Bleeding During Pregnancy – What‘s Normal?

Last Updated June 2023 | This article was created by editorial staff and reviewed by Kyle Bradford Jones, MD, FAAFP

Light amounts of vaginal bleeding early in your pregnancy can occur. In most cases, it’s not serious. It can happen in the first 20 weeks for different reasons. It can be the result of something serious or non-serious. Continued bleeding throughout the pregnancy is not common. Call your doctor immediately if you are bleeding heavily. Go to the emergency room if you have severe pain.

Path to improved health

Vaginal bleeding can happen from conception to delivery. Spotting is a type of light bleeding. You may see just a few drops of blood in your underwear. Heavy bleeding is more noticeable. It will require a sanitary pad to protect your clothing.

Call your doctor whenever you experience bleeding of any kind. Call your doctor if you have vaginal bleeding or spotting. This is important even if an ultrasound test confirms your pregnancy is normal. An ultrasound is where a technician moves a wand around your stomach to see an image of the baby.

Non-serious reasons for bleeding early in your pregnancy can include:

  • Implantation (as the egg settles into your uterus the first 6-12 days)
  • Sex
  • Infection
  • Hormones.

More serious causes of vaginal bleeding during the early part of pregnancy can include:

  • An ectopic pregnancy (a pregnancy that starts outside the uterus and will not survive but can be life threatening).
  • A miscarriage (losing the baby early in a pregnancy).
  • A molar pregnancy (a fertilized egg that implants in the uterus that does not live).

In later pregnancy, the following serious medical conditions can cause vaginal bleeding:

  • Placental abruption (the placenta detaches from the wall of the uterus before birth).
  • Placenta previa (the placenta is lying too low in the uterus and nearly covers the cervix).
  • Placenta accreta (when the placenta invades the uterus and doesn’t separate from the uterine wall).
  • Preterm labor (labor that starts before completing 37 of 40 weeks of pregnancy).

Bleeding may be just one sign of preterm labor. Preterm labor also can include vaginal discharge, pressure in your pelvis or abdomen (lower stomach), a dull backache, cramps, contractions, and your water breaking.

If you are bleeding early in your pregnancy, your doctor will want to know how long and how much. If you have cramps and pain early in the pregnancy, he or she will order tests. This may include an ultrasound, blood, and urine tests.

If continued bleeding is not serious, your doctor may treat it by recommending that you rest, relax, stay off your feet, and not have sex. Keep your body healthy. Take a prenatal vitamin with folic acid daily while pregnant. Take it earlier if you plan to get pregnant. Avoid smoking, drinking alcohol, and taking illegal drugs. Talk to your doctor before taking prescription medicine. When you are pregnant, you should never douche (use vaginal cleansing products) or use tampons. Serious bleeding may need to be treated with a long-term bed rest, hospitalization, or surgery.

You cannot prevent a miscarriage after it has started. The exact cause is usually unknown. It’s rarely something the mother did wrong. Most women can have healthy pregnancies in the future. If you have lost more than 3 pregnancies, talk to your doctor.

Things to consider

If you experience bleeding or spotting at any time during your pregnancy, your doctor will want to collect as much information as possible. That will include:

  • How far along is your pregnancy?
  • Have you had bleeding at any other time during your pregnancy?
  • When did the bleeding start?
  • Is the bleeding heavy or spotting?
  • Does it start and stop?
  • How much blood is there?
  • What color is the blood (bright red or dark brown)?
  • Does the blood have an odor?
  • Do you have cramps or pain?
  • Do you feel weak, tired, faint, or dizzy?
  • Have you experienced vomiting, nausea, or diarrhea?
  • Do you have a fever?
  • Were you recently injured (such as a fall or car accident)?
  • Have you engaged in any physical activity?
  • Are you under extra stress?
  • When did you last have sex? Did you bleed afterward?
  • Do you have a bleeding disorder? Women with bleeding disorders are at risk of complications during and after pregnancy. This includes iron-deficiency anemia, bleeding during pregnancy, and serious bleeding after delivery (postpartum hemorrhage). Talk to your doctor before getting pregnant if you have a bleeding disorder. Also, bleeding disorders are genetic.
  • What is your blood type? If your blood type is Rh negative, you will need treatment with a medicine called Rho(D) immune globulin. This prevents complications with future pregnancies.

Vaginal bleeding is usually blood without clots or tissue. If you see something other than blood, call your doctor immediately. Try to collect the discharge in a container and bring it with you when you see your doctor. It may mean you have miscarried. If that is the case, your doctor will provide additional care. If not all the tissue from the miscarriage has passed, your doctor may need to perform a procedure. This procedure is called a dilation and curettage (D and C). It involves opening (dilating) the cervix. Your doctor will gently suction out the remaining tissue from the miscarriage.

Questions to ask your doctor

  • Can certain foods (such as spicy foods) cause bleeding?
  • Is it best to avoid having sex throughout your entire pregnancy?
  • Is spotting during later pregnancy normal?
  • Is my life at risk?
  • I feel sad. Is there someone I could talk to about my feelings? Is there a support group?


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