Bleeding During Pregnancy – What’s Normal & What’s Not?

By BSc, MSc (embryologist) and BA, MA (fertility counselor).
Last Update: 04/15/2014

According to the experts, up to 10% of pregnant women experience vaginal bleeding at some stage of their pregnancy, especially during the first trimester. A small bleeding does not imply, however, that there is a serious problem going on.

Below you have an index with the 3 points we are going to deal with in this article.

Causes of bleeding during pregnancy

The main causes of vaginal bleeding during pregnancy are found among these ones:

  • Implantation bleeding: When the embryo implants itself in the lining of the uterus. This usually happens shortly before the expected day of the beginning of the period, and the bleeding is milder.
  • Cervical changes: When a woman is pregnant, the cervix experiences changes. These changes are produced during the pregnancy as a training for the labor, so little bleedings might occur because there is a higher flow of blood towards that area.
  • In the first trimester of pregnancy, bleeding can be an indicator of miscarriage. Usually it comes with some sort of period pains that are stronger. It is of vital importance to point out that, at least half of the women who experience mild vaginal bleeding at the beginning of the pregnancy do not lose their baby.
  • Placental abruption: It may occur towards the last 12 weeks of pregnancy, i.e., between week 29 of pregnancy and week 40.
  • Placenta previa: Is a severe condition where the bleeding is rather heavy. The placenta sits low in the uterine cavity so that it covers the opening of the birth canal. The bleeding is painless and the blood is bright.
  • Ectopic pregnancy: Is the term used when the embryo implants itself in the Fallopian tube instead of in the uterus.
  • Preterm labor (with bleeding)
  • Cervical trauma: Caused by sexual intercourse or after a pelvic exam. In these cases, the bleeding is minor.
  • Infection of the cervix.

Some medicines or illnesses can cause bleeding during pregnancy. These causes might differ depending on the woman's age.


The moment you are aware of vaginal bleeding, strong period pains, stabbing pain in the abdomen, vaginal discharge, etc., do not hesitate to go to the doctor as soon as possible. Your doctor will make a diagnosis and recommend you a treatment according to your case. Commonly, and always bearing in mind that these are just examples and should not be taken as a self-diagnosis or self-medication, your doctor could recommend:

  • In the case of risk of miscarriage: prescription of antibiotics to fight infections. If the loss of blood is severe, s/he might recommend a blood transfusion.
  • If the problem is an infection of the vagina or the cervix: your doctor will give you antibiotics that are not dangerous for your baby.
  • Provided that it is an ectopic pregnancy: surgery is needed or a especial treatment to remove the embryo and control the internal bleeding.
  • If the bleeding is caused by a placenta previa you should probably have to rest in a hospital, at least until the bleeding stops. If the bleeding appears close to the due date, or if it persists, a C-section will be performed.

Regardless of whatever the case is, sexual intercourse should be avoided until the causes of the bleeding are figured out. Tampons and vaginal douching are also to be avoided.

It is important to observe the characteristics of the bleeding: for how long has it been going on? is it mild or heavy? what have you recently done that could have caused the bleeding? etc. With this information, it will be easier for your doctor to detect the causes of your bleeding and determine whether it is dangerous for you and your baby or not.

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 Neus Ferrando Gilabert
Neus Ferrando Gilabert
BSc, MSc
Bachelor's Degree in Biology from the University of Valencia (UV). Postgraduate Course in Biotechnology of Human Assisted Reproduction from the Miguel Hernández University of Elche (UMH). Experience managing Embryology and Andrology Labs at Centro Médico Manzanera (Logroño, Spain). More information about Neus Ferrando Gilabert
Adapted into english by:
 Sandra Fernández
Sandra Fernández
Fertility Counselor
Bachelor of Arts in Translation and Interpreting (English, Spanish, Catalan, German) from the University of Valencia (UV) and Heriot-Watt University, Riccarton Campus (Edinburgh, UK). Postgraduate Course in Legal Translation from the University of Valencia. Specialist in Medical Translation, with several years of experience in the field of Assisted Reproduction. More information about Sandra Fernández

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