About Bleeding During a Pregnancy

Overview

Bleeding can occur at any time during the gestational period. Bleeding does not always mean there is something drastically wrong, though it is often a signal of a problem with the pregnancy. If it occurs in the first trimester it can be relatively insignificant, but bleeding in the second and third trimester is often a sign of a significant complication. A woman should report any vaginal bleeding to her obstetrician.

Early Bleeding

According to the American Pregnancy Association, bleeding during the first trimester occurs in 20 to 30 percent of women. Possible causes of early bleeding that are not generally very significant are mild infection, implantation bleeding (this can happen anytime during from 12 days following conception) and bleeding after intercourse due to a tender cervix. Some bleeding early on in pregnancy is significant, so a woman should not ignore it. Wear a sanitary pad if bleeding does occur to monitor its severity and alert your physician.

Ectopic Pregnancy

A more serious cause of early bleeding is ectopic pregnancy in which the embryo implants outside of the uterus (usually in the fallopian tubes). An ectopic pregnancy is never successful, and the embryonic tissue has to be removed. Women who have an increased risk for ectopic pregnancy are those who have had an infection in the uterus or tubes and those who have structural problems with their reproductive organs.

Miscarriage

Another possible reason for bleeding is miscarriage, also known as a spontaneous abortion. Miscarriage generally cannot be prevented and often occurs due to a serious problem with the fetus. You are more likely to miscarry if you are over 35, use illicit drugs, have a chronic health condition, underwent invasive tests during the pregnancy or have had a miscarriage before.

Placental Abruption

Bleeding during the second half of pregnancy can be caused by issues with the placenta. Placental abruption occurs when the placenta becomes detached from the walls of the uterus. Stomach pain will likely accompany bleeding in this case. Women who are over 35, are mothers already, have high blood pressure, sickle cell anemia, stomach injury or use cocaine are at a higher risk for this occurring. The Mayo Clinic reports that approximately 1 percent of women experience this issue. Often this condition necessitates an early delivery. Sometimes you may be kept in the hospital for monitoring and given a medication to help the baby's lungs develop at a faster rate to prepare for a possible early delivery.

Placenta Previa

Another placenta problem that can happen is placenta previa. This condition occurs if the placenta is positioned too low in the cervix or if it covers the cervix in any degree. There is often no pain with the bleeding in placenta previa. Women more at risk for this occurring are ones who have had uterine surgery, are carrying multiples, have undergone a caesarean and who have given birth before. The American Pregnancy Association says placenta previa occurs once in 200 pregnancies. Your physician may prescribe bed rest if the bleeding is minimal, or you might have to have an emergency caesarean in cases of severe bleeding.

Early Labor

Sometimes bleeding may be signaling preterm labor. This bleeding comes from the disruption of the mucus plug, an event that usually happens within three weeks of your anticipated delivery date. If this "bloody show" occurs more than three weeks shy of your due date, it maybe a sign that labor is imminent. The vaginal bleeding may be accompanied by a watery or mucus discharge, abdominal or pelvic pressure and dull pain in the lower back. Women who have had preterm labor before, those pregnant with multiples, those who use drugs and who have had miscarriages are more likely to go into early labor. Contact your physician right away if you experience bleeding three or more weeks shy of your due date. The doctor may be able to stop the labor until you are further along in the pregnancy.