any complications, you may need a procedure called as D and C (dilation and curettage). This helps stop bleeding and prevent any kind of infection.

Second and Third Trimester

Following are the signs of miscarriage during the second or third trimester:

  • abdominal cramping
  • no moment of fetus
  • tissue or fluid passing through vagina
  • spotting or vaginal bleeding

If you are miscarrying in the later stages of pregnancy, you may be given medication to deliver fetus or you may have to go through a procedure called D and E (dilation and evacuation).

Miscarriage, during any stage, requires both physical and emotional support. Consult your doctor when can you join office. Also, if you want to plan again, ask your doctor before trying to conceive again. Usually doctors recommend waiting for 5-6 months after miscarriage.

When to call your doctor?

During any time of your pregnancy, you notice bleeding or even spotting, it is appropriate to call your doctor or midwife immediately. It becomes particularly important if there is heavy bleeding or cramping. You should be prepared to answer to questions like colour of blood, amount of flow and description of how you are feeling.

If your bleeding is a sign of preterm labor, the doctor would take preventive steps such as bed rest or medication to make sure it doesn’t happen again. However, if the bleeding occurs due to miscarriage, then unfortunately, nothing can be done.