As an obstetrician, one of the biggest concerns voiced by patients is worry over bleeding during pregnancy. Whether or not there’s good reason to be anxious depends on the cause of bleeding.
First Trimester Bleeding Isn’t Uncommon
If you notice bleeding during your pregnancy, it is absolutely imperative you stay calm, which can be difficult to do. Sometimes numbers help keep things in perspective, so remember that about 20 percent of women have some type of bleeding during the first 12 weeks of pregnancy and typically there’s isn’t cause for alarm. If you notice bleeding, contact your physician. They’ll probably want to examine you to make sure everything is OK as a precautionary measure, but you don’t want to add to that stress by worrying.
What You Need to Know
Here are some of the reasons you might experience bleeding during pregnancy.
- Cervical changes – Pregnancy changes a body so. During pregnancy, more blood than normal flows to the cervix as a natural response. Because of this, anything that causes contact with the cervix, such as intercourse or an exam by your gynecologist, may cause bleeding.
- Infection - Infections of the cervix or vagina can cause bleeding. The majority of these infections will not affect the baby.
- Implantation bleeding - Light spotting can occur the first six to 12 days after conception in the form of implantation bleeding. This happens in some women when the egg implants itself in the uterus.
- Ectopic Pregnancy – This happens when the embryo implants itself outside of the uterus instead of inside. While a serious health risk, know that it only occurs in about 2 percent of pregnancies
- Miscarriage – A frightening and sad circumstance for expecting moms, miscarriages most frequently occur in the first trimester of pregnancy. Heavy vaginal bleeding is usually associated with miscarriage, but not in all cases. Physicians have found that if they see a heartbeat on your ultrasound, more than 90 percent of women who experience bleeding during their first trimester do not miscarry.
Beyond the First Trimester
If you’re experiencing bleeding beyond the second trimester that isn’t attributed to cervical changes or infection, there might be a serious, rare issue. It can indicate placenta previa, which occurs when the placenta sits very low in the birth canal, requiring medical attention. It can also indicate placental abruption, where the placenta detaches from the uterine wall and is dangerous for mother and baby, requiring emergency surgery. While these are serious, they are also extremely rare, occurring in 1- in 200 pregnancies and 1 percent of pregnancies, respectively. If you experience contractions, abdominal pressure or an aching lower back, you could also be going into premature labor.
Whatever the reason for the bleeding, it’s best to try to rein in your fears until you’ve had a chance to be examined by your doctor – which you should do as quickly as possible as a precaution.
Dr. Kathy Sander is an Obstetrics and Gynecology specialist at Kelsey-Seybold who treats patients at the Woman’s Center. Her clinical interests include general and high-risk obstetrics, menstrual problems, preconception counseling, contraception options, including Implanon, Mirena IUDs, Essure, Nuvaring and oral medications, and menopausal concerns.