Bleeding in Early Pregnancy: What to Know

Discovering you’re pregnant is often a moment of immense joy and anticipation. However, if you then experience bleeding in early pregnancy, your heart can sink, and fear may quickly set in. While it’s undoubtedly a frightening experience, it’s also surprisingly common. In fact, as our Superintendent Pharmacist Zeinab Ardeshir explains in her video, around one in four women will experience some form of bleeding during pregnancy. This post, inspired by Zeinab’s expert advice, aims to shed light on what causes bleeding in early pregnancy, what’s normal, and when you should seek urgent medical attention.

Understanding the Causes of Bleeding in Early Pregnancy

While the sight of blood can be alarming, not all instances of bleeding in early pregnancy indicate a serious problem. There are several reasons why light spotting or bleeding might occur, and some are quite harmless.

• Implantation Bleeding: This often happens around 6 to 12 days after ovulation when the fertilised embryo attaches itself to the uterine wall. It’s usually light pink to dark brown or rust-coloured spotting and can last from a few hours to a couple of days. Some women also experience mild cramping, fatigue, or nausea during this time.
• Increased Blood Flow to the Cervix: During pregnancy, there’s a significant increase in blood flow to the cervix. This can make the cervix more sensitive and prone to light bleeding or spotting, especially after sex or a vaginal examination.
• Infections: Sometimes, infections in the vagina or cervix can lead to light bleeding. These are usually manageable with appropriate medical treatment.

More Serious Reasons for Bleeding in Early Pregnancy

While some causes are benign, it’s crucial to be aware of the more serious reasons for bleeding in early pregnancy that require immediate medical attention. These include miscarriage and ectopic pregnancy.

Miscarriage

A miscarriage is the spontaneous loss of a pregnancy before the 24th week. It’s a common and heartbreaking experience, affecting about one in eight women during pregnancy. The vast majority of miscarriages (over 90%) occur due to a chromosomal dysfunction in the baby. This means the baby isn’t developing as it should, and the body naturally stops the pregnancy. It’s important to understand that a miscarriage is almost never your fault. No amount of heavy lifting, stress, or specific foods can cause it. Your body is naturally responding to a non-viable pregnancy. Most miscarriages are one-off events, and experiencing one doesn’t mean you won’t have a successful pregnancy in the future.

Pharmacist Zeinab shared her personal experience: “I had two successful pregnancies and two healthy, beautiful babies. My third pregnancy ended up as a miscarriage. The biggest thing for me, on top of the loss, was the surprise that this is so common. There’s nothing that I could have done. And I think this is really important to repeat and reiterate. A lot of us feel this loss, and we feel guilty about it. But there genuinely isn’t anything that you could have done to stop this.”

Ectopic Pregnancy

An ectopic pregnancy occurs when a fertilised egg implants and grows outside the uterus, most commonly in a fallopian tube. This is a serious condition that requires urgent treatment, although it is rare, affecting only about one in 90 pregnancies. Unlike a typical pregnancy where the embryo implants in the uterus, an ectopic pregnancy cannot develop normally and can cause serious internal bleeding if the fallopian tube ruptures.

Signs of an ectopic pregnancy can include:

• Vaginal bleeding: This can vary in amount and colour.
• Sharp pain: Often felt on one side of your tummy.
• Shoulder tip pain: This is a distinct symptom caused by internal bleeding irritating the diaphragm, which shares nerve pathways with the shoulder.
• Dizziness or fainting: Due to blood loss.

If you experience any of these symptoms, it’s crucial to seek immediate medical attention. Treatment for an ectopic pregnancy may involve medication to terminate the pregnancy or surgery. While it’s a serious condition, most women who experience an ectopic pregnancy can go on to have successful pregnancies, even if they’ve had one fallopian tube removed.

When to Seek Help for Bleeding in Early Pregnancy

Any instance of bleeding in early pregnancy should be reported to your midwife or GP. When you seek medical advice, they will ask you several questions to help assess the situation:

• Amount of bleeding: Was it light spotting, or was it heavier, like a period? They might ask for comparisons, such as the size of a penny or a 50p coin.
• Colour of the bleeding: Was it brown, bright red, or something else?
• Frequency: How often have you experienced the bleeding?
• Accompanying symptoms: Are you experiencing any pain, dizziness, or other unusual symptoms?

Depending on your symptoms, your healthcare provider may recommend several tests:

• Blood tests: To check your human chorionic gonadotropin (hCG) levels. This pregnancy hormone rises significantly in early pregnancy. If levels drop or don’t rise as expected over 48 hours, it can indicate a problem with the pregnancy.
• Urine tests: To check for infections that might be causing the bleeding.
• Scans: An ultrasound scan can help determine the cause of bleeding. If it’s very early in the pregnancy (before week 8), a transvaginal scan might be performed for a clearer view. While it can be a little uncomfortable, it’s the best way to understand what’s happening.

Urgent symptoms to watch out for:

If you experience any of the following, seek emergency medical services straight away:

• Heavy bleeding (soaking through a pad every hour).
• Feeling dizzy or faint.
• Severe abdominal pain or shoulder tip pain.

Support After Experiencing Bleeding in Early Pregnancy

Navigating bleeding in early pregnancy, especially if it leads to a miscarriage or ectopic pregnancy, can be emotionally challenging. It’s crucial to remember that you are not alone, and there is a vast amount of support available.

Reach out to your healthcare professionals, including your midwife, GP, and the gynaecology team. They are experienced and can provide both medical care and emotional support. There are also fantastic support groups available, where you can connect with others who have experienced similar situations. Sharing your experience and finding the right support can help you process your emotions and reduce feelings of isolation or guilt. For more information on women’s health, visit our women’s health hub, or for support with mental well-being, explore our resources on mental health.

Disclaimer: This blog post is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before making changes to your health routine.