Vaginal bleeding during pregnancy
Vaginal bleeding during pregnancy, whether it occurs at 14 weeks or indeed at any other time, can be a serious cause for fear and anxiety. Dr Tom Pettinger has written an exclusive article for My Baby Manual: Vaginal Bleeding in and Spotting Pregnancy which looks at when to seek help and discusses bleeding at various stages in pregnancy.
However, it is important to remember that although vaginal bleeding – also called “spotting” in cases of a lighter flow – can be a sign of a serious problem such as miscarriage, for most mothers-to-be there will be a far more innocuous cause. In fact, as many as 25% of women report that they experienced spotting during pregnancy with 8% categorising it has “heavy bleeding”.
For the most part, bleeding will be only a transitory phenomenon, lasting little more than a few days, although in some cases – if you have had more than two vaginal deliveries, for example – bleeding may last up to eight weeks.
For those concerned that bleeding increases the risk of miscarriage: fear not. Although bleeding can be a sign of miscarriage, one study indicates while 12% of women who bled during pregnancy miscarried, 13% of women who did not bleed during pregnancy experienced miscarriage.*
Further reassurance can be found in the fact that if you are experiencing bleeding at or after 14 weeks of pregnancy, your risk of miscarriage is lower than if you are at 12 weeks, when spotting may be a sign of miscarriage or ectopic pregnancy.
Additionally, you should remember that if your baby has been conceived using IVF you have a slightly higher chance of experiencing spotting during pregnancy.
What does bleeding look like?
Bleeding in pregnancy can vary from light to heavy and from dark red to bright red or brown. It may be a consistent flow over several days or may come as intermittent spotting over a longer period of time. The consistency of the blood may be more liquid like or it may come in clots, clusters or strings.
Discover the cause
Of course, the first thing you want to do if you experience spotting during pregnancy is to find out why it’s happening. You should make an appointment with your healthcare professional at the earliest opportunity. He or she will then organise or conduct some tests: a vaginal or pelvic examination, an ultrasound scan to check your uterus, or a blood test to assess your hormonal activity.
The findings will be looked at together with the details of any other symptoms you may be experiencing – for example, cramps, weakness, dizziness or pain.
Depending on the doctor’s diagnosis you may be discharged or admitted to hospital for observation. Sometimes, no cause will be identified; this is not an unusual situation so don’t panic, your doctor will continue to monitor you and in all likelihood your baby will be safe.
Possible causes
Many cases of bleeding will not have an identifiable cause. For example, doctors believe that hormones can cause so-called breakthrough bleeding and that this is unlikely to pose any harm to you or your baby. Hormones may also alter the surface of your cervix which can cause bleeding, particularly after penetrative sex.
In other cases bleeding may be caused by the fertilised egg pushing against the lining of your uterus, implantation bleeding.
Before you reach the 14-week stage of pregnancy there is a higher likelihood that the bleeding is caused by a serious health concern such as early miscarriage or ectopic pregnancy. Both of these complications are likely to be accompanied by cramps and/or severe pelvic or abdominal pain. Acute pain (low down on one side of your stomach) accompanied by shoulder tip pain (an unusual sensation at the point where your shoulder ends and your arm begins) alongside diarrhoea or bowel pain may be a sign of ectopic pregnancy. While bleeding together with back or stomach pain might indicate possible miscarriage.
Other possible causes of bleeding include the following:
- Cervical polyps: innocuous growths on your cervix
- Infection: either in the cervix or vagina
- Fibroids: small fibrous growths in the lining of the uterus
In some rare cases bleeding may be caused by a fall or blow to the abdomen.
General notes
Although all cases of bleeding in pregnancy should be investigated you should not consider it as a cause for panic – easier said than done, we know. Contact your health professional as soon as possible, particularly if you feel unwell or the bleeding is very heavy.
Remember, as many as one in four women experience some bleeding in pregnancy and all will experience anxiety as to its cause. Read our Mum’s perspective blog on her week 11 pregnancy scare.
