Bleeding During Pregnancy: Causes and Symptoms in Each Trimester

Changes in your body during pregnancy are the modes and methods in which your baby tries to communicate with you. Throughout the course of pregnancy, abnormal bleeding can occur and the reasons or causes for the abnormal bleeding can differ depending on the time period in which it occurs. Apart from your period, what other kinds of bleeding are there and when is the bleeding considered “abnormal”? As pregnancy is divided into 3 trimesters, let’s look at the types of abnormal bleeding in each trimester, as well as the different possible types of causes of the bleeding.

Bleeding during early pregnancy 

woman abdominal pain

In the first trimester of pregnancy, it isn’t an uncommon sight to see slight bleeding or have abdominal cramps. Many moms miss out on the early signs of pregnancy and they mistake the spotting or light bleeding around the date of the expected start of their period for their period. The spotting is “implantation bleeding”, blood that comes out as a result of implantation. This is a physiological phenomenon that is caused by the changes in the levels of hormones, so there is no need for you to worry.

What, then, is “abnormal bleeding”? Abnormal bleeding in the first three months can be a sign of either a molar pregnancy, an ectopic pregnancy or a threatened abortion.

A molar pregnancy, also known as a hydatidiform mole, is the cause of abnormal vaginal bleeding in the first three months of pregnancy. A molar pregnancy refers to the condition in which villi that normally would have grown into the placenta swells up with fluid. This aberrant growth of the villi into a grapelike mass of cells might not only cause bleeding, it might also be accompanied by strong lower abdominal cramps as well.

Bleeding can also be an indication that an ectopic pregnancy or a threatened abortion has taken place. An ectopic pregnancy refers to the state in which the embryo is implanted outside of the womb while a threatened abortion refers to a potential miscarriage that occurs in the first 20 weeks of pregnancy, and which may or may not be accompanied by bleeding. Both can be determined via checkups with your practitioner, so make sure you get yourself checked! When you have really bad abdominal cramps, try to head down to your practitioner’s straightaway!

Bleeding during pregnancy: Second trimester

woman bed

The possible causes of bleeding in the second trimester (Week 14 onward) are as follows:

  • A threatened abortion – bleeding with or without cramp-like pains that may be followed by the expulsion of the fetus during the first 20 weeks of pregnancy

  • A preterm labor – contractions of the uterus leading to birth before Week 37

  • Placenta previa – placenta covers part or the whole of the cervix

  • Cervical insufficiency – inability of cervix to retain pregnancy, opens too early

  • Placental abruption – premature separation of placenta from uterus

  • Late miscarriage – miscarriage taking place between Week 14 and Week 24

Cervical insufficiency, or cervical incompetence, refers to the cervix opening too early and causing labor to start before the baby is actually ready to be delivered. In most cases, there aren’t any detectable signs like lower abdominal pains or bleeding. An incompetent cervix can take place in the period between Week 16 to Week 27, but it is especially common in the days just before, during, and after Week 20. There are rare cases where abnormal bleeding is detected and check-ups and ultrasound scans are done, but in a first-time pregnancy, practitioners are sometimes unable to accurately diagnose cervical insufficiency.

Bleeding during pregnancy: Third trimester

pregnant woman research

In the third trimester of pregnancy, bleeding can be a result of the following:

  • A preterm labor
  • Preterm birth

  • Placenta previa

  • Placental abruption

Preterm birth is preceded by preterm labor. Preterm labor refers to the frequent and strong contractions in your belly, and this can lead to preterm birth. If you have these signs of a preterm labor, first rest until the contractions go away, but if the contractions continue and there is bleeding, calm down and go to your practitioner’s right away. With early intervention, there is a possibility of being able to prolong pregnancy and delay labor and preterm delivery.

The ideal period in which Baby should be delivered is anytime from Week 37 onward, as pregnancy enters its “term”. Some pregnant moms might see the bloody show – mucous discharge tinged with blood a few days before delivery. The bloody show is thick and gooey, can be pinkish or blood-red in color, and indicates that you’ll go into labor soon. Although the bloody show is a normal sign that precedes labor, if you have abdominal pains, and the discharge is not mucous and flows out steadily without signs of cessation, please go to your practitioner’s.

Bleeding during pregnancy: No to self-diagnosis

pregnant woman doctor hospital

You might be feeling a little worried about the numerous possible reasons underlying abnormal bleeding during pregnancy, but now that you have the information at the back of your hand, it’s not as worrying, isn’t it? If you see blood and it doesn’t seem right, first calm down and then do what you have to do – go to the hospital. You might be worried that you’re making a mountain out of a molehill, but don’t wait until you’re certain it’s a problem because it might be too late by then. Trust your gut instincts and if you feel that something is wrong, don’t tarry and go to your practitioner’s to get professional, medical advice as soon as possible.