Early Pregnancy Bleeding

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Is Bleeding Normal during Pregnancy?

Bleeding in early pregnancy can be frightening for any mother to be. However, miscarriage is just one of many possible causes for such bleeding. It is estimated that 25-30% of women experience some degree of bleeding in pregnancy and that only half of those women go on to miscarry.

Most women have what is called spotting. This refers to very light bleeding that may only appear on the toilet paper when using the bathroom or may require a panty liner. The color can range from pinkish orange to brown. It is always acceptable to call your doctor in the event of early pregnancy bleeding. They will be able to assess the risk based on a few questions and determine if you need to be seen.

If the bleeding becomes bright red, is heavy (more than a pad in an hour) or is accompanied by cramping, then you should definitely call your doctor for further direction or go to the hospital. These symptoms do not always mean that you are miscarrying; however, they would put you into a category medically referred to as threatened miscarriage. The Internet is full of stories from women who had heavy bleeding and cramping only to find a healthy little embryo on an ultrasound, complete with heartbeat.

Some causes of early pregnancy bleeding are listed below.

Implantation Bleeding

Implantation bleeding occurs when the fertilized egg implants into the lining for the uterus. Recall, the purpose of a menstrual cycle is to prepare the uterus to accommodate a baby. That mostly involves lining the uterus with blood and tissue. When the egg burrows into that, bleeding is common. Implantation bleeding is most common six to twelve days past ovulation. However, it can take as long as 2 weeks or more to travel out of the body.

Intercourse or Internal Exam

It is important to understand that during pregnancy, the cervix becomes a very blood rich environment. Therefore, any agitation to the vaginal/cervical area could result in bleeding. This includes intercourse or an internal exam, particularly a pap smear.


Certain infections that cause inflammation of the cervix may cause bleeding in pregnancy. A physician can screen for infections of concern. Urinary Tract Infections can be dangerous in early pregnancy and should be treated by a doctor promptly.

Sub-Chorionic Hemorrhage

This refers to active bleeding between the placenta and uterine wall. The cause is not known, and while it slightly increases the risk of miscarriage, many women that have this continue with healthy pregnancies.

Ectopic Pregnancy

Ectopic pregnancy is the term used for a pregnancy that forms in the fallopian tube instead the uterus. Unfortunately, these pregnancies are never viable and must be surgically removed. Ectopic pregnancies usually cause a significant amount of pain and can be diagnosed with an ultrasound.

Molar Pregnancy

A molar pregnancy occurs when there is an incomplete fertilization of an egg. The tissue designated to become an embryo becomes a mole instead. Symptoms include excessive nausea and rapid uterus growth.

Blighted Ovum

This is when the fertilized egg does not progress into an embryo. It is believed that blighted ovum accounts for up to 50% of miscarriages. When a woman has a blighted ovum, the gestational sac develops normally. Therefore, hormone levels will come in where expected for the first few weeks of pregnancy and the woman may experience all the normal symptoms of pregnancy. An ultrasound, however, will show an empty sac or an embryo that has not developed past the first few weeks. A blighted ovum is believed to be caused by chromosomal abnormalities and is not thought to be preventable.

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