Bleeding (Or Spotting) During Pregnancy

About 10% of pregnant women experience some bleeding during their pregnancy, and this can be because of a number of possible causes.

'Spotting' is a term used to describe very light bleeding. Spotting should be red or brownish in colour, but not as heavy as a period. Spotting is common during early pregnancy and can be brought on for a variety of reasons. Very often this spotting goes away and does not affect the pregnancy, however, it is important to acknowledge that in some cases spotting can go on to become heavier bleeding. Also, miscarriage in early pregnancy is relatively common. Another, less likely, but serious possibility is that the spotting is caused by an ectopic pregnancy. This is where the foetus implants and grows in the fallopian tube, rather than the uterus. Occasionally it occurs where the foetus embeds elsewhere such as the abdomen, the ovary or the cervix.

Bleeding during early pregnancy

If you are experiencing spotting during early pregnancy then it is quite likely that it will stop of its own accord and that your pregnancy will continue with no related problems. The sudden change in your hormones may be responsible for this small amount of bleeding and it will stop as your body adjusts to the changes you are going through. Many women find that they experience spotting or light bleeding at the time their next period is due, which sometimes leads women to believe they have not been successful in conceiving when in actual fact they are already four weeks pregnant.

Hormones can also cause the opening of the cervix to become irritated and this may bleed a little, especially after sexual intercourse. Other causes of early pregnancy bleeding that are unlikely to have serious consequences include fibroids, polyps or cervical or vaginal infections. Most infections can be treated easily by your doctor without any implications for your pregnancy, however, you should make sure you that you get them checked out as early as possible.

Bleeding during early pregnancy is not unusual. However, while it is probably not a cause for concern there are two fairly common causes which will have unhappy outcomes: miscarriage and ectopic pregnancies. Miscarriage is usually associated with period-like symptoms such as cramps in your lower abdomen. If the reason for your bleeding is because of a miscarriage, then it is unlikely that you can do anything to prevent it. Miscarriage is very upsetting but it does occur in up to 20% of pregnancies. Miscarriage is most likely to occur during the first trimester (the first 13 weeks of pregnancy).

If you have an ectopic pregnancy then unfortunately you will have to have the pregnancy terminated. To let the pregnancy progress could present very serious and possibly life threatening risks to your health.

Another possibility is that you have a molar pregnancy. As with an ectopic pregnancy, this will have to be terminated as soon as possible to avoid any serious consequences to your health. However, molar pregnancies are very rare so it is unlikely that this is the cause for your bleeding.

Bleeding in later stages of pregnancy

Bleeding later in pregnancy is usually associated with problems with the placenta. The most likely cause is placenta praevia, where the placenta is low-lying in the uterus and is either fully, or partly, covering the opening of the cervix. If you have a low-lying placenta then this will be identified at your 20 week ultrasound scan and you will be asked to attend another scan later in your pregnancy (normally at around 32 weeks) to check whether the placenta has moved up to where it is supposed to be. Generally, low-lying placentas move out of harm's way by the last trimester of pregnancy. Placenta praevia can cause bleeding as the cervix softens and widens towards the end of your pregnancy, causing some blood vessels to stretch and rupture.

Other reasons for bleeding associated with the placenta include placental abruption where the placenta separates from the wall of the uterus, or uterine rupture, a rare but dangerous splitting of the uterus.

What should I do if I experience any kind of bleeding?

There are so many possible reasons for bleeding during pregnancy that it is very important to get seen by a doctor as quickly as possible after you notice any bleeding, even if the bleeding has stopped before you get to see them. They may give you the all-clear very quickly, but it is important that they assess your symptoms and examine you if necessary. Vaginal examinations and ultrasound scans are not considered dangerous for the pregnancy so don't worry if you are given either of these. Make sure that you follow the advice from your medical practitioner, which could range from continuing as normal to taking complete bed rest, or possibly even being admitted to hospital. Often women are advised to abstain from sexual intercourse if the practitioner feels that there is a risk of further bleeding.