What Does Spotting or Bleeding in Early Pregnancy Mean?
|Expert Reviewed||Dr. Mark P. Trolice, MD, Director of the Fertility C.A.R.E. center and an associate professor of Ob/Gyn at UCF.|
Is it Normal to Bleed During Early Pregnancy?
Bleeding during pregnancy can be an unnerving event, and it can put your emotional rollercoaster on full speed. The first thing you need to know is that light bleeding during early pregnancy is very common and is, in most cases, not an indication of a miscarriage. Heavy bleeding, on the other hand, may be a sign of more serious problems.
Still, while spotting in early pregnancy is common, it always warrants a call to your doctor.
In this article, I will try to clarify the different types of bleeding in early pregnancy and what bleeding means for the remainder of your maternity.
What Is Normal Bleeding During Early Pregnancy?
Light bleeding or spotting during early pregnancy is usually not a cause for concern. Approximately 20 percent of women report bleeding during their first 12 weeks of pregnancy, and recent studies have shown that a little bleeding is usually harmless and does not have any effect on the health of the baby. The list below outlines what normal bleeding during early pregnancy may be like.
- Bleeding (or spotting) is a bloody discharge from your vagina.
- The blood is pink, red or brown.
- The amount of blood should no more than a few drops at a time. (When explaining the amount of blood discharge over the phone to your doctor, use visual measurements. For example, if the blood stain is as big as a small coin, perhaps you've discharged a teaspoon of blood. You can also describe the amount over time. How many hours does it take to stain or fill a sanitary pad?)
- The bleeding comes from the vagina, not the anus.
How to Differentiate Between Light Bleeding (or Spotting) and Heavy Bleeding
There is no exact definition or amount for bleeding to be considered light or heavy. Dr. Mark Trolice, a fertility expert and the director of the Fertility C.A.R.E center in Winter Park, Florida, says the amount of bleeding is "entirely subjective."
When talking to your doctor about your amount of bleeding, Dr. Trolice recommends comparing your discharge during early pregnancy to your menstrual flow, such as "light, moderate, [and] heavy flow."
What Does Blood Color Indicate When You're Bleeding?
If you are spotting during early pregnancy, the color of the blood may provide a hint as to what is taking place within your body. Learn about the differences between pink, red, and brown blood when it comes to bleeding during pregnancy. The table below lists the most probable reasons you may be experiencing either pink, red or brown blood discharge.
Cervix settling as it prepares for pregnancy
Damage to vaginal walls caused by sex
Leftover blood from previous period
Leftover blood from egg implantation
Minor cervical injury
Healed cervical injury
Possible Causes of Light Bleeding or Spotting During Pregnancy
The causes for a bleeding and spotting during early pregnancy are various. The most common source of bleeding is from the vagina wall or the inner lining.
When you get pregnant, the body changes the flow of the bloodstream and the small arteries or capillaries get filled with blood. That’s why it’s more likely to have some bleeding in areas with mucosa, like the mouth and the vagina. Because of this, the smallest irritation can cause bleeding. Some common irritants include:
While having sex during early pregnancy is completely safe, it may irritate the vaginal walls and cause light bleeding.
If you have gone to the doctor recently for an examination, or if you have performed one yourself, the vaginal walls or the inner lining may have become irritated, resulting in bleeding.
Implantation bleeding occurs around the time you should be expecting your period, or before you know you are pregnant. Sometimes, it occurs up to five weeks into your pregnancy. This type of bleeding happens when the fertilized egg attaches itself to the uterine lining. This can cause a few days of light bleeding.
Heavy Lifting or Excessive Exercise
Applying strain to your body, such as while working out, can irritate the vagina and cause bleeding.
In some women, the cervix or the endometrial lining of the vagina can have small growths called polyps. These can rupture easily and cause bleeding.
Polyps are totally benign in most cases, even though the amount of blood can be alarming. The only way to know for sure if you have polyps is to have a doctor or a midwife perform a vaginal examination.
Bleeding From the Cervix
Bleeding from the cervix is also common. The cervix is located deep inside the vagina, and is a tube shaped organ that will get thinner and dilate when the baby is born. The cervix, like the uterine lining, is rich with blood during pregnancy, and can bleed after being slightly irritated.
Possible Causes of Heavy Bleeding During Early Pregnancy
If you're are experiencing heavy bleeding during early pregnancy, something more serious may be going on. You should call your doctor immediately and report the amount and frequency of bloody discharge as accurately as possible. Some common causes of heavy bleeding during early pregnancy include:
Subchorionic hemorrhages occur when blood collects between the gestational sac and the wall of the uterus. This can cause heavy bleeding during early pregnancy.
An ectopic pregnancy occurs when the fertilized egg attaches somewhere other than inside the uterus. Most ectopic pregnancies take place inside the fallopian tube, which is why these types of pregnancies are also called tubal pregnancies. The embryo may also implant itself in the ovary, cervix, or abdomen. Occurring once in every 50 pregnancies, ectopic pregnancies can cause heavy bleeding during early pregnancy.
Dr. Trolice explains that "since pregnancy cannot survive outside the uterus, an ectopic pregnancy is a potentially life-threatening situation."
"As long as the patient is stable," says Dr. Trolice, "the first line of treatment is 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, if applicable."
What Causes an Ectopic Pregnancy?
- An infection or inflammation of the fallopian tube can cause it to become blocked, stopping the fertilized egg on its way to the uterus.
- Scar tissue from a previous infection or surgical procedure may impede the eggs movement.
- Abnormal growths or a birth defect can cause the tube to be misshapen.
A molar pregnancy occurs when an abnormal growth of tissue develops in the uterus, eventually consuming the fetus or causing severe birth defects. This type of pregnancy is very rare, occurring once in every 1,000 pregnancies. Heavy bleeding may be a sign of a molar pregnancy.
Heavy bleeding during early pregnancy may be a sign of a miscarriage. Studies report that 10 to 15 percent of pregnancies end in miscarriage, usually during the first 12 weeks of gestation. A genetic defect of the embryo is the most common cause of miscarriage, but a miscarriage may also be caused when the cervix refuses to close.
What Are the Signs of an Early Miscarriage?
Miscarriages are most often caused by factors out of the mother's control, such as chromosomal problems, hormone imbalances, uterine problems, or chronic illnesses. Some signs of a miscarriage include:
While spotting or light bleeding during early pregnancy is normal, bleeding that continues throughout the day and night, filling a sanitary pad within a few hours, is not normal and may be a sign of a miscarriage.
If the cervix starts to dilate, you will experience large amounts of discharge. A dilated cervix early in pregnancy is a sign of threatened or imminent miscarriage. In this case, visit your doctor immediately. It is sometimes possible to get a cervical cerclage (stitches) that will close the cervix temporarily. The state of the cervix can be examined by transvaginal ultrasound equipment that most OB/GYNs have in their practices or hospitals.
Mild to Severe Cramps
Cramps that do not go away with rest may be an early sign of a miscarriage.
Pain in Your Back or Abdomen
If you are experiencing pain in these areas during early pregnancy, you may be experiencing a miscarriage.
White-Pink Mucus, Tissue, or Clots
If white-pink mucus, tissue, or clots of blood are being discharged from your vagina, this may be a sign of a miscarriage.
Weight Loss or a Sudden Decrease in Signs of Pregnancy
Weight loss or other decreases in signs of pregnancy may be an early sign of a miscarriage.
What's the Next Step?
Amount of Blood
What You Should Do
Light bleeding or spotting
While this amount of blood is normal, it doesn't hurt to call your doctor to report your bleeding. Unless advised otherwise, simply take some time to relax. Light bleeding is normal.
Mild, constant bleeding
Call your doctor. This amount of blood may be cause for concern.
Heavy bleeding with cramps
Call your doctor immediately. This could be a sign of a miscarriage.
How to Make Sure Your Baby Is Okay
If you experience complications of any sort at the beginning of your pregnancy, including light bleeding or spotting, do not hesitate to call your doctor. Once your doctor confirms you and your growing baby are okay, the only way to keep tabs on your child's progress is to wait until you can detect a heart beat. Below is a timetable for keeping track of the health of your baby:
Stage of Pregnancy
How to Check Your Baby's Health
First Six Weeks
The baby is developing. The only thing you can do is wait and regularly consult your doctor.
After Six Weeks
You should be able to detect a heartbeat via transvaginal ultrasound.
After Eight Weeks
You should be able to detect a heartbeat via regular ultrasound.
After Ten Weeks
You should be able to detect a heartbeat using a doppler.
Listen to Your Body
In the end, pregnancy is a roller coaster ride of emotions. Thankfully, most of the time these worries are just that: worries. It's normal to be a little anxious for the life you carry. On the other hand, when we get hints or signs that something is wrong, it is important to listen. Slow down a little bit, take a moment to rest in the middle of the day, and do your best to cut down on stress. Ask your family and friends for help with your kids or other chores, and always make sure to take good care of yourself.
When the bleeding becomes so severe that it is indeed a sign of miscarriage, you have a choice. If the cramps are bearable, the bleeding is moderate and you can see that the embryo or fetus is gone, you don't have to get examined. On the other hand, most women prefer seek help with a professional to make sure they are okay and to receive advice on how to continue.
A miscarriage can be difficult, and for many it is the equivalent of the loss of an already-born child. If you unfortunately experience a miscarriage, seek help from your loved ones, your spiritual guide or a health professional. You are not alone.
Advice on Early Bleeding (Video)
Dr. Mark P. Trolice, MD
- The article has been modified since this review was written.
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