When bleeding happens during pregnancy, it can be a very scary. Bleeding (from the vagina) can hint at the health of the baby and the mother, as well as the viability of the pregnancy. However, bleeding in pregnancy is not always a sign of problems. Some causes of bleeding are serious, and others are not. Bleeding in pregnancy can be perfectly normal, especially if it’s not accompanied by other worrying signs. 1 out of every 5 women have some vaginal bleeding during pregnancy, so it is important to recognise the types of bleeding that can occur, and to know which are okay and which are alarming.
Some additional symptoms of bleeding in pregnancy include:
These symptoms are usually in more serious causes of bleeding. Benign bleeding is usually painless and mild.
We can separate bleeding in pregnancy into early bleeding (before 24 weeks) and late bleeding (24 – 40 weeks). Causes of early bleeding include implantation – when the newly fertilized egg attaches to the lining of the uterus (womb), cervical bleeding – when the cervix (the opening of the uterus) is brushed against during sexual intercourse or medical vaginal exams, and miscarriage. Out of these three, only miscarriage is typically a more serious cause of bleeding.
Causes of vaginal bleeding later in pregnancy can include cervical bleeding, and a “bloody show” – bleeding when labour is about to start. But it can also include more serious things like placental abruption – when the placenta gets detached from the uterus, placenta previa – when the placenta is attached abnormally low in the womb and lies closer to the cervix than it should. Miscarriage, vasa previa and rupture of ectopic pregnancy also can cause late bleeding. Vasa previa is when a baby’s blood vessels run through membranes that cover the cervix, and ruptured ectopic pregnancies occur when a fertilized egg doesn’t implant into the womb, instead implanting in places like the fallopian tubes or even the abdomen. These ectopic pregnancies can then burst, leading to vaginal bleeding that can be severe or life-threatening.
Vaginal infections can lead to bleeding at any time during a pregnancy, early and late.
The risk factors of bleeding in pregnancy include:
The exact cause of bleeding during pregnancy is usually diagnosed with an ultrasound. Ultrasounds can show the health and heartbeat of the foetus, as well as the location of the placenta. Most times, a doctor will not perform a vaginal exam on you if you’re having vaginal bleeding during pregnancy, as this can worsen the bleeding.
Bleeding during pregnancy is treated based on how severe it is. If bleeding is caused by something that is life-threatening to a mom or her baby, usually the baby’s birth will have to be induced early. After birth, the bleeding often stops. If the bleeding is due to a vaginal infection, medications are given. If the bleeding is just spotting, no treatment is necessary, although the doctor may wish to monitor you for a while to make sure everything is okay.