Who hurt you during pregnancy

The 9 most common reasons for bleeding in early pregnancy

Every expectant mother who has experienced this before can empathize with the shock: bleeding during pregnancy is scary. In the morning everything was still good, at noon suddenly there was blood on the paper when going to the toilet. Oh my goodness! Where does this blood come from?

To explain why it can bleed during pregnancy, one has to distinguish between bleeding in early pregnancy and in further pregnancy, i.e. in the 2nd and 3rd trimester.

Light bleeding is common in early pregnancy

Please don't panic first! Spotting in early pregnancy is quite common. About a quarter of all pregnant women suffer from vaginal bleeding early in their pregnancy. In no way does this mean that a miscarriage is inevitable. Around half of all pregnancies that start with light bleeding develop completely unobtrusively and in a healthy manner.

Bleeding in early pregnancy can have many causes. There are several reasons why bleeding can occur in early pregnancy.

1. Nidation bleeding (implantation bleeding)

The implantation of a fertilized egg in the uterus can injure small vessels in this area. This usually happens around the time the women are expecting their menstrual period. It is therefore not uncommon for nidation bleeding to be confused with menstrual bleeding. This bleeding is absolutely harmless and does not pose a risk to pregnancy.

2. Contact bleeding

Slight vaginal bleeding may also occur after a visit to a gynecologist or after intercourse. The examination or the mechanical irritation during sex can tear small blood vessels in the cervix. This is because this is particularly well supplied with blood during pregnancy. This bleeding is not dangerous either.

3. Infections of the vagina or cervix

An infection can also cause bleeding. If this is the case, it is important that it be treated, as infection can endanger the pregnancy as it progresses.

4. Deep placenta

If the placenta, i.e. the placenta, is still very deep at the beginning of pregnancy, that is, close to the inner cervix, this can be noticeable as vaginal bleeding. In this case, the risk of miscarriage is not increased. Usually the placenta pulls up as the uterus grows in the further pregnancy and there are no further complications.

5. Luteum deficiency

A deficiency in the corpus luteum hormone can lead to bleeding and also to the termination of the pregnancy. The corpus luteum hormone prepares the lining of the uterus for the fertilized egg cell to implant. If the amount of this hormone is not sufficient, the lining of the uterus can be shed and the pregnancy can end. It is medically possible to supply the corpus luteum hormone from the outside.

6. Ectopic pregnancy

If the fertilized egg does not lodge in the uterus, but in another place, such as the fallopian tube, this can be noticed by vaginal bleeding. Often this is also associated with abdominal pain. An ectopic pregnancy can be very dangerous for women.

7. Imminent abortion / threatened miscarriage (abortus imminens)

There are several reasons for an impending miscarriage. One of the most common is a hematoma in the uterus, which has formed as a result of implantation. This can cause bleeding from time to time, even multiple times. If the expectant mother spares herself, the chance is very high that the hematoma will disappear over time and the pregnancy will develop further without complications.

8.Missed abortion

If the child's heart has stopped beating, but the cervix is ​​still closed and there is no discharge, this is called “missed abortion”. Often there is slight vaginal spotting. Most of the time, the uterus has to be scraped off here.

9. Abortion / miscarriage (abortus incipiens)

If it bleeds and the cervix has already opened in early pregnancy, one speaks of an abortus incipiens (miscarriage taking place). Here the pregnancy can no longer be saved. Here, too, it is sometimes necessary to scrape the uterus.

If you have a bleeding in early pregnancy: See a doctor immediately

My tip: I recommend all mothers-to-be who bleed in early pregnancy to see their gynecologist. An (ultrasound) examination can rule out dangerous causes, such as an ectopic pregnancy, and take further measures. If there are no serious causes, it is often of great help to pregnant women in this situation that they know: everything is fine with their baby!

Miscarriage in early pregnancy 

One thing is very important to me: even if an abortus incipiens or a missed abortion actually occurs, please do not despair! I know that right now there is little that can comfort you. In most cases it is also not possible to find out the exact cause of the miscarriage. That weighs heavily on many women. I try to comfort my patients with the fact that they did not do anything wrong and that the most common cause of such a severe impairment (e.g. chromosome mismatch) in the baby was that it could not even survive the first trimester of pregnancy and that is why nature decided that an abortion would occur .

Why can bleeding occur in the 2nd and 3rd trimester?

Bleeding in later pregnancy is far less common. And even if there are harmless causes (e.g. contact bleeding after sexual intercourse or announcement of the birth around the calculated due date), they can still indicate a serious problem. Possible causes can be a placenta lying in front of the cervix (placenta previa), premature labor, and a rupture of the uterus (uterine rupture) or a solution of the placenta. This can put mom and baby at risk and therefore any bleeding at this gestational age should be medically clarified immediately.

If you are bleeding, you can always contact your midwife. She can help you in any case. If you don't have a midwife yet, you can also find your midwife using the acute search at Ammely. The nationwide, free platform of the German Midwives Association is now available to you.

Closing word

Dear mother-to-be, as you can see, there can be many different reasons for bleeding during pregnancy, but it does not mean that there is always a serious problem! Dangerous bleeding and emergencies in a later week of pregnancy are rare. If vaginal bleeding occurs during your pregnancy, please have the cause clarified medically. And otherwise: Enjoy your baby bump time and don't worry!

Author info:

Dr. med. Judith Bildau is a specialist in gynecology and obstetrics and lives with her family in Italy. She works as a gynecologist in both Rome and Tuscany and runs the online magazine Mutterkutter as a consulting doctor with three friends.