Bleeding during pregnancy

Bleeding before 14 weeks

Vaginal bleeding is common in early pregnancy: It occurs in 25 percent of pregnancies during the first trimester.

This type of bleeding is generally light and does not persist or intensify. It doesn’t affect the pregnancy and is not a cause for concern.

It’s often impossible to determine the exact cause of the bleeding. The most common scenarios are the following:

• Bleeding can occur very early in the pregnancy when the embryo implants in the uterus. Known as implantation bleeding, this is perfectly normal and can sometimes be mistaken for a shorter period.
• Light bleeding can also occur after a gynecological exam or sexual intercourse. This is because the cervix becomes highly vascularized, and therefore more fragile, during pregnancy. Once again, light bleeding in these circumstances is nothing to worry about.

When should you consult a doctor if you experience bleeding before 14 weeks?

Contact your health care provider if your bleeding is worrisome or intensifies. They will ask you a few questions and do a physical exam to assess your situation and make the appropriate recommendations. For example, if your blood type is negative (A-, B-, AB-, or O-), you may require an injection of an antibody-containing product called WinRho^®.

Some types of bleeding can signal a miscarriage, a detached placenta, or an ectopic pregnancy. Experts estimate that 50 percent of women who experience vaginal bleeding before 14 weeks will miscarry. That amounts to roughly 1 in 6 pregnancies.

Go to the emergency room immediately if you experience any of the following symptoms:

• Dizziness or fainting
• Fever
• Severe pain on one side of your stomach
• Shoulder pain
• Heavy bleeding for 2 to 3 consecutive hours that soaks two normal pads or one maxi pad in 1 hour

Bleeding after 14 weeks

Vaginal bleeding after the first trimester should be considered a warning sign. If this happens, consult a health care professional.

While it doesn’t always signal an issue with the pregnancy, bleeding at this stage is not normal. It’s important to get a medical evaluation. Your care providers may conduct an ultrasound to determine the cause of the bleeding.

Possible causes include placental abruption, cervical bleeding or dilation, and vaginal trauma. Bleeding from the placenta can lead to complications, which is why it’s crucial to consult a health care professional.

If you’re concerned about your health, call Info-Santé (811) or speak with your health care provider. In case of emergency, go directly to the hospital. If you’re near the end of your pregnancy, you can also contact your hospital’s obstetrics department.

Things to keep in mind

• Light bleeding is common in early pregnancy.
• Go to the emergency room if you experience either heavy bleeding or bleeding accompanied by other symptoms before the 14th week of pregnancy.
• See a health care professional if you experience bleeding after 14 weeks.

Scientific review: Dr. Jean-Philippe Blais, family physician specializing in perinatal care Research and copywriting:The Naître et grandir team Updated: August 2024

Photo: 123rf