Bleeding won’t necessarily lead to miscarriage so try not to panic
When you’re pregnant and you notice some blood – even a drop – in your knickers, it’s a shocking moment. But don’t instantly think of miscarriage. Surprisingly, one in four women bleeds during pregnancy, and only about half of these women miscarry.
There are plenty of easily explained reasons why you might bleed in each trimester. If it happens to you, take it seriously, but stay calm, says Dr Miriam Stoppard. “Always ask for help, and don’t hesitate to call your midwife or GP,” she says. “Never wait for bleeding or spotting to happen a second time, and if you can’t get an appointment as soon as you’d like, be forthright and don’t take no for an answer.”
In the early days
In your first trimester, it’s usually hormones that can cause a bit of bleeding. “It’s not a hormone deficiency, but more that they’re all over the place,” says Miriam. “It’s also quite common to have a slight bleed at the time you might normally have had a period. The first time you might get spotting in between periods is when the fertilised ovum implants into the uterine wall,” she explains. That spotting, known as an implantation bleed, can look a bit like the beginning of a period.
You could also have slight bleeding from the cervix, either due to a vaginal infection, or after having sex, as there’s increased blood supply to that area once you’re expecting.
12 weeks onwards
“It’s not uncommon to have some bleeding when the second or even third period was due,” says Miriam. That can be up to three months after your implantation bleed. “But bleeding after the time when you’d have had your third period (the start of your second trimester) would be considered serious.” This is because it can indicate an abnormality with your uterus or placenta, but these can both be monitored.
It could be placenta previa, where the placenta is lying too close to the cervix. “As the placenta gets bigger it can stretch across the cervix and cause a bleed,” says Miriam. Or it could be a placental abruption, where the placenta comes away from the uterus, and blood escapes through the cervix. “In these cases you’d be told to rest and monitored with ultrasound,” says Miriam.
In the final stages
From 37 weeks onwards, any bleeding must be monitored. Your cervix might bleed a little if you have any internal examinations around this time.
Then there’s one final time there could be bleeding – your mucus plug can have blood in it when it comes out just before your waters break.
“I had a bleed 7 weeks into my pregnancy and was given an internal scan. Living in Germany, the language barrier was a huge problem as my husband and I found it hard to understand what this meant for our baby, or for the pregnancy. I know that the baby is still there, and we saw the heartbeat, but bleeding in pregnancy is always a worry.”
Katie Rumgay, 26, from Germany, mum to Kyle, 4, and 12 weeks pregnant
Get emergency help immediately if…
You pass blood clots or thick pink or greyish material.
- You have bleeding that’s heavy and constant for at least one hour.
- You feel pains and/or bleeding and have experienced previous miscarriages.