BLEEDING IN PREGNANCY: NORMAL OR NOT?
Written by Caroline Meyer
In the first trimester your body will be going through a lot of changes. You may be experiencing all sorts of things for the first time. While some bleeding is common during this period, it can raise anxiety levels and cause concern especially if it is the first pregnancy. Around a quarter of women will experience bleeding during the first 12 weeks. This is usually spotting or a very light bleed, but can still cause worry of a miscarriage or that something is wrong.
In general, light bleeding in early pregnancy is nothing to worry about, but it is always good to get a medical opinion if there is some bleeding, especially if it is more than just spotting. If the bleed is heavier than just a few spots, then urgent medical attention is advised. If the bleeding is accompanied by any other symptoms, even if it is just light spotting, you should still book a check-up with your doctor or midwife to make sure everything is okay.
Most of the women that do experience spotting will find it occurs around the 4 to 7-week mark. This can also lead women to think they are having a menstrual period and they may not realise they are indeed pregnant. More than half of pregnancies are not planned and often the first signs may just be mistaken for menstrual symptoms. Fatigue, tender breasts, feeling a bit bloated could be misconstrued as the lead up to a period, especially if the spotting starts soon after. This can result in women not knowing they are pregnant until much later in the trimester. If you are trying to fall pregnant and have had the results confirmed, bleeding in the early stages can be quite worrying. If there is pain or fever along with the bleeding, treat it as serious and consult your health care provider.
Bleeding during early pregnancy can be caused from the fertilised egg attaching to the uterus. It can also be caused from infection or after intercourse as the uterus is a lot more sensitive at this point. Implantation bleeding is the most common cause and would usually happen close to the time that your next period may be expected. The burrowing of the egg into the lining of the uterus is the cause of the light spotting. The blood that is expelled ranges from pale pink to a reddish brown and will be a lot lighter than a normal period. If there is heavy flow there is likely to be another cause. That being said, some women will experience menstruation-like bleeding for 2 to 3 months after falling pregnant and may not realise they are expecting until many of the other pregnancy symptoms start to appear. This is referred to as decidual bleeding. It is not a normal menstrual period but may appear similar in length and quantity of flow as some of the lining of the uterus is shed, similar to the usual period flow. This does not happen very often as the hormones released when pregnant prevent a normal menstrual period in most cases.
If you experience additional symptoms such as cramping, pain, blood clots being shed, fevers or anything out of the ordinary along with the bleeding, you should speak to your doctor or midwife to check if everything is okay. Of the 25% of women that experience bleeding during pregnancy, more than half of them proceed normally with the pregnancy after the first 3 to 4 months. Some do however end up with issues that need to be treated. It is always good to be on the safe side and make sure everything is going smoothly with your pregnancy. If you have any concerns at all, get them checked out as soon as possible. While light bleeding is a lot more common and generally of minimal concern, heavy bleeding during pregnancy can signify a lot more serious issue.
Some of the issues related to heavy bleeding in pregnancy include miscarriage which is usually accompanied by back pain, cramping and blood clots. If you experience these symptoms you will need to be attended to by your doctor for aftercare to prevent infection and to make sure everything else is okay. You may want to attend counselling as well to help you through the loss.
Another reason for heavy bleeding can be due to inflammation or infection of the cervix or tumours in the region of the cervix. An ectopic pregnancy, where the fertilised egg attempts to grow outside of the uterus, often in the fallopian tubes can cause heavy bleeding accompanied by abdominal pain which can gradually become worse and worse. This needs urgent treatment as it is not a viable pregnancy and can cause further damage if allowed to continue.
Another cause is a subchorionic haemorrhage. This is where blood collects in between the gestational sack and the wall of the uterus. In most cases the blood is reabsorbed in to the body without any ill effects. Occasionally this can result in clots being passed along with heavy bleeding. One of the rarer conditions that can cause heavy bleeding is a molar pregnancy is a molar pregnancy. This is when the cells that should form the placenta and develop into a foetus develop abnormally. You may still experience morning sickness which may be a lot more severe than usual as these cells produce added pregnancy hormones. It is important that you do not ignore these symptoms and seek treatment straight away. If you have concerns due to heavy bleeding or even spotting at any point in your pregnancy, you should contact your doctor or midwife so they can assess the severity of the situation and advise you on next steps.