7 Causes of Bleeding During Pregnancy (Part 1)

It can be frightening if you start bleeding during pregnancy.

However, blood loss doesn’t always mean you could be experiencing a miscarriage.

Bleeding during pregnancy, especially during the first trimester, is more common than you might think.

According to a study, around 25% of participants reported bleeding during pregnancy, and 8% of women reported heavy bleeding.

Most incidences occurred between weeks five and eight, and in most cases, lasted no more that than three days.

Of the women who experienced bleeding, 12% had a miscarriage, compared with 13% of women who did not bleed.

While most women will have one incidence of bleeding, a small number of women will bleed throughout their pregnancy. It can take the form of spotting, streaking, or period-like blood loss.

Here is everything you need to know about bleeding during pregnancy.

Do I need to tell my doctor or midwife about any blood loss?

Yes. All bleeding during pregnancy should be reported to your doctor or midwife.

Any passage of blood from the vagina before 24 weeks of pregnancy is termed a threatened miscarriage or threatened abortion. After 24 weeks it’s termed as an ante-partum haemorrhage.

You especially need to see a doctor or midwife within 72 hours of any bleeding if you have a rhesus negative blood group (e.g. O-, A-). The reason for this is to check whether there has been a possible mixing of your baby’s blood with yours. If the blood has been mixed, it may cause your body to produce antibodies against positive blood.

A positive blood group is more dominant than a negative blood group. It’s most likely your baby will inherit a positive blood group, although you won’t know this before the birth. The blood mixing doesn’t have any bearing on your first pregnancy. But for subsequent pregnancies, if you have another baby with positive blood, your antibodies would attack what it thinks is foreign matter.

Below is an explanation of some of the more common reasons for bleeding during pregnancy. As you will read, it’s not always sinister. It’s possible to experience mild cramping or stretching sensations during a healthy pregnancy. But if there is bleeding accompanied by strong cramping, speak to your doctor or midwife as soon as possible.

#1: Implantation Bleeding or Streaking

When a fertilised egg attaches to the uterine lining, it can result in light spotting or streaking (streaks of blood). Usually it lasts only a day or two and occurs around the time of implantation or when your period would have been due. Some women mistakenly think they have simply had a light period and don’t realise they are pregnant.

#2: Breakthrough Bleeding

Some women experience what is known as ‘breakthrough bleeding’, during the times when a period would have normally been due. Therefore, bleeding would appear at around 4, 8 and 12 weeks of pregnancy. It’s often accompanied by the feeling you would normally associate with your period being imminent, i.e. backache, cramps, a heavy sensation in the pelvis, feeling bloated and ‘off’.

Of course, because you are actually pregnant, your period doesn’t arrive (even though you feel like it will). During pregnancy, hormones prevent your period from occurring. Sometimes, if the hormone levels are not yet high enough to stop your period, the result is breakthrough bleeding. It can last for about three months; after this time the placenta begins to take over hormone production from the ovaries. Some women experience breakthrough bleeding throughout the pregnancy, and under the close watch of their carer, have healthy babies.

#3: Threatened or Actual Miscarriage

Studies indicate that around one third of pregnancies end in miscarriage (the medical term is spontaneous abortion). That sounds like a huge number, but don’t despair. It refers to the first 12 weeks of pregnancy, and includes very early miscarriages which occur before a woman even realises she is pregnant. A miscarriage of this kind is often a result of a damaged fetus; it means a woman’s body is rejecting a pregnancy that is unable to survive its complications.

Once you have reached the 14-16 week mark, you can be fairly sure your pregnancy is safe. It’s probably not such a bad idea to refrain from telling the world you are pregnant until you reach the 12 week mark.  Although you might be bursting to share your wonderful news, it can be very distressing to have to break the news that you have lost the pregnancy. Sympathy is often comforting, but sometimes it can be overwhelming when you are grieving for lost dreams.

Common signs of miscarriage include bleeding (most common), cramping, backache and stomach pains. Women commonly say that they no longer ‘feel pregnant’ when they have miscarried and are bleeding. The signs of pregnancy disappear – no more nausea, sore breasts or bloated tummy. If you are bleeding and feel this way, then chances are you have lost the baby. If you’re bleeding but still feel pregnant, the chances are very good that the bleeding is just a scare and your baby is fine. An ultrasound will usually be reassuringly normal.

It is possible to miscarry without any bleeding. This is known as a ‘missed abortion’, where the fetus dies but is retained by your body. The signs of pregnancy would definitely have disappeared if that happened, but the absence of a heartbeat would only be detected using ultrasound. You might need a curette to clear out the uterus.



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