Bleeding while pregnant can be frightening, but this does not necessarily mean you are experiencing a miscarriage. Around 20-25 percent of women experience bleeding while pregnant and around half of these have a healthy pregnancy without a miscarriage. The most likely time to experience bleeding is during your first trimester, though some women will continue to bleed through their whole pregnancy. This can include streaking, spotting or blood loss that resembles your normal period. There are different causes for bleeding in the first half and second half of pregnancy and there are definitely danger signs that you should watch out for.

Causes of Bleeding During First Half of Pregnancy

1. Common Causes

Bleeding in the early stages of pregnancy could be implantation bleeding from the fertilized egg implanting itself in the uterine lining. This usually occurs 6-12 days into your pregnancy though every woman experiences this differently. Some women have spotting for a few hours while others may spot for days.

A urinary tract or pelvic infection can also cause bleeding during the first trimester. You may also find that your cervix is dry and sensitive during this time so intercourse can cause you to bleed. Discontinue intercourse or other actions that irritate your body until you talk to your doctor.

2. More Serious Causes

• Miscarriage

Bleeding in early pregnancy could also be a sign of miscarriage. Signs of a miscarriage do not necessarily mean you are in the midst of one, but it is important to be aware of the signs so you can get help. Symptoms include tissue passing from the vagina, vaginal bleeding or cramping and pain below the stomach that is stronger than normal menstrual cramps. Most miscarriages are an unhealthy pregnancy that was developing poorly and could not be saved. This does not necessarily indicate that you will not be able to have a healthy pregnancy in the future.

• Ectopic Pregnancies

Ectopic pregnancy refers to any implantation that occurs somewhere outside of the uterus, though most occur in the fallopian tubes. Around 1 in 60 pregnancies are ectopic pregnancies. Those that have had pelvic surgery, previous ectopic pregnancies or a fallopian tube infection are at a higher risk for this condition. These will cause sharp abdominal pain, cramping below the stomach, vaginal bleeding while pregnant and low hCG levels.

• Molar Pregnancies

Molar pregnancies refer to a tissue growth or gestational trophoblastic disease which grows in the uterus rather than an embryo. This is very rare, but can cause abnormal bleeding during what you believe to be your first trimester. It may also cause very high hCG levels and grape-like clusters which appear on an ultrasound. You will also notice that there is no fetal heartbeat during pregnancy examinations.

Causes of Bleeding During Second Half of Pregnancy

1. Placental Abruption

If the placenta detaches from the uterine wall it can cause danger to your pregnancy. The highest risk of this is in the last 12 weeks of pregnancy and those that are over 35, have already had children, experienced an abruption previously, use cocaine, have high blood pressure, have sickle cell anemia or have had an injury to the stomach are at a higher risk. This will cause bleeding along with stomach pain.

2. Placenta Previa

This refers to a condition where the placenta partially or completely covers the cervix because it sits too low. This occurs in around 1 in 200 pregnancies and is a very serious condition. This is more common in those having a multiple pregnancy, have already had children and experienced a cesarean birth or other surgery on their uterus. In most cases this will cause bleeding without pain.

3. Preterm Labor

Bleeding a few weeks before labor is set to begin can be a sign of premature labor. In this case there will be a small amount of mucus in the blood, dull backache, pressure on the pelvis or lower abdomen, stomach cramps, diarrhea and regular tightening of the uterus or contractions. If you believe you are experiencing preterm labor you will need to get medical help right away.

4. Other Causes of Bleeding While Pregnant

• A pap smear can cause you to spot or bleed, particularly if you have a cervical polyp because this increases the blood flow to the cervix. 
• As your body prepares for labor it will need to pass the mucus plug which can be covered in blood. This is commonly referred to as the “bloody show” for just this reason. If you are 37 weeks or more along and you passed the mucus plug you do not need to be concerned. However, if you are experiencing additional spotting or bleeding instead of mucus with a bloody tinge you will need to contact your doctor.

Watch a video to learn more information on bleeding while pregnant:

What to Do If You Have Abnormal Bleeding While Pregnant

Bleeding while pregnant can be a sign that something is wrong, so it is important to talk to your doctor. Wear a pad to help you track how much you are bleeding and what the blood looks like including color, clotting or other symptoms. Do not use a tampon or have sex while the bleeding occurs.

Bring a sample of any tissue that comes out of your vagina to your doctor’s appointment. You may need to have a full evaluation including abdominal and vaginal ultrasounds to determine why you are bleeding. If you have any of the following symptoms it is important to get emergency care immediately:

• Severe bleeding
• Severe pain or cramping in the lower abdomen
• Discharge from your vagina which includes tissue
• Dizziness or fainting
• Chills or a fever over 100.5 Fahrenheit