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Seeing blood in your knickers when you go to the loo is every pregnant woman’s worst fear. But bleeding when you’re pregnant doesn’t necessarily mean your baby’s in danger. While it’s natural to worry, one in 10 mums-to-be experiences bleeding, and most will go on to have a perfectly healthy baby. However, any bleeding should always be checked out.
In early pregnancy it’s common to have light bleeding or ‘spotting’ caused by fluctuating hormone levels around the time you would’ve had your period. This is sometimes referred to as ‘breakthrough bleeding’ and can last for a few days. The blood is usually dark red or brown and, unless it’s accompanied by pain, is usually nothing to worry abut. But tell your GP or midwife, who may recommend a scan to reassure you.
During the first nine weeks of your pregnancy you may also experience what’s known as ‘implantation bleeding’ This is usually brownish spotting that occurs when the embryo implants in the uterine lining, causing a small amount of the lining to be shed. It should only last for a couple of days but, again visit your GP or midwife if you experience any pain or cramps, as this will need to be checked.
Could I be having a miscarriage?
While bleeding is generally nothing to worry about, one in four pregnancies will end in miscarriage. But remember this is quite uncommon after the third month of pregnancy. The symptoms of miscarriage vary: you might notice spotting on and off for a few weeks, or even no bleeding at all. You could also experience painful abdominal cramps and heavy bleeding or clotting, and you may see brown discharge or other tissue that’s not clearly identifiable. It’s very important to seek medical advice immediately if you’re experiencing any of these symptoms. A scan and internal examination will confirm if you’ve miscarried. If this is the case you can let the process happen naturally, or the ‘products of conception’ will be removed using a process called dilation and curettage (D&C). For a D&C, medical staff will open the cervix of the womb and the tissue will be removed.
Could I have prevented it?
Although losing a baby is devastating, try to remember that it’s very common and is highly unlikely to have been caused by anything you did – or didn’t – do. It’s more likely to be down to random chance than any underlying problem. Having said that, the chances of miscarrying are higher in women who smoke or drink heavily during pregnancy, so it’s important to lead a healthy lifestyle. Most women who miscarry go on to have a successful pregnancy.
Is it normal to bleed after sex?
Sex during pregnancy shouldn’t be harmful to your baby as he’s lying safely in the womb. Occasional movement or orgasms cannot cause him harm, but it’s quite normal to bleed after having sex. Any bleeding you notice after having intercourse could be a sign of cervical erosion – where your cervix is softening and is therefore more fragile than normal – and should always be checked out by your GP or midwife.
A common cause of bleeding in the second and third trimesters is a low-lying placenta. Often diagnosed at an early ultrasound scan, a low-lying placenta occurs when the placenta attaches too low in the womb and partially or completely blocks the cervix. In most cases, the placenta is carried upwards as the womb stretches around the growing baby, so it doesn’t cause a problem. If the placenta continues to lie in the lower part of the womb into the last months of pregnancy, this condition is known as placenta praevia. One in 10 women who has a low-lying placenta will go on to have placenta praevia at term. In this case you will need a caesarean section to deliver your baby.
Placental abruption is when the placenta detaches from the uterus wall early, causing pain and bleeding. It is a common cause of third-trimester bleeding and if you have a small abruption you may be advised to rest in bed. It’s more common in women who have pre-eclampsia or high blood pressure, but if you notice sudden, prolonged pain in your abdomen, you need to call your midwife or hospital immediately. There is no treatment to stop placental abruption and it’s not possible to reattach the placenta, so an early caesarean delivery is performed for most cases.
Bleeding late in your pregnancy could be a show, which is a sign that your baby’s on his way. As your due date approaches, it’s common to notice a few spots of pale pink blood or blood-streaked mucus. This occurs when your cervix begins dilating in preparation for the birth and the mucus plug that seals the womb starts to come away. Having sex can also disturb the mucus plug, as can internal examinations. Let your midwife or doctor know if you notice any light spotting around this time, but it’s nothing to be concerned about and can happen up to a few weeks before you actually go into labour. It might be an idea to get that labour bag packed though, just in case!
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