Bleeding in pregnancy
Bleeding during pregnancy is very common, and although understandably worrying, there are many causes for this. Between 1 in 4 and 1 in 5 women have bleeding during the first twelve weeks of pregnancy (first trimester). Bleeding any time during pregnancy requires evaluation, so you should be assessed by your midwife or doctor urgently.
Miscarriage and ectopic pregnancy are two common causes of bleeding in the first trimester. There are other causes that are less worrying, but first, the medical team would want to exclude these.
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Causes of bleeding later in pregnancy
Bleeding later in pregnancy is likely due to other reasons. These include placenta previa (the placenta partially or completely covers the opening to the birth canal), placental abruption (detachment) and pregnancy-related changes in the cervix. As with bleeding earlier in pregnancy, you should be assessed by your midwife or doctor urgently.
At the end of your pregnancy, you may get your ‘show’, which is a small amount of mucus mixed with blood that occurs just before the first stage of labor. The show is caused by the shedding of the plug at the cervix in preparation for labor to start.
When should I see my doctor?
If you are pregnant and have had vaginal bleeding, you should seek urgent medical advice. Bleeding can be nothing to worry about, but your doctor will need to exclude any concerning causes. You can either speak with your doctor, your midwife, or be referred to your local emergency room where you will be reviewed by the most appropriate team.
The absence of baby movements is also reason for urgent medical attention.
What will my doctor do?
Assessment for bleeding in pregnancy is usually done by a specialist doctor called an obstetrician, or a midwife. It's best to take your antenatal notes with you, if you have them.
Your doctor or midwife will ask you questions about your pregnancy and medical history, and if you are comfortable, will examine you. If you are later in your pregnancy, a vaginal examination and check of your cervix may be required. Commonly blood tests and imaging such as an ultrasound will be needed, and they may listen to the baby's heartbeat.
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