If you start to bleed in pregnancy it’s natural to panic, but there are various reasons why it might happen and it doesn’t necessarily man you’re going to lose your baby.
Midwife Claire Friars, who runs the pregnancy information line for Tommy’s the baby charity, says, ‘We get calls all the time from women worried about bleeding. It’s frightening when it happens to you.
‘A bit of spotting in early pregnancy is very common but that doesn’t make it any less worrying. At this stage the majority of women haven’t told anyone and haven’t got a midwife so they don’t know where to go or what to do.’
Up to one in four women bleed at some time in pregnancy. It’s especially common in the first three months. But the good news is that of the women who do bleed in early pregnancy, which is when most miscarriages occur, a reassuring 75% go on to have healthy babies.
If you start bleeding, tell your GP or midwife straight away. You’ll be asked questions about the type of bleeding you’re experiencing (see below) as well as details about your pregnancy and medical history. This will help work out the cause and the help you may need.
Claire says, ‘Many hospitals now have an early pregnancy unit where you can have an ultrasound. In some areas you can refer yourself to the antenatal clinic at the hospital but in other areas you have to get a referral from your GP – if this is the case you should make an emergency appointment. If it’s in the middle of the night, it’s difficult to know where to turn. If the bleeding’s heavy enough to wear a pad go straight to A&E. Often though, it’s just a few spots and going to A&E may seem over the top. It’s quite common to get a few spots of blood when your period would have been due or when the egg attaches itself to the wall of the womb. If it’s very light you can probably wait until morning.
‘But if you need reassurance or if the spotting is accompanied by pain, ring the midwife on your hospital labour ward immediately,’ says Claire.
It’s likely the cause will turn out to be something minor, such as implantation bleeding (see below) so although it’s not easy, try to stay calm.
In the early months:
What you’ll notice: Light reddish-brown spotting, in some cases after sex
What it could be: Breakthrough bleeding: it can happen when your period would be due. Implantation bleeding: when the egg attaches to the womb wall. Cervical erosion: hormones can affect the cervix.
What to do: Contact your midwife or GP. If the bleeding is light and you’re not in pain, it’s probably nothing to worry about.
What you’ll notice: Dark red or dark brown blood. There may also be abdominal pain, often just on one side.
What it could be: Ectopic pregnancy. This is a rare but serious condition that happens when the fertilised egg implants itself outside the uterus, usually in one of the Fallopian tubes.
What to do: Contact your GP immediately. The growing embryo will eventually rupture the Fallopian tube, which can be life-threatening to you. Surgery is needed to remove the embryo.
What you’ll notice: Steady bleeding ranging from a light brown discharge to heavy red blood with clots and period-like pain.
What it could be: Threatened miscarriage. In most cases the bleeding will stop and the pregnancy will continue as normal.
What to do: Call your midwife or GP. You may be offered a scan to check things are OK. If you lose the baby, you may need surgery to clear your uterus, which is called a dilation and curettage or D&C.
In later months:
What you’ll notice:Light red bleeding, usually between weeks 34 and 38.
What it could be: Placenta praevia, also known as low-lying placenta – where the placenta implants low in the uterus, blocking, or partially blocking the cervix (the neck of the womb)
What to do: Go to the maternity unit or hospital immediately. If the placenta is blocking the cervix, you will most likely need a Caesarean.
What you’ll notice: Red bleeding which gradually decreases or possibly severe blood loss, usually after weeks 32 to 34.
What it could be: Placental abruption, also known as placental separation, where part of the placenta separates from the wall of the womb.
What to do: Go to the maternity unit or hospital. You may be advised to rest until it eases. Heavy blood loss may mean a Caesarean.
What you’ll notice: Light bleeding or blood stained mucus in the last weeks of pregnancy.
What it could be: A ‘show’ – where the plug of mucus that seals the womb in pregnancy comes away.
What to do: Contact your GP or midwife – labour could be about to start.
If you need help:
- Call Tommy’s Pregnancy Information Line on 0870 777 3060 if you have any worries.
- A miscarriage can be devastating so don’t be afraid to ask for support. Talk to someone or get details of support groups, call the Miscarriage Association helpline on 01924 200 799 or 0131 334 8883 in Scotland. You can also visit www.miscarriageassociation.org.uk which has a variety of factsheets to download, including Men & Miscarriage and Talking To Children About Pregnancy Loss.
For more information, visit www.netdoctor.co.uk/.