Bleeding During Pregnancy: What's Normal and What's Not

When you’re pregnant, you expect your periods to stop, since the egg implanting into the walls of your uterus breaks up the typical monthly cycle that accompanies the non-fertilization of an egg. 

While you shouldn’t have any bleeding resembling your normal menstrual flow, there are times when bleeding during pregnancy is normal, as well as times when it’s not. The team at ThriveOB and Women's Wellness in Barrington, Illinois, led by gynecologist Jennifer Moreira, MD, FACOG, wants you to know what to expect during pregnancy. 

Bleeding versus spotting

Spotting is the presence of a few drops of blood in your underwear, on a panty liner, or on toilet paper when you wipe after urination. There’s nothing substantial about the amount of blood, and most women experience occasional spotting often. 

Spotting may be red, pink, or brown in color, depending on freshness, dilution with urine, being dried, or other factors. In the first trimester of your pregnancy, spotting is normal and, on its own, is probably not a cause for concern. 

Bleeding is the flow of blood. It’s enough for you to use feminine protection products to absorb the flow. 

The first trimester

It’s possible to have bleeding in the first trimester. While bleeding and spotting may occur naturally in the first 12 weeks of pregnancy, let Dr. Moreira know so she can factor these symptoms into your pregnancy care.

Up to 25% of pregnant women may experience bleeding or spotting in the first trimester. Possible benign causes include: 

• Hormonal changes related to pregnancy
• Implantation bleeding, stemming from the fertilized egg implanting in the uterine wall
• Cervix changes, including cervical polyps
• Subchorionic hematoma: blood collects between the amniotic sac and the uterus, but typically clears up without issue

Problems like ectopic pregnancy and miscarriage can also cause bleeding in the first trimester. 

Second and third trimesters

Bleeding or spotting in the second and third trimesters is more likely to result from serious conditions. Contact Dr. Moreira about any instance of bleeding after the 12th week. 

Some of the possible causes of bleeding at this stage of pregnancy include:

• Preterm labor
• Miscarriage
• Placental abruption: When the placenta detaches from the uterine wall, it is a rare condition that is dangerous to both the fetus and the mother
• Placenta previa: the placenta covers some or all of the cervix
• Incompetent cervix: an early, abnormal opening of the cervix
• Bloody show: sometimes a sign of labor, this is light bleeding mixed with mucus near the end of pregnancy

Non-medical reasons, such as having sex, pelvic exams, ultrasounds, Pap tests, or injuries, may also cause bleeding at any point during pregnancy, though Pap tests are usually done only in the first trimester. 

Contact ThriveOB and Women's Wellness any time you notice irregular bleeding or spotting. Call 847-868-2908 to book your appointment today.