Bleeding during pregnancy - Early & Late

Many mothers-to-be are concerned about vaginal bleeding during pregnancy. In this article, we look at the different types of bleeding and risk factors.

Bleeding during early pregnancy

Bleeding during pregnancy can of course be scary. Spotty bleeding that occurs in early pregnancy usually happens without affecting the pregnancy or indicating anything wrong with the pregnancy. For example, you may bleed more easily from the vaginal mucosa due to pregnancy hormones and not from the uterus. You may also be bleeding from the rectum if you are constipated.

If you have vaginal bleeding in early pregnancy, this does not mean that it poses an increased risk to the baby that is subsequently born. Bleeding can occur in an otherwise normal pregnancy, but it can also be the beginning of a miscarriage. Bleeding during pregnancy is not due to stress, heavy lifting or excessive exercise.

Bleeding in late pregnancy

Bleeding in late pregnancy can have different causes. It can be completely harmless bleeding from the vaginal mucosa or cervix, but it can also be due to more serious pregnancy-related complications such as

Placenta Previa (present placenta)

In about one percent of pregnancies, the embryo attaches to the lower part of the uterus, and the placenta will therefore exit from there. This is often detected during the routine ultrasound, but the placenta often moves upwards as the uterus grows. Therefore, you will often have an ultrasound later in your pregnancy to see if the position of the placenta would prevent a vaginal delivery. If you have bleeding due to a low placenta, it usually occurs after week 32. The bleeding is usually painless and may come suddenly.

Risk factors:

- Increasing age
- The more children you have given birth to
- Multi-bedded room
- High blood pressure
- Smoking
- Previous caesarean section
- Fibroids or malformations of the uterus

Ablatio placentae (placental ablation)

It is not clear why the placenta detaches. Detachment can be partial or complete and occurs in about 0.5-1% of all pregnancies. It can range from a small amount of bleeding that stops on its own to a complete placental abruption that can be life-threatening for both the fetus and the pregnant woman. You may experience symptoms such as: contractions, abdominal pain, pain when you press your stomach (even between contractions/aches), a tense uterus, possible (!) bleeding.

Risk factors:

- Increasing age
- The more children you have given birth to
- Too much amniotic fluid
- Trauma (e.g. car accident)
- High blood pressure/ocephalus poisoning
- Smoking

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