Nothing strikes fear into the heart of a pregnant woman more than when she sees spotting or bleeding in her underwear. While this can be a cause of deep concern, one in four women experience bleeding in early pregnancy and many still go on to have perfectly healthy babies.
Bleeding, particularly spotting during pregnancy is very common in most cases and does not necessarily mean the baby is at risk.
Working out the cause of the bleed depends on many factors, such as how many weeks pregnant you are and the type of bleed you are experiencing. You should always err on the side of caution and discuss any bleed with your doctor.
What is pregnancy spotting? Is spotting normal during pregnancy?
Pregnancy spotting, meaning you have found traces of pink, red or brown blood on your underwear or toilet paper, can happen at any time during a pregnancy although it is most common in the first trimester.
Approximately 25% of pregnant women experience some type of discharge from the vagina in early pregnancy. It happens most frequently in the first 8 weeks of pregnancy.
What does pregnancy spotting look like?
Looking at pictures of spotting can give you a benchmark for what is normal. Light spotting can represent as either pink spotting or brown spotting. The amount is usually much less than a regular period.
Possible causes of bleeding in early pregnancy are:
- An early pregnancy sign, (implantation bleeding): This can happen around the same time as your period–sometimes before you even know you are pregnant. As the name suggests, implantation bleeding occurs when the fertilised egg burrows into the uterine lining.
- Sex: Sex is completely safe and will not harm your baby, however, during pregnancy, the surface of the cervix alters as pregnancy hormones take hold, making it more prone to bleeding.
- Cervical polyps (harmless growths) are more likely to bleed during pregnancy due to an increase in estrogen levels.
- Cervical or vaginal infection. Both are treatable.
- Ectopic pregnancy: This is when the embryo implants outside the uterus, most commonly in the fallopian tube, and therefore cannot develop. Other symptoms include abdominal cramps and pain as well as referred shoulder or neck pain. This is a medical emergency.
If the bleeding is accompanied by cramps and gets progressively heavier, it could be a sign of a miscarriage.
If you are bleeding later in your pregnancy, (after your first trimester), potential reasons are:
- A ‘Show’: One of the first signs you are about to go into labour is a small, blood tinged mucous discharge. This is the plug that has sealed the cervix which has come away enabling you to enter the first stage of labour.
- Placenta Praevia: This occurs when the placenta is laying in the lower part of your womb either close to or completely covering the cervix. The bleeding occurs as the lower part of the uterus thins out during the third trimester of pregnancy in preparation for labour. Your doctor will often recommend strict bedrest and possibly a caesarean birth.
- Vasa Praevia: A life - threatening but thankfully rare condition caused by the blood vessels in the umbilical cord running through membranes covering the cervix.
- Placental Abruption: Another rare condition in which the placenta tears away from the wall of the uterus, can cause severe life-threatening vaginal bleeding
What if I experience period like bleeding during early pregnancy?
Period like bleeding, (i.e. a heavy flow), is a sign there is something more concerning that needs medical attention.
What about intermittent bleeding?
Intermittent light bleeding is most common in the first trimester and usually abates by the 8 week mark.
Does IVF contribute to spotting while pregnant?
With the increased number of vaginal exams, as well as medications being taken to support a pregnancy, women who become pregnant via IVF can experience more bleeding than spontaneous pregnancies.
Can having an orgasm cause bleeding during pregnancy?
Having sex poses no risk to your baby. Although rare, an orgasm can rarely cause a discharge but again, with no risk to the baby.
Can a UTI cause bleeding and cramping in pregnancy?
Yes, UTIs can cause discomfort and sometimes lead to blood in the urine. If you suspect an infection you need to have it treated asap.
Although spotting while pregnant is common, there is nothing like checking things with your doctor. They will suggest either an internal examination, ultrasound or blood test to help determine the cause. In the case of a severe bleed, no matter what stage of your pregnancy, contact your doctor or Emergency Department.