Patient education: Bleeding in early pregnancy (The Basics)

Does bleeding mean that I am having a miscarriage? — Not necessarily. Vaginal bleeding during early pregnancy is common. This can be scary. But most of the time, the bleeding stops on its own, and the pregnancy will continue normally.

Sometimes, bleeding does end in miscarriage, also called "pregnancy loss." This is when a pregnancy ends before 20 weeks. (A normal pregnancy lasts about 40 weeks.)

What else can cause bleeding during early pregnancy? — There are other conditions that can cause bleeding from the vagina during the first half of pregnancy. They include:

●Ectopic pregnancy – This is when the pregnancy is located in the wrong place in the body, outside of the uterus. It can cause vaginal bleeding and belly pain, and needs immediate treatment. Ectopic pregnancy is sometimes called a "tubal pregnancy."

●Irritation or injury in the vagina or cervix – Pregnancy can make the cervix more likely to bleed after sex or a routine exam (like a Pap test). Occasionally, a wound, growth, or mass could also cause bleeding.

●Implantation – Some people have a small amount of bleeding when the egg implants into the lining of the uterus.

Should I call my doctor or nurse? — Yes. If you are pregnant and have bleeding from your vagina and/or pain in your belly, call your doctor, nurse, or midwife right away. Bleeding during pregnancy can sometimes be a symptom of an emergency condition such as an ectopic pregnancy.

Will I need tests? — Yes. Your doctor, nurse, or midwife will ask about your symptoms and do an exam. If the pregnancy is far enough along, they will also check for your baby's heartbeat. There are 2 main ways to do this. They can use:

●An imaging test called an ultrasound – An ultrasound uses sound waves to create pictures of the inside of your body and of your baby. This test can show pictures of your baby's heartbeat.

●A device called a "fetal Doppler monitor" – This device is placed on your belly. It uses sound waves to let you hear your baby's heartbeat. This is usually done after 10 to 12 weeks of pregnancy.

Your doctor might also do a test to measure the amount of "hCG" (a pregnancy hormone) in your blood. You might need to have this test again a few days later to see if the level has changed.

How is bleeding in early pregnancy treated? — There is no proven way to treat bleeding during pregnancy, and it usually goes away on its own.

Sometimes, doctors recommend avoiding heavy lifting and not putting anything in the vagina (including having sex). But these treatments have not been shown to help prevent pregnancy loss.

If you have bleeding from your vagina, your doctor will monitor your symptoms until 1 of the following things happen:

●Your bleeding stops, and your doctor has made sure that your pregnancy is growing normally.

●You have a pregnancy loss or another problem with your pregnancy. If this happens, your doctor will talk with you about what to do next.

Could I have done something to cause this? — Probably not. And if your bleeding results in pregnancy loss, do not blame yourself.

Most of the time, when a person has a pregnancy loss, it is not because of anything they did. It's normal to feel sad or upset about it, but there is usually nothing you could have done to prevent it.

If you are struggling or think you might be depressed, tell your doctor or nurse. There are treatments that can help.

More on this topic

Patient education: Pregnancy loss (The Basics)
Patient education: Coping after pregnancy loss (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Ectopic pregnancy (The Basics)

Patient education: Pregnancy loss (Beyond the Basics)
Patient education: Ectopic (tubal) pregnancy (Beyond the Basics)