Why do I have Bleeding during Pregnancy? ( Trimester Wise )

Bleeding in pregnancy is common, especially during the first trimester, and is usually not a call for alarm. But in some cases, bleeding can at times be a sign of something serious. So, it is important to find out the possible cause of bleeding during pregnancy. It is best to get it checked by the doctor to make sure that the mother and the fetus are healthy and there are no complications during pregnancy.

Causes of bleeding during Pregnancy in the First trimester

• Implantation bleeding

Implantation happens when the fertilized makes space and burrows into the walls of the uterus i.e. female’s womb. This happens around day 6 to 12 after the female conceives. The fertilized egg floats into the uterus and attaches itself to it to get oxygen and nutrition from the mother. 

Implantation can cause bleeding or light spotting in the first trimester. 

• Cervical polyp

It is a fact that about  2 to 5 % of females have polyps. Cervical polyps are small, finger-like growths on the cervix, which is the gateway from the vagina to the uterus. Cervical polyps are usually benign and do not cause cancer. However, cervical polyps can get inflamed or irritated and cause bright red bleeding during pregnancy.  

• Physical Exam or Sexual Intercourse 

Pregnancy hormones can make the cervix more sensitive than normal. So, physical exams during pregnancy such as pelvic exams can irritate the cervix and result in bleeding. Sexual intercourse during pregnancy can also cause bleeding due to the same reason. 

• Miscarriage 

Sometimes spotting or lighter bleeding can turn to heavy bleeding, just like menstrual bleeding.

Apart from heavy vaginal bleeding, other symptoms of miscarriage include-

• Blood or tissue clots in the bleeding
• Bright red to brown colored bleeding
• Fluid discharge from the vagina
• Severe cramping or pain in the lower abdomen
• Mild  to sharp pain in the lower back

It is true that heavy vaginal bleeding in the first trimester, especially if accompanied by cramping or pain can be a sign of miscarriage. Most miscarriages occur during the first trimester. Thus, if you experience any such situation, immediately visit the gynecologist.  

Also Read: Excessive Bleeding During Pregnancy

• Pregnant with twins or triplets

If a woman is pregnant with twins or triplets, she might have a greater chance of pregnancy bleeding. The chances of miscarriages in the first trimester of pregnancy increase when the woman is pregnant with more than one baby.

• Ectopic pregnancy

An ectopic pregnancy occurs when the fertilized egg mistakenly gets attached somewhere else outside the womb, most commonly in the fallopian tubes. An ectopic pregnancy is as rare as 2.5%, which is less common than miscarriage. The fetus can only grow and develop only inside the uterus, so ectopic pregnancies need to be medically treated. Also, ectopic pregnancies should be terminated at the earliest otherwise the fallopian tube can rupture due to stretching by the fetal growth and cause heavy bleeding.

Common symptoms of ectopic pregnancy include:

• Sharp vaginal or abdominal pain
• Rectal pressure
• Severe cramping 
• Lightheadedness or fainting
• Shoulder pain and feeling to have a bowel movement (when blood leaks from the fallopian tube)

If left untreated, these symptoms of ectopic pregnancy can be life-threatening. 

• Molar pregnancy

A molar pregnancy happens when the placenta’s tissues grow abnormally during fertilization. This can happen due to a genetic error.  Because of this, the fetus may not grow at all. A molar pregnancy can also lead to a miscarriage in the first trimester. Molar pregnancy is a rare complication, with a probability of about 1 in every 1,000 pregnancies.

Symptoms a female may experience in the case of molar pregnancy are:

• Bright red to dark-colored bleeding
• Lower stomach pain 
• Vomiting
• Nausea 

Infections during pregnancy

Bleeding in the first trimester of pregnancy might have nothing to do with the pregnancy at all. An infection in the female’s pelvic area, in the urinary bladder or urinary tract, can also be the reason for spotting or bleeding. Reproductive or urinary tract infections may be caused by bacteria, viruses, or fungi.

A serious yeast infection or vaginitis can also cause bleeding during pregnancy. Infections mostly cause pink or red-colored spotting or light bleeding.

Other symptoms of infections in pregnancy can include- 

• Vaginal itching
• Pain and heaviness in the lower abdomen 
• Dysuria or burning sensation when urinating
• White vaginal discharge
• Bumps or sores on the outer part vagina

Second and third trimester bleeding

Bleeding in the second or third trimester of pregnancy is mostly more serious than the first trimester light bleeding. Causes of bleeding during the second or third trimester of pregnancy may include-

• Cervix problems- Inflammation or growths in/on the cervix can cause light vaginal bleeding. This is usually not a serious problem but the female should notify her doctor if anything so happens.
• Placental abruption-This happens when the placenta detaches itself from the uterine wall before or at the time of labor. Placental abruption is as rare as just 1 % of pregnant females.
• Placenta previa- This happens when the placenta is very low in the uterus and partly covers the cervix. This can cause vaginal bleeding without any pain.
• Vasa Previa- This occurs when some of the placenta’s blood vessels go across the cervix.
• Premature labor- Vaginal bleeding in the second or third trimester may mean that the female might be having early labor.

When to get medical help from a gynecologist?

Talk to your gynecologust if you experience bleeding during pregnancy in any trimester. Proper diagnosis will clear the condition for you and doctor so better steps can be taken.

So, visit your gynecologist right away if you have any of the following symptoms:

• Heavy vaginal bleeding
• Vaginal discharge with clots or tissues
• Severe cramping and/or pain
• Nausea
• Fainting or dizziness 
• Fever of 38°C or higher
• Chills

Do not avoid any abnormal signs in your pregnancy and consult your doctor right away to rule out the chances of complications or any other risks. Doing so will keep you away from putting your life or fetus in danger.  

Also Read:

• Diarrhea in Pregnancy- Is it Normal?
• Foods that can harm a female’s pregnancy
• Headaches during Pregnancy- Should I worry?