Vaginal Bleeding During Pregnancy: What’s Normal, What’s Not

By Dr Manisha Ranjan , Gynaecology

Sudden bleeding during pregnancy can be a cause for worry. Bleeding could be a sign of an underlying condition; however, it isn’t always harmful.

I. Bleeding in the First Trimester

Bleeding is common among 20% women in the first twelve weeks during pregnancy. The moderate causes that induce bleeding in the first few weeks include:

1. Implantation Bleeding: When the pregnancy has progressed, and it has been 4 weeks, you may experience bleeding due to the fertilised egg implanting to the uterine wall.
2. Infections: Infection in the vagina or cervix can cause bleeding in the first trimester of pregnancy.

The more serious concerns are:

1. Ectopic Pregnancy: When the fertilised egg implants itself in the fallopian tubes instead of the uterus, it is called an ectopic pregnancy.
2. Molar Pregnancy: This is a rare condition, wherein instead of a foetus, abnormal tissues develop in the uterus.
3. Miscarriage: Unplanned loss of pregnancy is defined as miscarriage, which often includes symptoms such as bleeding and abdominal pain or cramping.

II. Bleeding in the Last Trimester

If there is bleeding during the last trimester, it is dangerous for both the baby and the mother. Some causes of bleeding include:

1. Placenta Previa: This is an extremely serious problem, wherein the placenta hangs low in the uterus and completely or partially covers the gap of the birth canal.
2. Placenta Abruption: Blood collects between the uterus and placenta when the placenta detaches from the uterine wall during or before labour.
3. Preterm Labour: Late trimester vaginal bleeding can be an indication of your body getting ready to deliver the baby before the term finishes. This usually happens before the 37th week and it requires immediate medical attention.
4. Bottom line: No matter when it occurs, any bleeding during pregnancy warrants a phone call to your doctor or midwife, even if only to confirm nothing is amiss. Be prepared to answer detailed questions about the color, amount, and timing of blood in order to best help your practitioner determine the possible cause.