Bleeding During Pregnancy

Understanding pregnancy bleeding, from normal spotting to emergency situations. Learn when to worry, when to call your doctor, and how to recognize urgent warning signs.

Emergency Warning Signs

Call 911 or go to the emergency room immediately if you experience:

Heavy bleeding (soaking a pad in an hour)

Severe abdominal or pelvic pain

Severe shoulder pain

Dizziness, fainting, or weakness

Fever with bleeding

Gush of fluid with bleeding

Contractions with bleeding before 37 weeks

No fetal movement for several hours (after 20 weeks)

Signs of shock (pale, rapid pulse, sweating)

Remember: It's always better to be safe than sorry. When in doubt, contact your healthcare provider immediately.

Understanding Urgency Levels

Monitor & Mention

Likely normal, discuss at next appointment

Contact Doctor

Call within 24 hours or sooner

Seek Care Today

Go to hospital or urgent care immediately

Emergency

Call 911 or emergency services now

First Trimester Bleeding (Weeks 1-12)

Bleeding in early pregnancy is relatively common, affecting up to 25% of pregnant women. While it can be concerning, many causes are benign. However, any bleeding should be evaluated.

Implantation Bleeding

Monitor & Mention

6-12 days after conception

Light spotting when embryo attaches to uterine lining

Characteristics:

Very light, pink or brown
Lasts 1-3 days
No clots
Lighter than period

What to do:

Monitor, mention at next appointment

Spotting After Sex or Exam

Monitor & Mention

After intercourse or pelvic exam

Light bleeding due to increased blood flow to cervix

Characteristics:

Light pink or brown
Stops within hours
No cramping
Small amount

What to do:

Normal, no immediate action needed

Threatened Miscarriage

Contact Doctor

Before 20 weeks

Bleeding with closed cervix, pregnancy may continue

Characteristics:

Light to moderate bleeding
Mild cramping
Cervix remains closed
HCG levels may be normal

What to do:

Contact doctor within 24 hours

Inevitable Miscarriage

Seek Care Today

Before 20 weeks

Heavy bleeding with open cervix, miscarriage will occur

Characteristics:

Heavy bleeding with clots
Severe cramping
Open cervix
Tissue may pass

What to do:

Seek immediate medical attention

Ectopic Pregnancy

Emergency

6-10 weeks

Embryo implants outside uterus, medical emergency

Characteristics:

Light to heavy bleeding
Severe one-sided pain
Shoulder pain
Dizziness or fainting

What to do:

Call emergency services immediately

Second Trimester Bleeding (Weeks 13-27)

Bleeding in the second trimester is less common but requires immediate medical attention. Most causes are serious and need prompt evaluation and treatment.

Cervical Changes

Monitor & Mention

13-27 weeks

Spotting from sensitive cervical tissue

Characteristics:

Light spotting
After sex or exercise
Pink or brown color
No pain

What to do:

Mention at next appointment

Placental Issues

Seek Care Today

After 20 weeks

Problems with placenta position or attachment

Characteristics:

Painless bright red bleeding
May be heavy
No contractions
Baby movement normal

What to do:

Go to hospital immediately

Incompetent Cervix

Seek Care Today

14-24 weeks

Cervix opens too early without contractions

Characteristics:

Pink or brown discharge
Feeling of pressure
Back pain
No contractions initially

What to do:

Contact doctor immediately

Late Miscarriage

Emergency

12-20 weeks

Pregnancy loss in second trimester

Characteristics:

Heavy bleeding with clots
Strong cramping
Contractions
Tissue passage

What to do:

Seek immediate medical care

Third Trimester Bleeding (Weeks 28-40+)

Late pregnancy bleeding can range from normal pre-labor signs to serious emergencies. Understanding the difference is crucial for both mother and baby's safety.

Bloody Show

Monitor & Mention

Near term (37+ weeks)

Normal sign of approaching labor

Characteristics:

Mucus with blood streaks
Pink or brown
Small amount
May occur with mucus plug loss

What to do:

Normal, labor may start soon

Placenta Previa

Seek Care Today

After 28 weeks

Placenta covers cervix partially or completely

Characteristics:

Painless bright red bleeding
Can be heavy
No contractions
May stop and restart

What to do:

Go to hospital immediately

Placental Abruption

Emergency

After 20 weeks

Placenta separates from uterine wall early

Characteristics:

Heavy bleeding (may be hidden)
Severe abdominal pain
Rigid, tender uterus
Contractions

What to do:

Call emergency services now

Vasa Previa

Emergency

Near delivery

Fetal blood vessels cross cervix

Characteristics:

Bleeding when water breaks
May be associated with rupture of membranes
Fetal heart rate changes

What to do:

Emergency cesarean needed

When to Contact Your Healthcare Provider

Don't wait if you experience any of the following:

Any bleeding in first trimester

Bleeding heavier than spotting at any time

Bleeding with cramping or pain

Bleeding after 20 weeks

Bleeding with tissue passage

Bleeding with decreased fetal movement

Any bleeding that concerns you

Reducing Risk of Pregnancy Bleeding

While not all causes of pregnancy bleeding can be prevented, these steps may help reduce risk:

Avoid Heavy Lifting

Don't lift objects over 20-25 pounds

Stay Hydrated

Drink plenty of water to prevent dehydration

Take Prenatal Vitamins

Ensure adequate nutrition for healthy pregnancy

Avoid Smoking and Alcohol

These increase risk of placental problems

Manage Chronic Conditions

Control diabetes, hypertension, and other conditions

Gentle Exercise Only

Avoid high-impact activities and contact sports

What to Expect When You Seek Medical Care

Information to Prepare

When bleeding started and how long it's lasted
Amount and color of bleeding
Any accompanying symptoms (pain, cramping)
Last menstrual period date
Previous pregnancy complications

Tests You Might Have

Pelvic examination
Ultrasound to check baby and placenta
Blood tests (HCG levels, blood count)
Blood pressure and vital signs
Fetal heart rate monitoring (if appropriate)

Stay Informed About Your Pregnancy

Knowledge is power when it comes to pregnancy health. Track your symptoms and stay connected with your healthcare provider for the safest pregnancy possible.

Start Pregnancy Tracking