Many women experience some form of bleeding during pregnancy. In the first trimester up to 1 in every 5 women may experience bleeding, despite having a healthy, on-going pregnancy. Of course, if you are pregnant any bleeding can be extremely worrying and you should seek advice from your midwife or doctor. In many cases your baby will be fine but it’s wise to discuss with your healthcare provider, as some bleeding in pregnancy can be dangerous.
What causes bleeding in pregnancy?
Bleeding in the first 12 weeks
First trimester bleeding or spotting is really common, and often it’s not a sign of miscarriage. Light bleeding, also known as “spotting” could be caused by several things including hormonal changes in early pregnancy, implantation bleeding (when the egg implants in the lining of the womb in the first few days of pregnancy), or irritation or infection in your cervix or vagina.
In some cases bleeding is a sign of miscarriage or ectopic pregnancy. Usually these conditions are associated with abdominal pain and cramping. If you have pain in addition to bleeding in early pregnancy then seek medical advice immediately.
Bleeding after the first 12 weeks
It’s less common to experience bleeding further on in pregnancy, but still very important to seek advice from your healthcare provider if you do experience any bleeding.
Causes of bleeding later on in pregnancy may be similar to those mentioned previously, for example changes in the cervix, infections in the womb, or a miscarriage.
Other conditions may also occur later in pregnancy which don’t affect pregnancies in the early stages:
A “show” can occur before or during labour, it happens when the cervix changes in preparation for birth, releasing the mucous plug that has been in the cervix during pregnancy. This is usually a blood stained discharge rather than heavy bleeding.
A low lying placenta – a condition known as placenta praevia – can lead to very serious bleeding requiring emergency treatment. Usually you will be told if you have a low-lying placenta as it will be seen on your ultrasound scan at 18 – 24 weeks. If you do have this condition you will most likely be advised to have a caesarean section to deliver your baby.
Placental abruption occurs when the placenta starts to detach from the inside of the womb before the baby has been delivered. This condition causes pain in the tummy and heavy bleeding, although the bleeding is sometimes internal so it can’t always be seen.
What should I do if I experience bleeding in pregnancy?
Get advice from a midwife or doctor as soon as you can, even if the bleeding stops or isn’t too heavy. It may be that your care provider can assess you over the phone and give you advice or you might be asked to attend for further assessment such as an examination, blood tests or a scan.
Dr Emma Scott (MBChB, MRCGP) is a qualified GP and mummy to two young children. She works in a GP practice in Edinburgh and in the out of hours GP service in Livingston and she has experience in both obstetrics & gynaecology and paediatrics.