Vaginal bleeding can occur during pregnancy for many reasons. Some women will have light bleeding during early pregnancy. In fact, 20-25% of women experience spotting or bleeding during pregnancy. Half of these women go on to experience normal pregnancies without any issues.
Of course, bleeding can be a frightening experience for an expectant mother. If you experience any bleeding during pregnancy, you shouldn't panic, but you should contact your doctor immediately.
Light Bleeding During Early Pregnancy
Some women have implantation bleeding during early pregnancy. This usually occurs during the first few weeks of pregnancy. You may notice slight bleeding around the time your period was supposed to arrive. This happens because the fertilized egg is attaching to the uterine wall. Sometimes light bleeding or brown spotting will follow this. Your doctor may order tests to check your hormone levels. Often doctors will check HCG levels to see how far along you are in pregnancy. HCG levels should double approximately every two days. Your doctor may check your levels more than once to see that they are rising appropriately. Low HCG levels can indicate a miscarriage or ectopic pregnancy. It is important to let your doctor know if you have any spotting or bleeding no matter how light it might be.
Reasons for Bleeding During Early Pregnancy
- Bleeding after sex: Many women will have light spotting after sex or following an internal exam performed by their doctors. Please let your doctor know if you've had sex prior to the time you noticed spotting.
- Ectopic pregnancy: Ectopic pregnancy occurs when the fertilized egg attaches somewhere outside the uterus. About 1% of pregnancies are ectopic. The symptoms of ectopic pregnancy are spotting and pain in the abdominal area, usually on one side. Your doctor may perform an ultrasound or order HCG testing to check for an ectopic pregnancy. HCG levels may rise during an ectopic pregnancy but not rise appropriately.
- Miscarriage: A miscarriage is the loss of a pregnancy before the twentieth week of pregnancy. About 20% of all pregnancies end in miscarriage. There are many causes for miscarriage. The most common are a result of chromosomal abnormalities, uterine anomalies, infection, or placental circulation. Signs of miscarriage are spotting or bleeding and cramping during pregnancy. If you are concerned that you are miscarrying, call your doctor right away. Your doctor may perform an ultrasound. Fifty percent of women who have spotting during pregnancy do not miscarry. If during the ultrasound the doctor sees a heartbeat, your chances of miscarriage are even less. If you have an ultrasound between seven and eleven weeks of pregnancy and a heartbeat is seen, your chances of miscarrying are less than 10%.
Bleeding During Late Pregnancy
There are several causes for bleeding during late pregnancy. Sometimes bleeding can be a sign of normal labor, but any time you experience bleeding during pregnancy you should call your doctor right away. Bleeding in late pregnancy can be a sign of problems with the placenta, such as placenta previa or placental abruption. It could also be a sign of a late miscarriage if you are in your second trimester or preterm labor.
Reasons for Bleeding During Late Pregnancy
- Placenta previa: Placenta previa occurs when the placenta lies low in the uterus. It may cover or partially cover the cervix. Placenta previa is diagnosed by ultrasound. A low-lying placenta will often correct itself during pregnancy. As the pregnancy progresses the attachment site may rise away from the cervix. Placenta previa is one of the most common causes for bleeding in the third trimester. If bleeding is severe, an immediate cesarean may be required to stop the bleeding and to save the mother's life.
- Placental abruption: Placental abruption is when the placenta separates from the uterus. Sometimes a partial separation occurs and sometimes it will separate completely. This is an emergency situation and can result in the death of the baby or the mother. Symptoms include vaginal bleeding, abdominal pain and tenderness, and a continuous uterine contraction.
- Labor: If you are approaching your due date and notice a small amount of bleeding, this could be an indication that you are going into labor. Contact your doctor as soon as possible.