“Is my baby alright?” is the first thought you’ll get if you experience spotting or bleeding during pregnancy. Bleeding and spotting are often confused as the same, but this is not the case. Spotting is really light bleeding and is usually just a few drops of blood on your panty. Bleeding, on the other hand, is a heavier flow of blood that requires you to wear a pad or panty liner.
First Trimester:
Your first trimester starts from the first day of your last period and goes on until the end of week 12. Put simply, your first trimester lasts for a period of 3 months. A lot of things happen during the first three months. Your baby grows faster than any other time with all the organs forming during this stage.
Light bleeding or spotting during the first trimester is quite common. It is seen in almost 20% of all pregnancies. Some of the pregnancies continue normally, a few however, may end in a miscarriage.
Why does it happen?
Bleeding in early pregnancy could be due to:
Implantation bleeding
It’s quite possible that you may have some normal spotting within the first six to 12 days after you conceive. This is because the fertilized egg implants itself in the lining of your uterus. As this happens quite early on in pregnancy you may not even know you’re pregnant and mistake it for a light period. Implantation bleeding is normally very light and lasts from a few hours to a couple of days.
Bleeding in the first trimester can, however, indicate several serious conditions such as:
Miscarriage:
Miscarriage is most prevalent in the first trimester and is a major cause of concern for mums-to-be. But, bleeding during early pregnancy doesn’t always mean you’ve miscarried your child. If your routine ultrasound during the first trimester shows your baby’s heartbeat, there’s a very strong chance you may not miscarry.
Strong cramps in the lower abdomen and tissue passing through your vagina are other symptoms that indicate miscarriage.
Ectopic Pregnancy:
An ectopic pregnancy is a condition in which your embryo implants outside your uterus most commonly in your fallopian tubes. It causes bleeding during the first trimester. It is a rare condition but is very dangerous. If you have an ectopic pregnancy you may also experience light headedness and cramps in your stomach.
Molar Pregnancy:
This is a very rare condition also known as gestational trophoblastic disease. It is a condition in which abnormal tissue grows inside your uterus within the pregnancy tissue instead of your baby. In a few cases, this tissue could be cancerous and spread in other parts of your body.
Along with these other causes of bleeding during pregnancy could include:
Changes in the cervix:
An increased amount of blood flows to the cervix during pregnancy. Also due to excess estrogen hormone during pregnancy the lining from inside the cervix grows on top of it, this is called Ectopy of the cervix. This lining is very fragile and can easily bleed with contact. Sexual intercourse could potentially trigger bleeding that isn’t usually a cause of concern.
Infections:
Sexually Transmitted infections or infections in your cervix or vagina may cause bleeding during this stage.
What to do?
Keep a check
Wear a pad or panty liner to keep a check on the bleeding.
Try preventing further bleeding
Don’t put anything into your vagina. Avoid sex and usage of tampons while bleeding.
Call for help
Be sure to inform your doctor or midwife if you have heavy bleeding, cramping, pain in your abdomen, light headedness, or if you faint. In case any tissue passes from your vagina store it clean container and present it to your doctor for testing.
Second and Third Trimester:
Your second trimester consists of the middle three months of your pregnancy. That is from week 13 to 28. It comes as a relief from the sickness and exhaustion of trimester. Your bump will start to show and you’ll be able to feel your baby.
The third trimester starts from 7th month and lasts till 9th month of pregnancy. Your little one will get a whole lot bigger in this trimester.
Bleeding in these trimesters is fairly uncommon. Bleeding in late pregnancy affects 1 out of 10 mums to be. It is not always indicative of something serious but you should mention it immediately to your doctor or midwife and get it checked.
Why does it happen?
Bleeding in the second and third trimesters can be caused by:
Changes in your cervix
During pregnancy, the cervix usually softened and more likely to bleed.
Vaginal infections
Vaginal infections are common in pregnancy due to a surge of hormones.
Placental abruption
This is seen when the placenta comes away from the walls of your uterus and causes bleeding. It is extremely dangerous for both you and your baby. Pain in your abdomen, clots from your vagina, a tender uterus, and severe back pain are other indicators of the condition.
Placenta praevia
Low lying placenta after 20 weeks is called placenta praevia and can lead to bleeding in trimester 2 or 3. In this condition, the placenta will either partially or completely cover your cervix. Bleeding due to placenta praevia calls for urgent medical action.
Vasa Praevia
Vasa praevia happens when blood vessels related to the baby run through the membranes covering your cervix. Once labour begins your cervix dilates and the vessels can break causing heavy vaginal bleeding. It is an emergency needing urgent intervention.
A ‘Bloody Show’
In late pregnancy, a small amount of blood is mixed with mucus and a plug sealing the cervix comes away indicating impending labour. Discharge from your vagina which is pink in colour is often called ‘the bloody show’ especially if associated with painful contractions.
What to do?
Inform your doctor or midwives and get the bleeding checked. Depending on the severity of the situation your doctor will suggest the next course of action.
Common treatments:
In the late stages of pregnancy, bleeding calls for round the clock monitoring to check for anaemia, sepsis or foetal distress. You may also need blood transfusions if you suffer from consistent heavy loss of blood. Despite a normal birth being the ideal method, your doctor may ask you to keep your mind open to having an emergency C-section.
Couple of injections called “steroids” might also be prescribed to you if you haven’t still reached week 36 of pregnancy. This is because you may have premature labour and the steroids will help fasten the growth of your baby’s lungs. This is to help your baby breathe better outside the womb. In a few instances (extremely rare) of placenta previa with uncontrolled bleeding, the uterus may be removed via a hysterectomy as a life saving measure when all other treatment options fail. The bleeding however, can be surgically controlled in a number of cases.
Practising self-care at home is an easy way of managing bleeding during early pregnancy. Bleeding while pregnant does not always indicate serious conditions but may be a warning sign. If you bleed while being pregnant don’t panic just contact your doctor or midwife at the earliest to avoid problems in the future.