3 Times Bleeding During Pregnancy Could Signal A Problem
Spotting—as in, bleeding from your vagina when you’re not supposed to be on your period—can be perplexing under any circumstances. The phenomenon can occur for normal reasons, like that you started a new birth control and your body is adjusting to the hormones. But when you’re pregnant, spotting can take on an entirely new, much more nerve-racking meaning. Even though it’s easier said than done, there’s no need to automatically panic because you notice a little spotting while pregnant—it can actually be a completely standard part of the pregnancy experience.
“You can have spotting throughout your whole pregnancy, and it can be considered normal,” says Sherry Ross, M.D., an ob/gyn and women’s health expert at Providence Saint John’s Health Center in Santa Monica, California. There can be various causes. First and foremost, pregnancy creates more blood flow than usual to the uterus, vagina, and cervix, Jamil Abdur-Rahman, M.D., board-certified ob/gyn and chairman of obstetrics and gynecology at Vista East Medical Center in Waukegan, Illinois, tells. That blood can seep out after sex or other physical activity, or even for seemingly no reason, he explains.
You may also experience implantation bleeding, which occurs after the embryo has implanted in the uterus, Abdur-Rahman and Ross say, or subchorionic hematoma or hemorrhage, which occurs when blood collects between the chorion, or outermost membrane around the embryo, and the uterine wall, Jacques Moritz, M.D., an ob/gyn at NewYork-Presbyterian and Weill Cornell Medicine, told us in a previous article. Those are all pretty normal reasons for spotting during pregnancy and aren’t really worrisome (although subchorionic hematoma can increase the risk of miscarriage a bit depending on specifics).
With that said, spotting can be a sign of miscarriage or ectopic pregnancy, which happens when a fertilized egg implants in a fallopian tube instead of the uterus, says Abdur-Rahman. It can also be a sign of preterm labor or infection, he explains. Although those are all the less likely reasons behind pregnancy spotting—chances are it’s nothing to freak out about—it’s good to know the following signs that your spotting might be cluing you into something up with your pregnancy.
- The bleeding is pretty heavy. “If it’s not menstrual-like or heavier, it’s probably nothing to be concerned about,” says Abdur-Rahman. It’s hard to quantify exactly what to look for, but Ross says if you’re soaking through less than one pad or tampon in three hours, that’s considered mild bleeding and is likely NBD. If it’s more than one pad or tampon in three hours, that’s moderate. Anything more than that is heavy bleeding, and both moderate and heavy bleeding can be a “cause for concern,” she explains.
- It’s accompanied by intense pain. Cramps often accompany spotting, so you might feel some twinges of discomfort here or there. But anything that morphs into more significant pain is worth noting. “Mild cramping can be considered normal, but if you have to sit down or put a hot water bottle on your lower back or it’s anything more than a little cramping, it’s more of a cause for concern,” says Ross. Abdur-Rahman agrees, saying a lot of pain with spotting is one key sign there may be a problem.
- And in conjunction with the heavy bleeding and a lot of pain, you are spotting for several days (or weeks) straight. But if you’re only noticing light bleeding every once in a while, you’re likely in the clear, says Abdur-Rahman. “As a general rule, if there’s no pain, it’s not persistent, and it’s not heavy, it’s probably nothing to be concerned about,” he explains.
With all of that said, both doctors emphasize that you should feel free to call your healthcare provider or go in for an appointment even if your spotting doesn’t seem severe. “I tell people, just to be on the safe side, call or come in,” says Abdur-Rahman. Ross agrees. “The word ‘spotting’ is so different for everybody, so I think any kind of bleeding—even if it’s light—is worth a phone call to the doctor’s office,” she says. “Does it have to happen at 3:00 A.M.? No, not if there aren’t any other symptoms. But it never hurts to call just for reassurance—that’s what doctors are for.”