What You Need to Know About Bleeding and Spotting During Pregnancy

Are you currently expecting and terrified because you just noticed some blood on your underwear? Have you been trying to conceive and wondering if you could be pregnant even though you’ve still been having your period?

Bleeding can be quite alarming for many moms-to-be, but there may or may not be a need to worry. 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 post, 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!

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 (source).

If you are expecting, you might also be experiencing:

If you’re having an abnormally short or light period and you think you might be pregnant, you may want to go ahead and take a home pregnancy test. For best results, take the test what would be one week after your “missed” period with your first-morning urine.

Causes Of Light Period During Pregnancy

Bleeding, especially in the first trimester, is quite common. But that doesn’t make it any less scary when it happens to you.

There are a number of reasons you might be bleeding during pregnancy, but it is often not cause for concern.

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 with implantation cramps which can be mistaken with PMS cramping. However, with implantation bleeding, your period should be much lighter in color, flow, and length.

2. Sex

During the second and third trimester, your cervix starts to swell because of increased blood flow to the area. Therefore, it’s not unusual to have some spotting after sex (source).

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.

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When Do I Need to Worry?

Many expecting moms that experience light bleeding go on to 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:

1. Miscarriage

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. Contact your doctor if you’re having light bleeding that continues to get heavier or is accompanied with painful cramping or back pain.

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. There’s no specific treatment for these miscarriages, but your doctor can run some tests to help diagnose possible underlying causes. Some women who have these don’t even realize they were ever pregnant (source).

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. 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 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 (source).

5. 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.  Along with light bleeding, you might also be experiencing back aches, cramping, contractions, pelvic pressure, vomiting, diarrhea, or fluid leakage if you are in preterm labor.

6. Infection

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.

What Should I Do if I’m Bleeding?

If you’re having an abnormal 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.

Spotting in pregnancy is very common but true bleeding is not common and could be serious. Pay attention to the amount of bleeding you are having and other symptoms (like pain) and see your doctor accordingly.
Headshot of Christine, Traxler, MD, BS

Editor's Note:

Christine Traxler, MD, BS

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

You should always call your provider if you’re experiencing excessive or bright red bleeding or are in severe pain. If you’re unable to get ahold of your doctor, head to the emergency room (source). If you’re too frantic to drive, be sure to call a family member or friend to take you.

To Sum it Up

While light bleeding 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 better safe than sorry!

Did you experience light bleeding with any of your pregnancies? Did you go on to have a healthy pregnancy or was it a sign of a more serious problem?

Feel free to share your experiences with us in the comments below and be sure to share this post with other expecting moms.

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