Understanding Prenatal Care

While women may be accustomed to the normal cycle of monthly bleeding that occurs during menstruation, bleeding during pregnancy can be worrisome. Some types of bleeding are completely normal. Some bleeding is caused by serious conditions that require medical treatment to insure the health of both the mother and baby.

Bleeding vs. Spotting

The amount of discharge can help to determine if the cause of the bleeding is normal, should be seen by a doctor, or is a medical emergency. Light bleeding that causes some spots in your underwear is typically a normal occurrence during pregnancy. Bleeding that fills a pantyliner or pad is a cause for concern and warrants a call to the doctor. Heavy bleeding accompanied by pain or fever should receive immediate medical attention. 

Implantation Bleeding

In the very early stages of pregnancy, the fertilized egg attaches to the lining of the uterus. This occurs 1-2 weeks after fertilization. Implantation causes spotting in about 15-25 percent of women and is completely normal. 

Other Causes of Light Bleeding

Because of increased vascularization and blood flow in the cervix during pregnancy, normal activities can cause bleeding more readily. Contact with the cervix during sexual intercourse, pelvic exams, and transvaginal ultrasounds can result in spotting. This type of bleeding is also normal.

Pregnancy Loss

Heavier bleeding in the first trimester may indicate a serious problem. Two causes of heavy bleeding include ectopic pregnancy and miscarriage. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus. It causes cramping and bleeding and can be life-threatening if left untreated. Heavy bleeding is also a sign of miscarriage, where the pregnancy is lost before the baby can survive outside of the mother's body.

Placental Problems

Problems with the placenta can also cause heavy bleeding during pregnancy. Placenta previa occurs when the placenta grows over the cervix. This causes heavy bleeding that is bright red and usually painless. Bleeding may be treated with bed rest or reduced activities to keep it under control. Placenta previa may resolve itself later in pregnancy as the uterus continues to expand and the placenta no longer covers the cervix. 

Late Pregnancy

Later in pregnancy, bleeding can be a sign of pre-term labor if it occurs prior to 37 weeks gestation. In addition to bleeding, the woman may experience cramps, pelvic pressure, diarrhea, or her water breaking. For full-term pregnancies, the early stages of labor often begin with passing blood and mucus called a bloody show. A bloody show is a normal sign that the baby is on its way.

When to Call the Doctor

If vaginal bleeding occurs during pregnancy that is heavier than spotting, it is worth calling your ob-gyn. Bleeding in conjunction with cramping, contractions, pelvic or abdominal pain, fever or chills, dizziness, or fainting may be a sign of a serious problem that needs emergency medical treatment.

For more information, reach out to a local OBGYN.