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

Ben Lynch, ND

Q. What are some causes of normal vaginal bleeding during pregnancy?

A. There are a few normal reasons for vaginal bleeding.

* Implantation of your fertilized egg causes slight spotting in a minority of woman. If it happens, it will be near the time you would normally have your period. This bleeding should be very light spotting and last for a day or two. [Spotting: very light bleeding similar to the end of your period.]

* Cervix is more prone to bleed as blood flow is naturally increased during pregnancy. That said, anything that may touch or irritate the cervix can cause bleeding. Sex, gynecological exam, pap smear, physical work, exercise. This bleeding should only spot and last for a day or two.

* If you notice spotting after exercising or working, ease off a bit and see if the spotting stops. Keep a log of your workouts and spotting frequency. This way you know how much you can work or exercise.

* If you are spotting for more than two days, or see an increase in the amount, or do not see a cause of the bleeding, contact your health provider.

* At around 37 weeks, a mucous plug may come out tinged with blood. This is an early sign of labor.

Q. What are some causes of abnormal vaginal bleeding during pregnancy?

A. As the cervix is more engorged, STD’s or any type of vaginal infection may cause bleeding. Infections irritate the cervix causing bleeding or spotting for more than a day or two. Bacterial vaginosis, yeast infections, Chlamydia, Herpes are some common infections that may cause prolonged bleeding. See your health provider. They will do a pap or wet mount slide prep to see if an infection is present and treat accordingly.

Spontaneous abortion is a cause of abnormal bleeding. Of the 10% to 25% of women who report spotting during the 1st trimester, 20% to 50% of those will spontaneously abort. If you cannot pin-point a cause of the spotting or it progresses, see your health provider.

Pain with spotting may indicate an ectopic pregnancy or early signs of miscarriage. Pain and spotting is not normal. An ectopic pregnancy must be terminated for the woman’s safety. Ultrasound can confirm or rule out an ectopic pregnancy. This occurs in the first trimester and occurs in 1.5% of all pregnancies.

Abnormal bleeding in pregnancy may indicate placenta problems (eg. placenta previa during any trimester which presents as painless bleeding) or premature labor. Again, if bleeding is more than spotting, increasing in amount or duration, call your health provider.

Q. What is too much bleeding?

A. Duration or quantity are the keys here. If spotting is happening for more than two days and you cannot pin-point a normal cause, contact your health provider.

If bleeding is increasing beyond spotting, it is necessary to contact your health provider. There does not have to be pain associated. If painless bleeding is present, do contact your provider.

If you think it is too much bleeding and you need reassurance, call. Relaxation is very important for a healthy mom and baby. One cannot relax when unsure. Don’t be tough. Call. Your health provider is there to assist and educate you during this amazing time.

GOOD NEWS! 😉 An ultrasound that shows a heartbeat between 7 – 11 weeks, the chances of continuing the pregnancy are better than 90%

Disclaimer: This is information only. Seek the advice of a trained healthcare professional. Bleeding during pregnancy can be life-threatening to the woman and/or the baby. Do not delay professional assistance. Also see this article