Are you currently expecting and terrified because you just noticed some blood on your underwear?
Bleeding can be quite alarming for many moms-to-be. But how do you know when bleeding and spotting is just a normal part of pregnancy and when it’s a sign of a more serious problem?
In this article, we will talk about if you can still have a period while pregnant, what causes bleeding during pregnancy, and when you should worry.
Can I Be Pregnant and Still Have a Period?
If you’ve been trying to conceive and noticed your period is much lighter this month, then you’re probably wondering if this might be it! Vaginal bleeding can occur in up to 25% of pregnant women.
Many women do experience light, irregular bleeding or spotting during early pregnancy, but a light period could also be due to stress, hormone imbalance, birth control pills, menopause, poor nutrition, low body weight, or excessive physical exertion.
Bleeding during pregnancy is typically dark brown to light pink. It should never be bright red.
There should also not be enough blood to fill pads and tampons over a few days. If you’re bleeding enough to fill pads or tampons, then it’s unlikely you’re expecting.
Although some women claim that they were still having their periods during pregnancy, according to the medical community this is not possible and is most likely due to other reasons that require consultation by a healthcare professional. Spotting is normal, especially in the first trimester. However, heavy consistent bleeding should not occur during pregnancy.
Editor's Note:Dr. Njoud Jweihan, MD
If you are expecting, you might also be experiencing:
- Changes in the breasts, such as swelling, tenderness, darkening of the areolas.
- Nausea and vomiting, otherwise known as morning sickness.
- Feeling constipated.
- Loose stools or diarrhea.
- Food aversions or cravings.
- Mood swings.
- Frequent urination.
If you’re experiencing spotting and light bleeding when you think you might be pregnant, you may want to go ahead and take a home pregnancy test. For best results, take the test that would be one week after your “missed” period with your first-morning urine.
Causes Of Light Period During Pregnancy
Light bleeding or spotting, especially in the first trimester, is quite common. But that doesn’t make it any less scary when it happens to you.
There are several reasons you might be bleeding during pregnancy:
1. Implantation bleeding
Implantation bleeding is one of the first signs of pregnancy for many women. Implantation bleeding can be confused with your normal period, as it tends to happen around the same time as your period would, and it’s often accompanied by implantation cramps which can be mistaken for PMS cramping.
However, with implantation bleeding, your period should be much lighter in color, flow, and length. No treatment is usually necessary and the symptoms resolve on their own.
During the second and third trimester, your cervix starts to swell because of increased blood flow to the area and the blood vessels in the area are easier to break during intercourse. Therefore, it’s not unusual to have some spotting after sex (1). You can try other positions during intercourse that decrease the chance of spotting since they have minimal contact with the cervix such as the rear-entry position and side-lying.
3. Vaginal exams
Vaginal exams, such as a pap smear or cervical check, can irritate the cervix and cause spotting due to your increased blood volume. Bleeding can occur within 24 hours of your exam, but should not last for more than a day. Your provider will most likely give you a light pad to wear following these exams.
4. Nearing Labor
Light bleeding toward the end of your pregnancy is often an indication your birthing day is almost here. As your body starts to prepare for labor, your cervix begins to soften and dilate, and you may lose your mucus plug, also known as the bloody show. Your mucus plug will most likely be a stringy and thick discharge that is brown with a tinge of pink or red.
This does not always mean that you are in labor and labor may not start until hours or even days after. Even though it might not mean you are about to be in labor, If you lose your mucus plug before reaching 37 weeks of pregnancy, let your doctor or midwife know.
Editor's Note:Dr. Njoud Jweihan, MD
When Do I Need to Worry?
Many expecting moms that experience light bleeding have normal and healthy pregnancies. However, there are times when bleeding can indicate a more serious problem with the pregnancy.
Bleeding during pregnancy is always worrisome if it’s heavy, bright red, lasts more than a few days, or presents with a fever, fainting, or cramps.
If you’re having any of these symptoms, you could be dealing with:
Miscarriages are more common than you would think. Nearly half of women who experience light bleeding early on in their pregnancy go on to have a miscarriage usually in the first 12 weeks of pregnancy. Contact your doctor if you’re having light bleeding that continues to get heavier or is accompanied by painful cramping or back pain, or if you see tissue passing through the vagina.
2. Chemical pregnancy
A chemical pregnancy is a very early miscarriage that occurs when an egg gets fertilized, but never fully implants to the uterus. This happens even before the fetus can be seen on ultrasound. There’s no specific treatment for these miscarriages, but your doctor can run some tests to help diagnose possible underlying causes such as checking the levels of the hormone human chorionic gonadotropin the hormone that forms after implantation. Some women who have these don’t even realize they were ever pregnant (2).
3. Ectopic pregnancy
An ectopic pregnancy is where the embryo implants itself somewhere other than your uterus, most often the fallopian tubes. If left untreated, you could be dealing with a rupture that could lead to internal bleeding, fainting, shock, and even death, so be sure to head to the emergency room if your light bleeding is coupled with severe pelvic or abdominal pain, shoulder pain, or extreme lightheadedness.
Ectopic pregnancies can occur if you have scarring in the fallopian tubes due to prior infection which can block the tubes, previous surgery in the area, or abnormal growths and congenital disabilities. Smoking and older age are examples of risk factors that can lead to an ectopic pregnancy.
If you’re diagnosed with an ectopic pregnancy, you will most likely be treated with medication or surgery.
4. Placenta problems
After about 20 weeks, bleeding could be a sign of a problem with the placenta, such as placenta previa or placental abruption. Placenta previa is a rare condition that usually occurs in the third trimester and it is where the placenta is near or covers the cervical opening and it can lead to hemorrhage, birth defects, slow fetal growth, and preterm birth. Placental abruption is where the placenta separates from the wall of the uterus before birth and can cut off nutrients and oxygen to your baby and is a dangerous condition that requires a prompt diagnosis (3).
The important difference to know between the two is that with placenta previa the bleeding is usually painless, while placental abruption can be associated with abdominal pain, clotting, and back pain.
5. Uterine Rupture
This occurs when the scar from a prior C section tears open during pregnancy. It is a rare but dangerous condition and usually requires an emergency C section.
6. Premature labor
Vaginal bleeding in the second or third trimester could be a sign of premature labor, so it’s never a bad idea to go in and get checked out. There are things your doctor can do to help delay an early delivery and they may prescribe bed rest or medication that attempts to stop labor, mature the baby’s lungs, and antibiotics to prevent infections. Along with light bleeding, you might also be experiencing backaches, cramping, contractions, pelvic pressure, vomiting, diarrhea, or fluid leakage if you are in preterm labor.
A vaginal or sexually transmitted infection (STI) may or may not be related to your pregnancy, but they are known to cause inflammation and irritation of the cervix, making you more prone to bleeding. If this is the cause, your underlying condition will need to be treated since STIs can be harmful to your baby. Symptoms associated with STIs can include bumps or sores near the mouth or genital area, skin rash, burning or pain upon urination, severe genital itching, and discharge.
What Should I Do if I’m Bleeding?
If you’re having an irregular period and haven’t confirmed you’re pregnant yet, then the first place to start would be to take a home pregnancy test. If you get a positive result, call and schedule an appointment with your OB/GYN or midwife, and be sure to let them know about the bleeding.
If you know you’re pregnant and are having some spotting, call your provider and see if they need you to come in for testing or monitoring. Spotting usually isn’t concerning, but it’s best to have a proper diagnosis.
Make a Call If
To Sum it Up
While light bleeding or spotting is quite common during pregnancy, it’s always best to call your doctor if it happens to you.
Bleeding could be an early sign of pregnancy, but it could also be an indication of a serious complication with the pregnancy, such as a miscarriage or ectopic pregnancy. Sex and vaginal exams can also cause bleeding later on in your pregnancy, but it could also be a sign of a placental problem or preterm labor.
If you’re in pain or your blood is heavy or bright red and you can’t get ahold of your doctor, be sure to head to the nearest ER. It might be nothing, but it’s better safe than sorry.