Bleeding during pregnancy

It is not normal to bleed during pregnancy. Pregnancy has three trimesters, and bleeding can occur in any one of them. Bleeding is more common in the first trimester and more dangerous later in the pregnancy.

Depending on the trimester, an infection, hormone changes, sexual activity, or even implantation of the egg can result in a bleeding episode. It can also indicate more serious issues like a miscarriage or an imminent spontaneous abortion.

Bleeding can be light or heavy, but the severity of the bleeding may not always indicate the seriousness of the issue. Each time you bleed, whether it is light or heavy bleeding, you should contact your healthcare provider to inform them.

In the first trimester, bleeding can be the result of;

• Implantation bleeding that occurs a few hours to a few days after the attachment of the egg to the womb. This is usually light and harmless.
• Bleeding can occur when there is an infection to the cervix, uterine lining or the vagina itself (which make up the birth canal).
• High levels of hormones may affect the linings of the birth canal and cause bleeding.
• Having sex during this period can cause spotting.
• A miscarriage, where you lose the baby before the end of the 12th week of pregnancy, can be the cause of bleeding and lower back pain.
• Pregnancy outside the womb, a condition whereby the fertilised egg is implanted outside the womb, can be a threat to the mother's life.

In the second and third trimesters, bleeding is a sign of a serious disorder. Bleeding can be caused by:

• Premature labour, when you experience contractions before the 37th week of pregnancy.
• Having the birth canal open before the expected delivery date can cause bleeding.
• A blocked birth canal.
• When the placenta detaches from the wall of the womb before delivery causes severe bleeding and can lead to the death of the foetus.
• When placenta is too deeply embedded in the wall of the womb it can cause light bleeding during pregnancy.

If you experience any of the following, you should see your healthcare provider as soon as possible:

• Light or heavy bleeding.
• Discharge with clots or tissue.
• Severe pain.
• Intense cramping.
• Severe nausea.
• Dizziness or fainting.
• Chills.
• Fever of 38°C or higher.

Bleeding during pregnancy cannot be prevented.

What can you do in the meantime?

• Get plenty of rest. Resting does not sort out the problem but reduces your oxygen and nutrient requirements so that your baby gets enough.
• Avoid having sex while bleeding. The reduced movement can reduce bleeding severity.
• Drink a lot of water and eat a healthy diet.
• Don't use medicines that your healthcare provider has not recommended.

What will your healthcare provider recommend?

• Medical management usually depends on the cause of the bleeding. Your healthcare provider will usually examine you and your baby to determine the cause. Tests, such as ultrasound scans, can be used to aid the decision by your healthcare provider about treatment.
• Your healthcare provider may recommend a mild pain reliever to reduce discomfort.
• After determining the cause and the risk to you and your baby, the healthcare provider may recommend watchful waiting, treatment or surgery.

Bleeding during pregnancy can be scary. It isn't always a sign something serious. However, it is important to take bleeding during pregnancy seriously. By understanding the most common causes of bleeding during pregnancy, you'll know when to contact your healthcare provider. If bleeding comes with pain and serious discomfort, seek medical attention immediately.

Your healthcare provider may recommend bed rest, this usually means spending most of your day in bed with minimal activity. You can walk around or sit up in bed for short periods of time during your prescribed bed rest. Your healthcare provider will recommend the amount of activity that you are allowed.