Bleeding and Spotting In Early Pregnancy: Period or implantation bleeding?

This post is very important to me because bleeding in early pregnancy is not openly discussed and when women bleed they panic and assume the worse. In fact bleeding in early pregnancy is common and is often not a reason to panic.

When you are trying to conceive, you are religiously peeing on pregnancy tests and checking for your period. What if you get a positive pregnancy test, but then start bleeding? What does bleeding in early pregnancy mean? Does bleeding always lead to a miscarriage?

Bleeding is actually surprisingly very common in pregnancy and does not always signal a problem.

If you are bleeding but not sure if you are pregnant, check out my article “Can you Get Your Period and Still be Pregnant?”

What Does Bleeding in Early Pregnancy Mean?

The cause of pregnancy bleeding depends primarily on the timing and quality of the bleeding.

Implantation Bleeding

The first and most common type of bleeding is implantation spotting. This spotting in early pregnancy can occur around the time of your expected period and before you have a positive pregnancy test. The implantation bleeding color is often pink and it should only be a small quantity. You may notice this spotting when you wipe. It is benign and not typically associated with any other symptoms.

Irritation Bleeding

The second kind of bleeding during pregnancy is caused by irritation. This spotting in early pregnancy can occur at any time. When you are pregnant your cervix becomes very sensitive and any irritation can cause bleeding. This occurs most often after having sex or after a pap smear or pelvic exam. If you notice bleeding after sex, abstain from sex until the bleeding has completely resolved.

Subchorionic Hemorrhage

Bleeding in early pregnancy could also be a subchorionic hemorrhage, or subchorionic hematoma. A subchorionic hemorrhage is synonymous with a subchorionic hematoma. It is a collection of blood outside the fetus. With a subchorionic hemorrhage you may experience bleeding similar to that of a menstrual period. The bleeding can be bright red and heavy. Bleeding associated with a subchorionic hemorrhage can be very scary as many women will assume they are miscarrying. It does increase the risk of miscarriage but many women who have subchorionic hematomas in early pregnancy resolve and go on to have healthy pregnancies. Subchorionic hematomas can occur at any point and can take a long time to resolve. However, they are often not associated with any pain or cramping. If you are experiencing menstrual-like bleeding without any cramping, stay positive.

Miscarriage

Unfortunately bleeding could be a sign of a miscarriage. Bleeding associated with miscarriage is heavy, bright red and contains clots. It is associated with severe cramping. Sometimes it can be difficult to discern what is nausea, gas pain and normal uterine stretching from uterine cramping. However, with uterine cramping from a miscarriage the pain will be mostly in your back and will most likely be severe enough to inhibit your daily activities. Mild uterine cramping can be normal in pregnancy.

What Should You Do?

You can always call your provider. Even if you haven’t had your prenatal appointment yet, if you call and say you are bleeding your doctor or midwife should be able to see you. Depending on how far along you are, your provider will most likely do an ultrasound to ensure the baby is ok and then to reassure you.

With almost all types of bleeding there is nothing your provider can do. If you are beginning to miscarry, there is nothing you can do to stop the miscarriage from occurring. So if you are experiencing some bleeding there is no harm in waiting to see if it worsens or improves.

When Is it an Emergency?

The exception to this is if you are light headed, short of breath or losing large quantities of blood (soaking through a pad in an hour). In these cases you need to go to the nearest hospital as soon as possible. You could have something called an ectopic pregnancy. This is where the pregnancy implants outside of the uterus. If your pregnancy has not been confirmed to be in your uterus and you are having severe pain and bleeding, you should see your provider to ensure that the pregnancy has not implanted outside the uterus.

Do You Need to Be on Bedrest?

With bleeding during pregnancy there is no evidence to suggest that bed rest improves the outcomes. Most miscarriages are caused by chromosomal abnormalities and therefore are inevitable and could not be prevented. If you are experiencing early pregnancy spotting or bleeding take it easy. Skip your workout or make it a light day at the gym. Stay hydrated and avoid any vaginal penetration. That includes sex and tampons. Only use pads for pregnancy bleeding.

I would recommend these organic unscented cotton panty liners if you are experiencing any spotting in early pregnancy. It helps to use a liner to protect your clothing and to quantify the amount of bleeding you are experiencing. I found these panty liners to be very comfortable and absorbent.