Vaginal bleeding in pregnancy is far more common during the first trimester of pregnancy than many women believe. It's probably among the first concerns that women have in the first trimester up to 12-14 weeks of the pregnancy. Bleeding in the second and third trimesters of pregnancy, however, is of far greater concern. Some bleeding issues may be normal, but others, especially in the late second and third trimester could be a problem. Show
Implantation bleedingImplantation bleeding happens about 6-12 days after ovulation/fertilization, shortly before you expect the next period. In fact, implantation bleeding could mimic a menstrual period because it happens around the same time but it's much less heavy and shorter than a normal period. Implantation bleeding normally occurs within the first 6-12 days after the fertilized egg has implanted onto the walls of the uterus. While some women may only bleed or spot for a few hours, others may bleed or spot for a few days. Dealing with vaginal bleeding during pregnancyNo matter the trimester of the pregnancy, if bleeding occurs there are a few rules that should be followed immediately after recognizing the bleeding.
First trimester bleeding in pregnancyBleeding during the first trimester, up to about 12-14 weeks of the pregnancy, when you already know that you are pregnant, is a fairly common occurrence hapening in up to 1 in 2 pregnant women. First trimester bleeding can be associated with sexual intercourse, infection of the urinary tract or pelvic cavity or implantation. It can also be the first sign of a miscarriage, pregnancy loss. Bleeding after sexual intercourse during pregnancy is often associated with the tenderness of the cervix. After conception occurs, the cervix softens for the duration of the pregnancy. Sexual intercourse can cause mild damage to the cervix resulting in spotting or light bleeding. Pregnant women most often notice bleeding when they are using the bathroom. It is hard to tell if the blood is coming from the vagina or the urinal tract. A urinary tract infection may be the cause of the bleeding and will need to be treated in order to prevent a worsening infection. Possible first trimester complications associated with bleeding in pregnancyNot all first trimester bleeding is associated with a normal condition, especially if it's heavy and/or associated with pain and cramps. First trimester bleeding can be associated with miscarriage, ectopic pregnancy, or molar pregnancy. You should let your doctor know about the bleeding and get a check-up to find out what it could be. Work-up for first-trimester vaginal bleeding1.History and Physical 2. Vaginal speculum examination 3.Sonogram Second and third trimester bleedingBleeding in the second or third trimesters of the pregnancy is of more concern to the obstetrician and the mother-to-be. Second and third trimester bleeding can be associated with placental abruption, placenta previa, or preterm labor. Placental abruption, placenta previa, and preterm labor all carry similar symptoms. These conditions are most often characterized by vaginal bleeding of varying amounts and abruption and labor also are associated with stomach pains. If bleeding occurs in any form after the first trimester, it is important to immediately contact the physician on call or your obstetrician for further instruction on how to deal with the bleeding. Dealing with bleeding in pregnancy is certainly a concern of both the mother-to-be and the obstetrician. While some form of bleeding is expected during the first trimester of the pregnancy, once the initial 3 months of growth are over, bleeding occurring in the second and third trimesters may be a reason for further health care. At any time during the pregnancy, if bleeding occurs, the doctor caring for the mother and baby should be contacted immediately. If you have any bleeding during your pregnancy, with or without pain, it’s very important to get it checked out. It’s common to have light bleeding or ‘spotting’ without pain before 12 weeks. This isn’t often serious, but you should contact your doctor, midwife or
Early Pregnancy Unit immediately to be checked, just in case. Bleeding in pregnancy after 12 weeks is not common. Contact A&E or your hospital maternity unit immediately so you can be checked. Light bleeding or spotting can happen in the
first trimester (first 12 weeks of pregnancy) for a few reasons. Implantation is when the fertilised egg (developing embryo) is embedding into the wall of the womb. This usually happens around the time your period would normally have been due. Some women have had implantation bleeding after 8 weeks of pregnancy. An
implantation bleed is very light bleeding (spotting) that is usually pinkish and sometimes brown. You may see it when you wipe after going to the toilet or in your underwear. It shouldn’t be enough to soak through pads or underwear. Usually it only lasts for a day or so, though for some women it can last a little longer. Pregnancy hormones can cause changes to the cervix, which can sometimes cause bleeding. The cervix gets an increased blood supply and
becomes softer. This can cause some bleeding after sex (known as post-coital bleeding). Occasionally, vaginal bleeding can also be caused by an infection. Bleeding can sometimes be a sign of something more serious. Try to remember that many women who have bleeding in early pregnancy (before
12 weeks) go on to have a successful pregnancy. Just make sure that your symptoms are checked. A miscarriage is when a pregnancy ends before 24 weeks. Symptoms can include:
Some women may experience a 'threatened miscarriage'. This is diagnosed where there is ongoing bleeding with or without pain but the woman is still pregnant. Ectopic pregnancyAn ectopic pregnancy is when a fertilised egg implants outside the womb, usually in the fallopian tube. Symptoms can include:
Molar pregnancyA molar pregnancy is when a foetus doesn't form properly in the womb and a baby doesn't develop. Symptoms can include:
What are the causes of bleeding in late pregnancy (after 24 weeks)?Some women may experience a light bleed later on in their pregnancy. This is may not be from inside the womb, but from the cervix, for example, which can cause bleeding after sex. This may settle and doesn't necessarily mean there is a problem, but you should contact the hospital maternity unit immediately so you can be checked, just in case. There are two more serious causes of bleeding in late pregnancy: Low-lying placenta (placenta praevia)The area where the placenta is attached usually stretches upwards away from your cervix. A low lying placenta is when the placenta stays low in your womb, near to or covering your cervix. This may block the baby’s way out. In most cases, this would have been seen at one of your routine ultrasound scans and you will have an extra scan later in your pregnancy to see if the placenta has moved up. If the placenta is still low in your womb you may blead heavily during your pregnancy and your baby’s birth. This can put you and your baby at risk. If you have a low lying placenta and you have bleeding you may need emergency treatment – call 999. You’re more likely to need a caesarean section if you have a low-lying placenta. Placental abruption (abruptio placentea)This is a serious condition in which the placenta starts to come away from the womb wall. It usually causes extreme stomach pain which does not come and go like contractions. It may occur even if there is no bleeding. Contact your hospital maternity unit immediately if you are bleeding in late pregnancy. Find out more about placental abruption. Rhesus negativeDuring your antenatal care your midwife will find out your blood group and whether you have rhesus positive or negative blood. Knowing which group you are in is important. If you have rhesus negative blood, but your partner has rhesus positive blood, your baby has a chance of having rhesus positive blood too. If this happens, your body might see your baby’s blood as different to yours and develop antibodies. These antibodies can pass across the placenta and attack your baby’s blood cells. This won’t normally affect your first pregnancy, but it can be very serious in later pregnancies. Because of this, if you have rhesus negative blood your midwife will offer you an injection called anti-D during your pregnancy to protect your baby. If you have any bleeding or trauma to your bump (for example, if you fall over) contact your midwife or hospital maternity unit immediately. You may need to be checked and possibly have another injection of anti-D. Talk to your midwife if you have any questions about your and your baby’s blood type. Where should I seek help for bleeding in pregnancy?Any bleeding in pregnancy should be investigated even if you are not experiencing any other symptoms. It is important to make contact with a health professional to be seen as soon as possible. Before 12 weeks pregnantIf you feel generally well and the bleeding is not heavy, then you can call your GP or midwife (if you have one yet) for an appointment who can then assess if they need to refer to the local Early Pregnancy Unit. Sometimes, you can self-refer to a local Early Pregnancy Unit depending on your history and where you live. If you call your local GP surgery they should be able to advise you. You can also call NHS 111 if you feel you need urgent medical help but it is not an emergency. Go to your local A&E if you are experiencing bleeding and:
After 12 weeks pregnantGo to your local A&E or contact the hospital maternity unit immediately so you can be checked, just in case. Bleeding in pregnancy when you have had a previous miscarriageIf you have bleeding in your current pregnancy after one or more previous miscarriages, recent research has shown that progesterone can be beneficial. This research was published in 2019 and showed that the more previous miscarriages you had, the greater the benefit from progesterone treatment. Progesterone is a hormone that helps thicken the lining of the womb and the mother’s body to accept the growing baby. It is given as pessaries (tablets) and taken twice daily in the vagina (like inserting a tampon). The study that showed that progesterone can be an effective treatment was a large, multi-centre, randomised controlled trial, which is the gold standard of research trials. Talk to your doctorIf you have early pregnancy bleeding and a history of a previous miscarriage, progesterone treatment can be of benefit. As this research is relatively recent, your doctor may not have heard of it, so please discuss this treatment with your GP or the doctors at your local Early Pregnancy Unit. If necessary, show them this information or or download this leaflet and take it with you. Read more about the Prism trial. Review datesReviewed: 11 October 2018 | Next review: 11 October 2021 This content is currently being reviewed by our team. Updated information will be coming soon. Is it normal to have blood when you wipe in early pregnancy?Causes of bleeding in early pregnancy
In early pregnancy, you might get some harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due.
Should I be worried if I see blood when I wipe while pregnant?Bleeding and spotting in pregnancy don't always mean there's a problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. Call your health care provider if you have any bleeding or spotting, even if it stops.
What does it mean when you wipe blood after peeing during pregnancy?What Does Blood in Urine During Pregnancy Mean? If you're pregnant and see blood in your urine, or your doctor detects blood during a routine urine test, it could be a sign of a urinary tract infection (UTI). A UTI is an infection in the urinary tract typically caused by bacteria.
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Blood after urinating and wiping during pregnancy first trimester
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