Does Early Pregnancy Bleeding Mean a Miscarriage?

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First things first: If you are pregnant and are experiencing vaginal bleeding, take a deep breath. It's scary and worrisome, but vaginal bleeding during pregnancy does not always mean miscarriage -- even if it is red and has clots. Anywhere between 10% and 30% of pregnant women who carry to term (that's 37 weeks of gestation and beyond) remember having some amount of bleeding or spotting at some point in their pregnancy.

Here’s a look at what bleeding or spotting can mean at different points in the pregnancy. Remember that with any case of bleeding or spotting in pregnancy, the best thing to do is to call your doctor for advice.

During the First Trimester

It’s undeniable that bleeding or spotting in the first trimester may mean a miscarriage (a type of pregnancy loss), but it can also signal other issues. About half of women who have first-trimester vaginal bleeding have a miscarriage. That might sound terrifying, but keep in mind: That also means that half of the women who have bleeding don't miscarry.

So if you're not miscarrying, what else could be going on?

Light, brown-tinged spotting can happen after a pelvic exam or sexual intercourse, but this type of spotting should stop within a day or so. Some women also have something called implantation bleeding, which is spotting that occurs in the first month as the lining of the uterus adjusts to the newly implanted pregnancy.

First-trimester vaginal bleeding is more likely to be the result of a miscarriage if it is heavy and red, and if the quantity gets heavier rather than lighter. Still, even heavy bleeding with clots does not automatically mean miscarriage.

During the Second and Third Trimester

In some cases, vaginal bleeding in the second or third trimester is not serious. For instance, light brown spotting could occur for similar reasons as first trimester bleeding (it could be from slight irritation of the cervix after sexual intercourse or from a medical exam). However, vaginal bleeding in the second or third trimester usually means that you need to see a doctor right away, particularly if the bleeding is heavy and red or accompanied by other symptoms (such as abdominal pain or contractions).

Bleeding in the second or third trimester could indicate a serious condition, such as placental abruption or placenta previa.

  • Placental abruption is when all or some of the placenta suddenly separates from the uterus after week 20 of gestation. It's a rare condition, occurring in about one out of every 100 pregnancies, usually in the third trimester, and it can trigger preterm delivery or stillbirth. You may feel contractions and abdominal pain along with the bleeding.
  • Placenta previa is a condition in which the placenta is low-lying and either somewhat or totally covers the cervix. It can cause growth restrictions in the baby and fatal hemorrhaging (blood loss) in the mother, among other complications. A woman who is diagnosed with placenta previa usually has to go on bed rest, often in a hospital. Placenta previa is also rare, occurring in approximately one out of every 200 pregnancies.

In conclusion, vaginal bleeding during pregnancy can have lots of different causes—some serious and some not. Since it's hard to know the difference, always call your doctor immediately for advice when experiencing bleeding at any point during a pregnancy.

View Article Sources
  • A.D.A.M. “Vaginal bleeding in pregnancy.” 23 May 2006. A.D.A.M. Healthcare Center.
  • American Pregnancy Association. “Bleeding During Pregnancy.” Aug 2007.