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

While it’s not common to notice vaginal bleeding during pregnancy, it may not be a sign of trouble either. Understanding what’s normal and what isn’t can ease your mind or help you with the decision to seek urgent medical assistance.

Doctor Joan Bergstrom from Woman’s Health Services in Arlington, Texas, is here to provide care and answer all of your questions so you can have a happier, healthier pregnancy.

Any bleeding requires follow-up

While there are many situations where some bleeding is either not an issue or unrelated to your pregnancy, when you’re bringing a child into the world it’s always better to be safe rather than sorry. You should talk to your Women's Health Services obstetrician any time you notice vaginal bleeding, no matter how little. However, there are certain times when the presence of blood may be expected, and urgent action isn’t necessary.

Light, intermittent spotting

In the first 12 weeks of pregnancy, about one in five women experience spotting. This blood is usually lighter in color than menstrual bleeding, ranging in color from pink to reddish-brown. You may notice spots on your underwear, as there’s probably no sensation associated with the small amounts you’ll pass. You may notice spotting on toilet paper after wiping, but there won’t be enough blood to cover a pad or panty liner.

Implantation bleeding is common in the first trimester. As a fertilized egg attaches to the uterine wall, small amounts of blood may be released, and this could occur before you even know you’re pregnant. It’s also unlikely to be spotting from implantation if it occurs after your first missed period.

Cervical polyps are harmless growths that may bleed due to higher levels of estrogen during pregnancy. These can bleed spontaneously or after contact with the cervix through intercourse or a gynecological exam.

Spotting during the second and third trimesters is more unusual, and informing your obstetrician becomes more urgent.

Heavy and/or painful bleeding

When bleeding starts to rival menstrual blood in color and volume and is accompanied by cramping or pain, seek medical care to rule out complications to your pregnancy. Early in your pregnancy, bleeding could indicate an ectopic pregnancy (outside the uterus), molar pregnancy (a failed egg that is implanted but doesn’t survive), or a miscarriage.

Bleeding later in pregnancy could be due to placenta issues, such as attachment or placement problems. Preterm labor, occurring before 37 weeks of pregnancy, can also cause late-stage bleeding, but it’s not necessarily the only sign. You could also experience more typical signs, such as cramps, contractions, and water breaking.

The importance of diagnosis

Bleeding of any level is not a sure indicator of problems with your pregnancy. It’s important to remain calm and observe what you’re feeling around the time you notice blood. Your obstetrician will have plenty of questions for you to help pinpoint the problem, so take note of factors like cramping, exercise, problems with urination, and more to assist with the diagnosis.

Your Women’s Health Services OB/GYN is your partner during the journey of pregnancy, so stay in touch and contact the office whenever you have concerns about yourself or your baby. You can call the office directly or request an appointment using the website tool if you haven’t scheduled a visit already. It’s your baby’s health, so it’s always better to be safe than sorry. 


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