Vaginal bleeding in early pregnancy is, obviously, almost always worrying. But studies suggest it happens to up to 24% of us in the 1st 12 weeks of pregnancy and to a much smaller number from 12 to 24 weeks – and, though you should always get it checked out, it doesn't necessarily mean the worst.
"Bleeding in the 1st trimester is pretty common," says Patrick O'Brien, consultant obstetrician at University College Hospital, London. "Many women fear it's going to lead to a miscarriage but that's not necessarily the case. It can do, of course, but, for most women, the bleeding will settle down and stop."
Why am I bleeding?
There are lots of possible causes of bleeding in early pregnancy, ranging from the minor to the more serious. Here's a rundown of what it could be...
It could be… implantation bleeding
Some (but not all) pregnant women experience a small bleed 6 to 12 days after conception – so often just before the time your period would have been due. This happens as your fertilised egg implants in the lining of your womb and usually appears as light, brownish spotting.
It could be… hormonal bleeding
Hormonal or 'breakthrough' bleeding can happen at about 4 to 8 weeks into pregnancy (so round about the time your period would have been due), and is pretty common. It’s caused by early-pregnancy changes in your levels of oestrogen and progesterone. It is usually light.
It could be… cervical erosion
This is a lot less serious than it sounds. Cervical erosion, sometimes called cervical ectropion or ectopy, is the medical term for when the blood supply to your womb and cervix is increased, as a result of your pregnancy. As these cells are soft, they can bleed more easily (though harmlessly and painlessly). This can result in spotting or light bleeding – either for no apparent reason or after sex.
It could be... a vaginal polyp
A polyp is a harmless growth. And if it's in your vagina, it can cause harmless bleeding at any stage in your pregnancy.
It could be… an infection
Any infection of your vagina or cervix (including sexually transmitted diseases, such as genital herpes, chlamydia or gonorrhoea) can cause bleeding. (And will, obviously, need to be treated.)
It could be… an ectopic pregnancy
Bleeding, or brown, watery discharge, in the first 12 weeks that's accompanied by strong, painful cramping in your lower tummy and maybe also a pain in the tip of your shoulder may signal an ectopic pregnancy – which happens when your fertilised egg remains stuck in 1 of the Fallopian tubes that connect your ovaries to your womb. It's a potentially dangerous condition but it is also very rare (affecting about 2% of pregnancies).
It could be… the start of a miscarriage
Yes, blood loss in early pregnancy can be a sign of miscarriage, especially if the blood's red and the flow is heavy or you’re also cramping and in pain. If you are also passing clots of pink or grey material, it’s very likely to be a miscarriage.
More like this
What should I do if I’m bleeding in early pregnancy?
Any bleeding in the 1st 24 weeks of pregnancy should be checked out – with a call to your midwife or GP.
As we've see above, there is quite a range of potential reasons for your bleeding but "as a general rule," says Patrick O'Brien, "the heavier the bleeding, the more worrying it would be".
When you call, try to give as much information as you can about how you're bleeding. Try to include details about:
- how heavy the blood flow is
- how light/thick the blood is
- what colour the blood is
- whether you're seeing any clots or other bits of tissue along with the blood
If it's very early on in your pregnancy (before 6/7 weeks) and you're not in pain, you may be told to wait to see if the bleeding stops of its own accord. Unfortunately, there is little doctors can see on an ultrasound scan at this point that will tell them – and you – whether your baby is OK.
This is what happened to Jaxxy who posts on our MadeForMums Chat forum. "I'm 5 weeks and 5 days pregnant today. I’ve had bleeding – admittedly not loads but enough to make me think it could be miscarriage. Spoke to the doctors and they’ve just said I’ve got to ride it out."
This is very typical of a lot of women’s experiences at this stage of pregnancy – and we know how difficult it can be. You may find it helps to share your experience with others on our MadeForMums Chat forum or you could call the Miscarriage Association's helpline on 01924 200799 (open Monday to Friday, 9am to 4pm). They also run a Facebook page and an online Live Chat.
If, as result of your call, you're asked to go in to see your GP or midwife or to visit your local Early Pregnancy Unit, it's a good idea (if you can) to save any underwear or pads with blood on them, so that you can show them what your bleeding looks like.
Once you've arrived, your doctor or midwife will want to examine you or refer you to be examined – with an (internal) ultrasound scan and some blood tests, and maybe a vaginal swab, if an infection is suspected.
It may well be that nothing concerning is found, and you will be sent home and told only to return if the bleeding gets heavier and/or the pain gets worse. You may, at this point, hear the term 'threatened miscarriage': this means that, although you're bleeding or have been bleeding, there is no sign – right now – that you've having a miscarriage. Many women who have a 'threatened miscarriage' go on to have a healthy baby.
If, however, doctors find evidence that something is wrong with your baby, then, unfortunately, this is a 'confirmed miscarriage' and doctors will talk you through your options about what happens next.
About our expert: Patrick O'Brien
Patrick O'Brien has been a Consultant & Honorary Senior Lecturer in Obstetrics and Gynaecology at University College London Hospitals since 1999. He is also the Divisional Clinical Director for Women's Health. He specialises in Maternal Medicine and high-risk obstetrics and has a particular interest in medical complications of pregnancy.