Bleeding During the First Trimester—Don't Panic!
Many Women Bleed During Pregnancy!
As a result of my two misdiagnosed miscarriages, I've done a lot of research about potential pregnancy complications. I now run a website about misdiagnosed miscarriages, and I frequently hear from women who want to know if their bleeding or spotting means that their pregnancy is doomed.
I personally experienced bleeding and spotting during my own pregnancies, so I very much understand the uncertainty, fear, and confusion that arises with these episodes.
Unfortunately, some doctors do not tell women much about what might cause the bleeding, and some even lead women to believe that they are miscarrying—even when they are not.
I'd like to share with you what I've learned about bleeding in the first trimester—and why, for many women, there is still hope for a viable pregnancy.
Why You May Be Bleeding
Let's just get down to the nitty-gritty here. I don't want you to have to dig through this article looking for the reason you may be bleeding. Here are the most common reasons I've found.
Less Serious Reasons You May Be Bleeding
- Sex - Your cervix is very sensitive and tender right now. Any contact can cause spotting or bleeding.
- Internal Exam - Again, your cervix may become irritated during the exam. It is not uncommon for women to tell me that spotting began within 24-48 hours of an exam.
- Transvaginal Ultrasound - Again, your cervix is a bit irritated. Particularly if you have a tilted uterus, techs tend to really shove everything around in there to get a good view. Don't be alarmed if you look a week or two behind, or if the tech cannot see the baby. This is common with a retroverted uterus. Toward the end of the first trimester, the dates will be on track again.
- Bowel Movement - So many women have told me they've been constipated and really straining. As a result, they've noticed spotting or even heavy bleeding during the following day or so.
- Progesterone Supplements - Many women have reported harmless spotting or bleeding while taking supplements.
- Implantation - Sometimes spotting or bleeding will occur around the time your period was due. Often, women will report it as a light period or spotting.
More Serious Reasons You May Be Bleeding (Care Required)
- Infection - Whenever you have any unusual discharge, you should be examined. Bleeding does not always accompany an infection, but it is always a possibility. If you have any pain, tenderness, foul-smelling discharge, or fever, go to your doctor as soon as possible.
- Urinary Tract Infection - UTIs can cause spotting. Visit your doctor right away; an untreated UTI can compromise the pregnancy.
- Dehydration - Some women have experienced spotting as a result of dehydration. Sometimes their hCG levels will temporarily plateau or dip—but once they are hydrated their hCG levels will jump back up again.
- Vanishing Twin - Due to the frequent use of early ultrasound, researchers now know that up to 1 in 10 pregnancies start off with multiples but end up with a single baby. Most often, women will not ever know they have a "vanishing" twin. They may show signs of miscarriage, however. Their hCG levels may plateau or drop, sometimes by quite a bit. Bleeding ranges from spotting to what appears to be an actual miscarriage. I've had women tell me they thought they completely miscarried—only to return to their doctor a few weeks later and find out there was still a baby.
Most Serious Reasons You May Be Bleeding (Care Required)
- Miscarriage - With roughly one in five (or six) pregnancies ending in miscarriage, there is the chance that bleeding may indicate an actual miscarriage. Often the bleeding will be associated with cramping, but keep in mind that many women cramp during viable pregnancies, as well.
- Molar Pregnancy - This is the growth of abnormal tissue. If you have hCG levels that are abnormally high and you are bleeding, your doctor may suspect a molar pregnancy. An ultrasound can catch this fairly early. Rather than a gestational sac, the image will look like a bunch of grapes or have a snowstorm look to it.
- Ectopic Pregnancy - If you experience any stabbing pains, whether it be in the lower abdomen, shoulder, neck, or chest—even if there is no bleeding—you need to be seen by a doctor right away.
Bleeding Is Common During the First Trimester
Research indicates that up to 1 in 3 women will bleed at some point during their pregnancy. Of the women who spot and bleed, many continue their pregnancies.
You should always contact your physician if you have had bleeding.
You must see your doctor immediately if you show any signs of infection, fever, heavy clotting, dizziness, pain (whether abdominal or in the chest, shoulder, or neck), urination pain, passing of tissue, and/or dehydration.
Some physicians are more pessimistic. Please, expect that up front. I cannot tell you how many women have been told by their doctor to expect a miscarriage—myself included—but have then gone on to carry the pregnancy to term.
This is why you need to educate yourself. If you know dehydration is an issue, hydrate yourself. If you've recently had an exam or sex, try not to do anything to further irritate the cervix. If you have an infection, be treated immediately.
It is sad to say, but some doctors will quickly, and I would say prematurely, recommend a D&C. Unless there is a serious complication, like molar pregnancy, serious infection, or ectopic pregnancy, you can ask to wait before doing this procedure. Just take it easy, as much as possible, and make sure you see your doctor if you show any sign of the complications mentioned above.
Do you know anybody who bled during the first trimester and continued their pregnancy?
Important New Guidelines for Diagnosing a Miscarriage
The UK is the first country to acknowledge that misdiagnosed miscarriages are indeed a problem. The Royal College of Obstetricians and Gynaecologists has revised its guidelines. If your gestational sac is more than 25mm and/or the CRL is 7mm or more, you should wait a week to verify (if there are no complications). If the measurements are less, you are too early to diagnose. For more information (and something to take to your doctor), please see my article: New Blighted Ovum Guidelines! You ARE Being Diagnosed Too Soon! I believe every woman deserves to have no doubt before having her pregnancy ended.
Please note: I am not a medical professional. This information is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you, or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.
WebMD has a very useful background article about the first trimester, including what to expect and possible problems.
I'd love to hear your thoughts. If you have questions or suggestions for how to improve this article to make it more helpful for women, please comment below.