There is no certain amount of “normal” bleeding during pregnancy. While bleeding during pregnancy is cause for concern, it is a fairly common symptom during early pregnancy. According to the American Pregnancy Association, 20 to 30% of women experience bleeding of some type during the first trimester of pregnancy and 10% of women report bleeding throughout their pregnancy.
Bleeding by itself is not a major risk factor for miscarriage. It is the amount and type of bleeding that needs to be monitored to determine if there is risk to the fetus as well as when during the pregnancy the bleeding occurs.
First Trimester Bleeding During Pregnancy
Many women experience bleeding during the first trimester pregnancy as a result of implantation bleeding. This seems to be the cause of most first trimester bleeding not related to other health risks.
Implantation bleeding is a normal symptom of early pregnancy. It usually occurs within 6-12 days of the implantation of the embryo.
For this reason many women do not realize they are pregnant right away and often mistake the bleeding as their normal menstruation cycle. Patients described as having implantation bleeding report the symptoms differently and it usually presents itself as a light, spotty flow of blood anywhere from a few hours to a few days.
Other common causes for none threatening bleeding during early pregnancy include a pelvic or urinary tract infection or irritation of the cervix during intercourse or after a pelvic exam.
If bleeding whilst pregnant during the first trimester occurs longer than a few days, is heavy, is dark, or accompanied by a vaginal discharge of mucus, a strange odor or cramping, there is more cause for concern of health risks. This can sometimes be caused by other conditions. Some of the most common conditions that accompany these types of symptoms include possible risk of miscarriage and ectopic pregnancy.
Bleeding During Second Half of Pregnancy
Bleeding during the second half of pregnancy is of more concern to health care providers. This can be a sign of health risks or conditions which may impact the pregnancy.
Some causes for bleeding during the second half of pregnancy include irritation of the cervix or possible growths on the cervix.
During the last few weeks before labor a woman may experience a small discharge of blood mixed with mucus. This is normal. It is caused from the cervix thinning out which ejects the mucus plug covering the cervix as the body prepares for labor.
If a woman experiences this earlier than a few weeks before delivery she should contact her healthcare provider immediately as it may be a sign of early labor.
Other conditions that include bleeding during the second half of pregnancy include placental abruption, placental previa and preterm labor. These conditions are usually associated with women who have other risk factors as well such as previous episodes, unusual cramping or pain, women over the age of 35 or are carrying multiple fetus.
Bleeding During Pregnancy- When to Call a Health Care Provider
Health care providers recommend that pregnant women contact a health care provider immediately if they experience any of the following symptoms:
- Moderate to heavy bleeding
- Bleeding accompanied by pain
- Chills or fever
- Pass tissue with the bleeding.
These are indicators that the bleeding can be serious and pose a health risk to the woman and fetus.
Women who experience bleeding during pregnancy should always report it to their health care provider regardless of when it occurs.
What to Expect From a Health Care Provider
The health care provider can determine if there is cause for further investigation of the cause for the bleeding and it should never be taken lightly. In most cases, when the bleeding isn’t serious, the health care provider will recommend rest and to drink plenty of fluids until the bleeding subsides.
If patients are experiencing bleeding whilst pregnant, health care providers will likely recommend that they wear a sanitary pad to monitor the amount of bleeding. They may ask to see the pad to determine the type and amount of bleeding.
Never insert anything into the vaginal area until the cause for bleeding has been diagnosed; this includes tampons or participating in an act of intercourse. Intercourse should be avoided until the seriousness of the bleeding is accessed by a health care professional.