Spotting & bleeding in pregnancy

Wherever you are in your pregnancy experiencing spotting or bleeding can be incredibly worrying as you inevitably end up thinking the worst. To help you stay informed we share all you need to know about spotting in pregnancy.

Is spotting during pregnancy normal?

While it's not 'normal' per se, spotting or bleeding during pregnancy is experienced by a large number of women, many of whom go on to have healthy, full term pregnancies. In fact, the NHS estimate that 1 in 10 women notice some kind of bleeding at some stage during their pregnancy.

It's most common for women to experience spotting in early pregnancy, although bleeding can occur later in pregnancy too. It does not however always mean miscarriage although this is undeniably one of the possible causes.

Generally, spotting during pregnancy appears as a lighter bleed that can be anything from light pink to brown in colour. It tends to resemble the bleeding experienced at the start or end of a menstrual period.

What should I do if I notice bleeding?

If you experience any bleeding at all during the course of your pregnancy it's important to take it seriously and get checked out by your doctor, midwife or at a hospital as soon as you are able. While you're waiting for an appointment it's usually best if you try and rest and remain as calm as possible (although naturally that is often easier said than done).

What will my doctor test for?

When you see your doctor or midwife about bleeding in pregnancy they're likely to carry out several tests and checks to make sure that you and your baby are healthy.

To begin with they are likely to feel your abdomen and may also conduct an internal examination. They're also likely to carry out an ultrasound to check that baby is ok. Transvaginal ultrasounds are generally used as these give a more accurate picture of where your baby is positioned and whether the foetus is developing as would be expected, this is particularly the case in early pregnancy.

Your doctor is also likely to listen for your baby's heart beat and take both urine and blood samples from you to check hormone levels.

What will my doctor be able to tell me?

From the various tests and checks he or she carries out your doctor should be able to tell you if your baby is well and whether or not they are developing healthily. If there is an obvious cause for the bleeding such as an infection they will be able to prescribe treatment or, if it is a more serious condition, refer you to a specialist.

What causes spotting in early pregnancy?

Bleeding in early pregnancy can be caused by a number of reasons these include:

• Implantation bleeding - This occurs when a fertilised embryo attaches itself to the wall of your uterus. As the placenta begins to develop and links between your own and your developing baby's blood vessels begin to occur a small amount of blood can be lost. This is usually experienced 6 - 12 days after ovulation although it's not experienced by all women.
  
  
• Breakthrough bleeding - When you fall pregnant it can take a while for your body to adjust completely and some of the hormonal fluctuations that governed your menstrual cycle can continue to rise and fall. As a result a few women experience light breakthrough bleeding around the time their period was due although this tends to be much lighter than regular menstruation.
  
  
• Trauma - A fall or knock to the stomach may result in spotting or bleeding wherever you are in your pregnancy.
  
  
• Infection - Infections or inflammations of the cervix or vagina or sexually transmitted infections may result in spotting or light bleeding particularly after sexual intercourse.
  
  
• Cervical polyp - These are benign growths that can occur on the cervix and can cause bleeding.
  
  
• Fibroids - These are growths made of muscle fibre that can develop in a women's reproductive system and may cause bleeding.
  
  
• Ectopic pregnancy - This is where a pregnancy attaches and begins to develop outside of the womb, usually in the fallopian tubes. Many women experience a sharp, persistent pain in one side of their lower abdomen (either with or without bleeding) when a pregnancy is ectopic. However, unfortunately, for the safety of the mother ectopic pregnancies are not usually allowed to continue developing and have to be removed as soon as possible.
  
  
• Molar pregnancy - This is a relatively uncommon cause of bleeding in pregnancy and is however sadly one in which the mother's safety is at risk. It is for this reason that molar pregnancies are also ended prematurely.
  
  
• Miscarriage - It is possible that bleeding during early pregnancy is a sign of miscarriage, this is particularly the case if it is experienced with abdominal cramping and an increasingly heavy flow of blood. Unfortunately once a pregnancy begins to miscarry there is little that anyone can do to stop it. However, just because you experience bleeding it doesn't necessarily mean that this is the reason so you shouldn't give up hope.
  
  

What causes spotting in late pregnancy?

There are also a number of causes of bleeding later on in pregnancy, these include:

• Cervical ectropion - Cervical ectropion is the most common cause of bleeding in later pregnancy and is simply a result of hormone led changes to the neck of the womb.
  
  
• Placenta praevia - Placenta praevia occurs when the placenta attaches in the lower portion of the womb. It can cause bleeding from the second trimester onwards as the uterus begins to stretch and adapt to your growing baby. Bleeding can also occur if the placenta attaches over the entrance to the cervix.
  
  
• Placenta abruption - This occurs when the placenta comes away from the wall of the womb. Generally, the greater the area of separation, the heavier the bleeding. Bleeding due to placenta abruption is usually accompanied by stomach pain or cramps.
  
  
• Labour - Bleeding later on in pregnancy can be what is known as a show, where the mucous plug that sealed the cervix comes away. This can often appear as heavy, bloody discharge and is often a sign that labour will soon start.
  
  

Will my baby be ok?

The sad fact is that when bleeding occurs it is very difficult to predict whether or not a pregnancy is going to end in miscarriage. However, women frequently experience bleeding during pregnancy with no lasting effect on the health of their baby so it's not a foregone conclusion.

So...

Experiencing spotting or bleeding during pregnancy is undeniably a worrying experience whatever the cause. For this reason the best thing you can do if you do experience spotting is to seek medical assistance right away. This way you can stay informed so that you don't stress unnecessarily and get the help you need to make sure you and baby stay as healthy as possible.

Share your worries, concerns and questions about bleeding during pregnancy or anything else with other members on the AskBaby forums.