8 Common Causes for Bleeding in the First Trimester

Updated on July 10, 2019
modern housewife profile image

Sarah is a homemaker and stay-at-home mom who enjoys writing about motherhood, healthy living, finances and all things home and garden.


Perhaps you've noticed a little blood in your undies, or felt a gush and looked down only to see your bed covered in blood. You are immediately full of fear and with good reason. Bleeding in pregnancy is most commonly associated with a miscarriage so it is natural to assume the worst.

You shouldn't lose all hope. "In the first trimester, 20 to 40 percent of pregnancies can experience vaginal bleeding," says Dr. Mark Trolice, a reproductive specialist at the IVF Center in Orlando. Most women will have normal pregnancies and deliver healthy babies. This article will cover the potential causes of bleeding in the first trimester.

If you are suffering or have suffered a miscarriage, I am so sorry.  I understand the depths of your pain.
If you are suffering or have suffered a miscarriage, I am so sorry. I understand the depths of your pain. | Source

1st Trimester Miscarriage

Let's get the scariest scenario out of the way first. A miscarriage is the natural death of an embryo. It is classified as occurring before the 20th week. Afterwards, the death of an embryo is medically classified as a stillbirth. A miscarriage is sadly one of the most common complications during early pregnancy. According to Medical News Today, roughly one quarter of all pregnancies end in a miscarriage. 85% of them occur before the 12th week and can potentially occur before a woman realizes she is pregnant. You can read this article for a detailed account of a miscarriage.

What Causes a Miscarriage?

There are a variety of issues that can lead to a potential miscarriage.

  • Poor lifestyle habits such as smoking, drinking alcohol, and use of illegal drugs.
  • The International Journal of Obstetrics and Gynecology reports that women who are underweight are 72% more likely to have a miscarriage within the first trimester. Obesity also carries a high risk as well.
  • Weak muscles in the cervix can open the cervical cavity too early during pregnancy.
  • The placenta may have abnormal development. This could lead to blood supply being interrupted.
  • Abnormally shaped wombs can cause problems for the development of a fetus.
  • Chromosomal abnormalities can cause issues during development. This is actually the most common reason for a miscarriage in the first trimester.

What Are the Symptoms of Miscarriage?

"While any bleeding is alarming, it is not associated with miscarriage unless heavy bleeding occurs—resulting in approximately a 24 percent risk of loss," says Dr. Trolice. "There is no definitive evidence on the amount of bleeding, color of blood, or associated symptoms that will predict a miscarriage."

According to Dr. Ingrid Rodi, these are some potential symptoms. Keep in mind that there is no proven indicator that a miscarriage has occurred, so be sure to seek medical attention if you exhibit any of these symptoms.

  • Bleeding can be a first sign, though it can be misleading as it can be caused by multiple factors. You should see a doctor if the bleeding is heavy.
  • Pain can be a leading symptom. "Women who experience heavy vaginal bleeding with abdominal cramping are more likely to suffer a pregnancy loss," says Dr. Trolice. It is usually around the abdomen or lower back. It can range from a dull, aching pain to feeling like a period cramp. This symptom can also be misleading as cramping and pain can be common during the first trimester.
  • While not common, a decrease in pregnancy symptoms may be noticeable. This can include no longer feeling morning sickness or breasts no longer feeling tender. This is due to the reduction of pregnancy hormones.

How to Diagnose Miscarriage as the Cause of Bleeding

  • Severe and persistent cramping and/or passing large clots can suggest a miscarriage, but they could be from other causes as well. However, passing tissue, which often looks gray or beige in color, is most likely the baby and is a definite sign that you have miscarried. A pelvic exam can also detect tissue matter passing through.
  • Blood tests can find descending HCG levels, which also indicates an impending miscarriage.
  • An ultrasound may show no heartbeat or no fetus, indicating that the miscarriage is complete. You may also see heart tones that are much slower than normal, and/or that the baby is measuring smaller than it should be. This can imply an impending miscarriage.

Implantation Bleeding

Implantation bleeding is (usually) light spotting or bleeding that occurs between 6 to 12 days after conception. This happens when a fertilized egg begins dividing and forms an embryo, which then implants into the uterine wall. It is often one of the first signs of pregnancy and can occur before a woman realizes she is pregnant. Implantation bleeding is completely normal, harmless, and does not require any medical attention. According to the American Pregnancy Association, roughly one-third of pregnant women will experience this bleeding. It can often be confused with regular menstrual bleeding.

How Long Does Implantation Bleeding Last?

It could potentially last for only a few hours. It should not occur beyond three days. Menstrual bleeding by comparison can last for three to seven days. You can read this article for more information on implantation bleeding.

What Are the Symptoms of Implantation Bleeding?

  • Implantation bleeding is reported as usually being pinkish or darker in color than typical menstrual bleeding. However, most women don't find the two types of bleeding to be substantially different.
  • Some women report to have clotting during menstruation. Implantation bleeding should not feature any clotting.
  • Implantation bleeding is usually just some spotting or a light flow. It shouldn't be a full flow like a period.
  • It usually comes along with other various early pregnancy symptoms such as light cramping, nausea, and breast tenderness.

How Is Implantation Bleeding Diagnosed?

It can only be verified with a positive pregnancy test or a blood test to read rising HCG levels. It is merely a part of pregnancy and is not a cause for concern.

Ectopic Pregnancy

"This is the implantation of an embryo outside the uterine cavity, most commonly in the fallopian tube," says Dr. Trolice. Less common areas include the cervix, ovary, and abdomen. As an embryo can not develop outside the uterus, this means the embryo is not viable. According to WebMD, this condition must be treated as it can cause a fallopian tube to burst. While an ectopic pregnancy can cause issues for future pregnancies, it does not rule them out. You can read this article on having a successful pregnancy after an ectopic pregnancy.

What Are the Symptoms of an Ectopic Pregnancy?

Most women will be unable to recognize an ectopic pregnancy since they will experience most of the regular pregnancy symptoms initially. Vaginal bleeding is a major sign, particularly if it is heavier and lighter in color than normal menstruation. Pain in the abdomen and pelvis is another clue. This is due to blood gathering up under the diaphragm.

How to Treat an Ectopic Pregnancy

"An ectopic pregnancy is a potentially life-threatening situation," says Dr. Trolice. "As long as the patient is stable, the first line of treatment is a methotrexate injection, a chemotherapy used to disrupt the pregnancy cells for the body to absorb. If the patient is medically unstable or has been unsuccessful with conservative treatment, surgery is performed to remove the ectopic pregnancy. This may involve removing the affected fallopian tube."


Cervicitis is the inflammation of the cervix. It can be caused by a number of infections, most commonly by sexually transmitted diseases such as chlamydia and gonorrhea. The cervix can become irritated and potentially lead to some spotting or bloody discharge.

What Are the Symptoms of Cervicitis?

According to Harvard Health, cervicitis usually doesn't have any major symptoms. While not common, some signs do exist such bloody vaginal discharge or spotting. Here are some potential symptoms of cervicitis.

  • Pain during intercourse.
  • Vaginal itching.
  • Burning feeling when you urinate.

You should consult a doctor if you exhibit any of these symptoms. Cervicitis can spread to your fallopian tubes and ovaries if left untreated.

Cervical Polyps

Cervical polyps are benign growths that appear around the opening of the cervix. According to Healthline, they may appear during pregnancy due to the rise of hormone levels. However, their exact cause remains unknown. While not usually cancerous, they should be examined since rare types of cancers can look like polyps.

What Are the Symptoms of Cervical Polyps?

Cervical polyps typically don't cause any major noticeable symptoms. The biggest sign is usually some light bleeding. It is typically nothing more than spotting, but it can appear as heavier bleeding as well. Bleeding most commonly occurs after intercourse. A doctor can identify polyps during a vaginal exam. If surgery is needed to remove the polyps, you can expect vaginal bleeding for the next day or two. Some women experience a watery discharge with some blood as well.

Subchorionic Hemorrhage

A subchorionic hemorrhage, or subchorionic hematoma or bleed, is when blood accumulates within the chorion or between the placenta and uterus. According to WhattoExpect, about one percent of all pregnancies will experience a subchorionic hemorrhage. It seems to be more prevalent with women who become pregnant via IVF. For women that experience bleeding in their first trimester, a subchorionic hemorrhage is diagnosed as the reason 20 percent of the time. This bleeding is not necessarily dangerous to a mother or her baby but it should be monitored to ensure that no complications arise. Most cases will resolve on their own and women will go on to have healthy pregnancies.

What Are the Symptoms of a Subchorionic Hemorrhage?

This condition is difficult to detect since it usually doesn't have any noticeable symptoms. The only visible signal is some potential light spotting or bleeding.

How to Diagnose a Subchorionic Hemorrhage

This condition is diagnosed most of the time through a routine ultrasound, especially if there was no visible bleeding.

The empty sac on the right side indicates a twin that didn't make it past the embryonic stage. See the blood in the lower half of the sac.
The empty sac on the right side indicates a twin that didn't make it past the embryonic stage. See the blood in the lower half of the sac.

Vanishing Twin Syndrome

This is a phenomena where multiple eggs are fertilized (usually two) but one of the embryos fails to progress. Often, the deceased embryo gets absorbed by the placenta, the mother, or the other baby. This can be considered a type of miscarriage. According to the American Pregnancy Association, if this occurs in the first trimester, there is usually not any risk to the mother or surviving twin. With the development of ultrasonography, experts now believe VTS occurs in roughly 21-30 percent of all multiple pregnancies.

What Causes Vanishing Twin Syndrome?

The exact cause is unknown. Examination of fetal tissue or placenta has often revealed some type of chromosomal abnormality. Improper cord implantation can also be a key factor as well. According to Dr. Robert Wool, VTS is more likely with fraternal twins since that type of twin is a sort of genetic malfunction to begin with.

How is Vanishing Twin Syndrome Diagnosed?

An ultrasound is the only way to diagnose VTS during the 1st trimester. A follow up ultrasound will notice the disappearance of the second fetus that was previously visible. A Doppler may also only read one heartbeat where two were previously detected.

Decidual Bleeding

Decidual bleeding is a condition related to the partial shedding of the lining of the uterus during the first trimester. This shedding is believed to be caused by hormonal imbalances. According to Prime Health Channel, it is caused by portions of the decidua that has yet to be covered by the embryo or placenta. The passage of this tissue may be confused with a miscarriage or menstrual blood.

What Are the Symptoms of Decidual Bleeding?

This type of bleeding usually appears as spotting or bleeding that can be comparable to menstrual-like bleeding. As such, it is often confused for a period. Blood clots may be passed, and there may be small pieces of uterine lining present. This can cause some confusion as women may mistake this as a symptom of a miscarriage.

How to Diagnose Decidual Bleeding

As with all bleeding, a doctor should be consulted as it may be a sign of a major problem. An examination can find decimal bleeding to be a cause if no major complications are present.

When Is 1st Trimester Bleeding a Medical Emergency?

According to the Mayo Clinic, you should seek a doctor if you have any type of bleeding that has lasted over a day. You should seek immediate medical attention if you experience any of the following.

  • Moderate to heavy vaginal bleeding.
  • Passing tissue from your vagina.
  • Any vaginal bleeding that is accompanied by fever, cramping, or abdominal pain.
  • Feeling any dizziness or experience fainting.

What Is Rh Incompatibility in Pregnancy?

An important reason to see a doctor for any type of bleeding is the condition known as Rh incompatibility or Rh isoimmunization. "If a pregnant woman bleeds and her blood type is Rh negative, and the sperm source is Rh positive or unknown, then the woman has the potential of developing antibodies that can harm the baby who is Rh positive," says Dr. Trolice. "This can result in severe anemia, jaundice, brain damage, and heart failure in a newborn."

According to the National Heart, Lung, and Blood Institute, Rh incompatibility can be treated with injections of Rh immune globulin. This medicine prevents your body from creating Rh antibodies that will harm your baby.

What to Do If You Experience 1st Trimester Bleeding

If you become one the of 20% of women who experience 1st trimester bleeding, stay calm and remember that no matter how heavily you are bleeding, there are several possible explanations besides miscarriage.

Let your doctor or midwife know what you are experiencing. Your doctor may tell you to go to the emergency room or labor and delivery to be checked out. Understand that a 1st trimester miscarriage in progress cannot be stopped. The main benefit to going in right away is that you will hopefully find out immediately what is going on.

Know, however, that you do have the option of staying at home until normal office hours, or to miscarry naturally in an environment in which you will be more comfortable. According to the American Pregnancy Association, a D&C procedure is not usually necessary unless the miscarriage occurred later than 10-12 weeks or if there are any related complications.

Overall, it is suggested to call a doctor for any type of noticeable bleeding that you feel is unusual. Here are some other steps you can take.

  • Wear pads so you can monitor how much you are bleeding as well as what type of bleeding you are experiencing.
  • Do not use a tampon or introduce anything into the vaginal area if you are bleeding. Avoid sexual intercourse as well.
  • Contact a doctor if you experience cramps or abdominal pain.
  • If you happened to have collected any tissue you passed through, you could bring that to a doctor for examination.

First trimester bleeding is indeed very scary. However, it is not always related to a miscarriage. It is not usually necessary to go to the emergency room when you experience bleeding, although you should still call your doctor for guidance. As long as you are comfortable at home and are not bleeding excessively, you are safe staying home until you feel physically and mentally ready to go to a hospital or office to find out what is going on with your baby.

Have you experienced 1st trimester bleeding? You are not alone. Share your experience in the comments below.


  • Cervicitis: What Is It? (2013, January). From Harvard Health.
  • Bleeding during pregnancy When to see a doctor. (2018, January 11). From Mayo Clinic.
  • Brusie, C. M., & Dashiell, A. (2018, March 27). Signs of Miscarriage. From Parents.com.
  • D&C Procedure After a Miscarriage: Risks & Complications. (2017, July 18). From American Pregnancy Association.
  • Decidual Bleeding - Symptoms, Causes and Complications during Pregnancy. (2011, July 28). From Prime Health Channel.
  • Ectopic Pregnancy Symptoms and When to Call 911. From WebMD.
  • Lack, E. (2018, April 03). Strange but true: Vanishing twins. From BabyCenter.
  • Maconochie, N., Doyle, P., Simmons, R., & Prior, S. (2006, December 05). Risk factors for first trimester miscarriage-results from a UK‐population‐based case–control study. From the International Journal of Obstetrics and Gynecology, Volume 114, Issue 2.
  • Nordqvist, J. (2018, January 11). Miscarriage: Warning signs, treatments, and prevention. From Medical News Today.
  • Polyp of Cervix: Causes, Symptoms, and Diagnosis. From Healthline.
  • Rh Incompatibility. From the National Heart, Lung, and Blood Institute.
  • Subchorionic Bleeding During Pregnancy. (2018, February 08). From What to Expect.
  • Vanishing Twin Syndrome: Causes, Signs and Effects. (2016, September 02). From American Pregnancy Association.
  • What Is Implantation Bleeding? (2017, November 25). From American Pregnancy Association.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Questions & Answers

  • I have bleeding and clotting and I am 7 weeks pregnant. What should I do?

    Try to rest as much as possible and call your OBGYN.

  • I am 7 weeks pregnant. On Tuesday afternoon I start to bleed and pass clots. Yesterday, light pink blood no clot, today bright red blood. Is It a miscarriage?

    Unfortunately, there is just no way to tell, but it’s not necessarily a miscarriage. It could some sort of bleeding from the cervix or a SCH. The best thing to do is to call your OB and ask to be seen.

  • I am 8 weeks pregnant and I am bleeding bright red with no pain. Is it normal to bleed at 8 weeks pregnant?

    That is not uncommon, but scary, I know. The best thing to do is to stay calm and call your medical care provider.

  • I'm bleeding at 4 weeks pregnant, should I be concerned?

    Give your OBGYN a call. They can run blood work to test your HCG levels.

  • I am around 6 weeks pregnant and am experiencing spotting. It is very light and is only in the morning when I first go to the bathroom. Should I be worried?

    Try not to worry. My doctor always told me not to worry unless the blood was red with cramping. Touch base with your OB.

© 2014 Sarah


    0 of 8192 characters used
    Post Comment
    • profile image

      my name is Jennifer 

      4 days ago

      I am 9 weeks pregnant and even before My period i notice blood stain on my pant after that day i did nt see d blood again. Then i go for pregnancy test I found out am pregnant after 4weeks of pregnant I start seeing blood if I urinate clean out blood like dark red and the blood is nt steady.sometimes it came out with clot.but now is dropping almost everyday on d pad i put those it mean i wil miscarriage? I need help please

    • profile image


      2 weeks ago

      I am 8 weeks pregnant i’ve bled at the beginning of the pregnancy with brown color ..also yesterday but it was light spotting unfortunately today i’ve bled but with fresh red color.My doctor told me that there was hematoma.but after searching i think about Vanishing twin syndrome because i had ivf experience and 2 embryo retrieved but only one sac With only one embryo was in ultrasound.how can I differentiate between the 2 cases?

    • profile image


      8 weeks ago

      Hey i have a question i havent had a period last m ok nth it was supposed to be the 25 but this month and last month it lasted for 2-3 days i bleed but it was a little weird it was light pink sometimes dark brown and red is this a sign or pregnancy?

    • profile image


      20 months ago

      This is a great article - exactly what I needed. I had a MC back in June and am pregnant again. I began spotting back @8 weeks and have been on and off and am now almost 12 weeks. Everyone keeps telling me its ok and that we heard a heartbeat so the chances of another MC are lowering every week. But noone can say exactly what causes bleeding however little it is. This really gave me valuable information and helped me feel more at ease. I will still be a little nervous but having explanations go a long way. Thank you so much.

      To all the moms out there, I feel you its so scary especially after you have experienced a loss. The stress on your heart and soul is almost unbearable. But these forums help, and knowing that others have gone through what you are and have had healthy babies is a ray of light. Best I can say is have faith and stay hopeful. Hope can move mountains and it will help you believe your baby is healthy but it will also help you get through a loss and look to the next time when you will have a healthy happy bump to love.

    • profile image


      23 months ago

      hi Lydia I am going through the same thing as you. I have been bleeding since 11/01 and now its 11/24. The doctors said they don't know whats wrong. I got an ultrasound at 7 weeks 4 days and saw a heartbeat.

    • profile image


      23 months ago

      I've bled with clots for over 4 weeks now, the can showed a sac with no embryo but with closed cervix, i was put on duphustone for 2 weeks but nothing has changed, yesterday i had something in my panty and when i checked it was a small piece greyish in colour with some mucus -like mixed with red. am supposed to go back to the doctor for another scan today but the bleeding has always been on and off and little but with some small clots. am scared, anyone with similar issues plese share with me

    • profile image


      2 years ago

      I started with a brown spotting that turns into light pink and heavy red blood with small clot. Yesterday night there’s something came out of me like a flesh with blood on it and when I woke up today one more flesh came out from me. It’s like a minced fat. (Sorry for the word) is there anyone experienced same? I’m worry abt my 6weeks baby.

    • profile image

      10 weeks, spotting, article helped 

      2 years ago

      I'm about 10 weeks prefix, have had mild cramping the past 3 days, and started spotting this eve. In my previous pregnancy I had a bit of spotting around this same time of pregnancy, and baby was fine.. I'm praying for the same this time. I've been very busy the past week and on my feet a lot, so I am hoping possibly it's just something mild, and not to worry.. Guess we shall see... God willing, Life willing, my little one will live...


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, wehavekids.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://wehavekids.com/privacy-policy#gdpr

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)
    ClickscoThis is a data management platform studying reader behavior (Privacy Policy)