Any vaginal bleeding during pregnancy may be startling, but it can be due to normal bodily changes. Most normal bleeding occurs within the first 12 weeks of pregnancy, says the American Congress of Obstetricians and Gynecologists (ACOG). Despite some bleeding being normal, it is always important to consult your health care provider to help identify the cause. By the 19th week, the causes of bleeding may be more serious, especially if it is accompanied by other symptoms.
Light bleeding or spotting in the second half of pregnancy is commonly caused by cervical inflammation or growths on the cervix, says the ACOG. Some common causes of cervical inflammation include sexually transmitted diseases and bacterial or fungal infections, like a yeast infection. Routine testing and exams can help diagnose this issue. This common problem can be resolved with medication and typically results in a successful pregnancy. Once these cervical abnormalities are discovered, a health care provider will monitor them closely to make sure no complications arise.
When the placenta spontaneously detaches from the uterus, the result is often heavy bleeding. This is called placental abruption. When the placenta detaches from the uterus, a woman may have some pain before she has any bleeding. It is often a serious threat to the mother and the pregnancy. The fetus may struggle to get adequate oxygen without the placenta in place. Placental abruption can even occur during labor when the baby has not yet been delivered. Emergency medical treatment is necessary for this pregnancy complication. At 19 weeks it is not feasible to deliver the baby early as he cannot survive outside the womb at this point. Early delivery, whether by cesarean or an induced vaginal labor, is a very common method of dealing with placental abruption. The ACOG points out that most often placental abruption occurs in the last 12 weeks of pregnancy, making it even less likely to occur during the 19th week of pregnancy.
Placenta previa is a condition where the placenta lies low in the uterus. In some cases it may be blocking the cervical opening, which can pose a very serious risk to the pregnancy. Bleeding with this condition is usually painless. When the placenta is resting over the cervical opening the baby may not receive adequate oxygen, which can make vaginal delivery too risky to attempt.
Women who pass blood from the vagina and experience abdominal cramps (contractions) may have pre-term labor. The contractions with this condition are consistent in length and gradually occur closer together. Labor at 19 weeks is too early and emergency medical intervention is necessary to attempt to prevent the labor. Bed rest or hospitalization may be required to save the baby and to promote the safety of the mother. The American Pregnancy Association explains that after the first trimester, or after the 14th week of pregnancy, the spontaneous loss of the baby is no longer called a miscarriage. Instead, a loss of the baby from the 15th week until the 37th week is considered to be pre-term labor or stillbirth, if the baby is ejected from the vagina but is no longer alive.
The cervix is more sensitive and contains more blood in the tissues during pregnancy. A simple vaginal exam during a prenatal appointment or sexual intercourse can cause some light spotting or brief periods of bleeding at any point in the pregnancy, including the 19th week. The blood from this may be bright or brownish. Bright blood typically indicates the cervix was irritated. Brownish blood may be older blood that has just made its way out of the body. Pregnant women should confirm this is the cause of bleeding with a medical care provider.