If you are pregnant and experience any type of bleeding, it can be a cause for concern. You are probably asking, “Does bleeding mean miscarriage?” Sometimes, this is the case, but other times there can be other causes. Pregnant women have enough to worry about as it is and experiencing bleeding during the pregnancy only elevates stress. It is important to understand the different types of bleeding that can occur during pregnancy, as well as what they may mean. In this blog post, we will discuss the causes and symptoms of bleeding during pregnancy, as well as when you should call your doctor.
As soon as you get that positive pregnancy test, you have all the hopes and dreams of having a healthy pregnancy and bringing a healthy baby into the world nine months later. When you have any bleeding during pregnancy, it is hard to not jump to the worst conclusion. You always hear that bleeding is a sign of miscarriage, yet do not often hear that bleeding can also be caused by other things. No one wants to experience the loss of a pregnancy. It is something that happens to so many women and families, yet something no one ever thought they would be a part of. Fortunately, you can rest assured that not every type of bleeding means you will lose the pregnancy. There can even be bleeding in healthy pregnancies. Read on to find out what the other causes of bleeding during pregnancy can be.
This article does not give medical advice. Please always check with your doctor or healthcare provider to find out the causes of bleeding you are experiencing. If you feel you are having a medical emergency or are ever in severe pain, go to the nearest emergency department or emergency care facility.

Table of Contents
First Trimester Bleeding in Pregnancy
You are considered to be in your first trimester up until you are at 14 weeks of pregnancy. If you have any signs or symptoms that are causing you concern, please always reach out to your healthcare provider. They can do blood tests to check your HCG hormone levels to see if they are properly rising. The doctor can also perform an ultrasound exam to check the status of the pregnancy and the baby. They will use all of this information to help you come up with any possible causes as to why you are bleeding. Typically, you can also look at the color of the blood as an indicator. Many doctors consider brown blood to be “old blood” and bright red blood or dark red blood to be “newer or active bleeding”. Make sure you always check with your doctor about any concerns.
Implantation Bleeding
One of the most common causes of first trimester bleeding is implantation bleeding. This can occur when the fertilized egg implants in the lining of the uterus, and is usually a sign that the pregnancy is progressing normally. Implantation bleeding is typically light spotting or streaking that occurs around 10-14 days after your ovulation date. It may last for a few hours to a couple of days, and is nothing to be concerned about.
Ectopic Pregnancy
An ectopic pregnancy is a type of early miscarriage. It occurs when the fertilized egg implants outside of the uterus, usually in the fallopian tubes. Ectopic pregnancies are not viable and can be dangerous because they can cause internal bleeding. If you experience bleeding and any abdominal pain in the first trimester, it is important to call your doctor immediately. The abdominal pain is the main sign of an ectopic pregnancy. Other symptoms of ectopic pregnancy can include pelvic pain, bleeding, dizziness, or pain on one side of your body.
Your healthcare provider or early pregnancy unit can perform an early ultrasound scan to make check the status of the pregnancy and confirm if it did properly implant in the wall of the uterus. If you are not able to get in to see your health care provider right away, make sure you go straight to the emergency room. There can be serious complications for not getting an ectopic pregnancy treated right away.

Miscarriage
This is a common cause of first trimester bleeding, occurring in about 15-20% of pregnancies. Bleeding is the most common sign of miscarriage. Some of the other main symptoms of miscarriage include cramping in the back or abdomen, fatigue, belly pain, passing pregnancy tissue or having a lot of vaginal discharge, and nausea. If you experience any of these symptoms, it is important to call your doctor right away. They can perform an ultrasound scan to check on the pregnancy and confirm if a miscarriage has occurred. While miscarriage is a common and often unavoidable occurrence, it is still a traumatic and heartbreaking thing to experience. The risk of miscarriage decreases the further along your pregnancy progresses.
Threatened Miscarriage
A threatened miscarriage is when you have vaginal bleeding in the first trimester and have the potential of having a miscarriage. In this case, the bleeding may or may not be a sign of a miscarriage. This usually happens within the first 12 weeks of pregnancy. It does not mean you will for sure miscarry, but that there is a chance due to bleeding.
Missed Miscarriage
A missed miscarriage is when the pregnancy has ended but your body does not show any of the typical signs of miscarriage. This type of miscarriage is also known as a silent or early pregnancy loss. It can be especially hard to deal with because there are often no symptoms. A missed miscarriage is usually only found during a routine ultrasound scan.
Recurrent Miscarriage
Recurrent miscarriages are defined as three or more consecutive losses before 20 weeks gestation. Issues with recurrent loss can be caused by a medical condition, hormonal imbalances, autoimmune disorders, infections, chromosomal abnormalities, or uterine problems. If you have experienced recurrent miscarriages, it is important to talk to your doctor. There are some blood tests and other types of tests they can run for recurrent pregnancy loss.
SCH (Subchorionic Hematoma)
This is a common cause of first trimester bleeding. It occurs when there is bleeding between the uterine wall and the gestational sac. It can often resolve on its own. If you experience heavy bleeding or cramping, make sure you contact your health provider to get checked. This type of bleeding can be scary if you do not know what is causing it. There can be certain risk factors making you more at risk to experience an SCH. These include recurrent miscarriages, a malformation of the uterus, or a history of pelvic infections.
Molar Pregnancy
A molar pregnancy is a type of pregnancy where the fertilized egg does not develop properly. This can cause heavy bleeding and abdominal pain in the lower tummy. If you experience these symptoms, it is important to call your doctor right away as this type of pregnancy needs to be monitored closely. Molar pregnancies are a rare condition, occurring in only about one out of every thousand pregnancies. They are more common in women younger than 20 or older than 35.

Second Trimester and Third Trimester Bleeding in Pregnancy
When you think of bleeding during pregnancy, you mostly are thinking of the first trimester and not during later pregnancy. However, there can still be spotting and bleeding during the rest of the pregnancy as well. The second trimester starts at week 14 and lasts until week 28, while the third trimester is all of the remaining time afterwards. This covers the months of pregnancy after the first three months. In the second and third trimester, there can be many causes of bleeding, including placental problems, infection, or other health conditions. If you experience any bleeding or pass a blood clot in the second or third trimester, it is important to call your doctor right away to find out the underlying cause. By checking out your concerns, you can hopefully go on to avoid serious problems and deliver your healthy baby.
Placenta Previa
Placenta previa is a condition where the placenta covers the cervix. It can cause bleeding in the second or third trimester. If you have this condition, it is important to be on bed rest and avoid any activity that could potentially jar or jostle the womb. You will also need to deliver your baby via C-section.
Placenta Accreta
Placenta accreta is a condition where the placenta grows too deeply into the uterine wall. This can be a serious problem that can cause bleeding during pregnancy and heavy bleeding after delivery. If you have this condition, you will need to deliver your baby via C-section. You may even require a blood transfusion afterwards due to blood loss.

Placental Abruption
Placental abruption is a serious condition where the placenta starts to separate from the uterine wall before delivery. An abruption can cause heavy bleeding and is considered a medical emergency. If you experience this, it is important to call your doctor or head to the hospital right away as it can be dangerous for both you and your baby.
Cervical Irritation
This can happen in any of the three trimesters of pregnancy. The cervix is more easily irritated during pregnancy, which can cause some spotting or bleeding. This is usually nothing to worry about and will hopefully resolve on it’s own. Irritation can also occur because of sexual intercourse or even a pelvic exam. The bleeding could range from brownish discharge to bright red blood. Ask your doctor if you need to refrain from any particular activities to help lessen the chance of spotting or bleeding due to irritation.
Preterm Labor
Preterm labor is when contractions start before 37 weeks of pregnancy. This can cause spotting, light bleeding, or even heavy bleeding, as well as other symptoms like abdominal cramps, back pain, and increased pressure in the pelvis. If you experience any of these symptoms, it is a good idea to call your doctor right away as they will need to monitor you closely.

As you can see, there are many different causes of bleeding during pregnancy. While some of them are nothing to worry about, others can be more serious. If you are a pregnant woman, it is always best to err on the side of caution and call your doctor if you experience any type of bleeding or cramping. Do not ever worry about calling too often, that is what the doctors are there for. Whether these are symptoms of a miscarriage, related to other health problems, or something completely normal, the doctor can then help you figure out the cause and hopefully provide reassurance. Worrying about bleeding during pregnancy is no fun, but with the help of your doctor you can hopefully get to the bottom of it and have a healthy pregnancy.
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