Bleeding in early pregnancy is fairly common, affecting about 25% of pregnant women — most of whom go on to deliver perfectly healthy babies.
Most often, bleeding happens when the fertilized egg implants itself in the uterus — known as implantation bleeding — which can produce some spotting for about one or two days.
At the same time, bleeding in early pregnancy can also be a sign of serious complications that should be addressed immediately by a health care provider.
Knowing when to seek medical attention rests on knowing how much bleeding is normal in early pregnancy.
This guide from PregnancyResource.org breaks down what causes early pregnancy bleeding, how much bleeding is considered normal, and when bleeding can be a sign that you should see a doctor.
What Causes Bleeding in Early Pregnancy?
For many women, early pregnancy bleeding happens during implantation, about 10-14 days after conception.
Implantation bleeding happens after a sperm fertilizes an egg, turning it into an embryo. The embryo travels to the uterus and implants itself into the uterine lining.
This process can cause spotting or light bleeding that lasts a couple of days.
Another reason for early pregnancy bleeding is increased cervical blood flow. When you become pregnant, extra blood flows to the cervix, which is the lower part of the uterus.
Having sexual intercourse, getting a pap smear, or doing anything else that prods the cervix can trigger light bleeding.
Similar to implantation bleeding, this isn’t a sign of anything serious and should go away on its own.
How Much Bleeding Is Normal in Early Pregnancy?
There’s a difference between spotting, light bleeding, and heavy bleeding during pregnancy. You should notice only a few drops of blood in your underwear or on tissue paper when you spot.
Likewise, light bleeding should only produce minor stains. If you wear a panty liner, then the bleeding should not be enough to fill it over the course of the day.
Heavy bleeding during pregnancy is anything more than spotting or light bleeding. During pregnancy, needing more than one pantyliner per day is considered heavy bleeding, and can potentially signify something serious.
This is especially the case if you experience symptoms like cramping, nausea, and vomiting. When combined with heavy bleeding, these symptoms can indicate serious pregnancy complications in the first trimester.
In the second and third trimesters, bright red bleeding can be a sign of placenta previa.
This condition can cause bleeding from placenta blood vessels (placental abruption) and even hemorrhage during delivery. However, it occurs in later pregnancy and does not commonly appear before 20 weeks.
The following section will go over the potentially serious conditions that can cause heavy bleeding in the earlier weeks of pregnancy.
What Are Some Potentially Serious Causes of Early Pregnancy Bleeding?
Healthy pregnancies are the norm and serious pregnancy complications are uncommon; according to some estimates, about 7 in 1,000 women experience pregnancy complications.
Here are three serious causes of bleeding in early pregnancy that require urgent medical care:
1. Sexually Transmitted Infection (STI)
An STI such as chlamydia, gonorrhea, or herpes can cause inflammation of the cervix. This can lead to bleeding all on its own or during any activity that involves penetration, such as sexual intercourse.
An STI during pregnancy is serious. When left untreated, some STIs can lead to preterm labor, low birth weight, or even a miscarriage, which is why doctors screen pregnant women for STIs during their prenatal visits.
However, it’s possible to contract an STI at any time during your pregnancy.
If you experience light bleeding in addition to symptoms such as burning during urination, vaginal itching, or unusual vaginal discharge, discuss your concerns with your OBGYN so they can conduct additional STI blood tests or a pelvic exam as needed.
Keep in mind: Some STIs may present no symptoms at all. If you have unprotected sex, it can be beneficial to ask your doctor for an STI test even if you don’t experience any symptoms.
Heavy bleeding is the most common sign of miscarriage and pregnancy loss. It is usually accompanied by symptoms such as blood clots, white-pink discharge, and abdominal cramping.
Classic pregnancy symptoms such as morning sickness will begin to subside right after a miscarriage begins.
Once a miscarriage starts, there’s very little that you can do to stop it. However, it’s still important to see a doctor so they can confirm if you’re actually experiencing a miscarriage as opposed to a treatable pregnancy complication.
Miscarriages affect about 25% of all early pregnancies — the vast majority occurring in the first trimester.
Obstetricians don’t know what exactly makes some women miscarry, but it’s speculated that common causes may include advanced age, unhealthy lifestyle behaviors, and significant emotional stress.
3. Ectopic Pregnancy
An ectopic pregnancy is a rare condition that happens when the embryo doesn’t implant in the uterine lining, but instead in another reproductive organ, most commonly the fallopian tubes.
This condition can cause spotting, and as it progresses, heavier bleeding.
If the embryo is not in the uterus, the pregnancy cannot continue. For this reason, it’s important to see a doctor so they can advise on the next steps.
While an ectopic pregnancy usually resolves on its own, in some cases, the pregnancy may continue to develop outside of the uterus.
Down the line, this can cause the fallopian tubes to rupture, leading to extremely heavy bleeding and severe pain, and can be fatal to the mother.
Ectopic pregnancies can also cause severe pelvic pain that brings pregnant people to the emergency room.
Doctors must terminate an ectopic pregnancy with medication or surgery to prevent life-threatening complications in these cases.
Many women experience light bleeding in early pregnancy and go on to deliver perfectly healthy babies.
However, if your bleeding is enough to fill a panty liner, you should see a doctor right away to ensure your wellness and the baby’s health.
Heavy bleeding can signify a potential complication, such as an STI, miscarriage, or ectopic pregnancy.
For you and your baby’s health, it’s better to be safe and to see a doctor about your symptoms as soon as possible.
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Bridget Reed is a Tampa-based content development manager, writer, and editor at GR0; specializing in content related to varying fields including medicine, health, and small businesses. Bridget went to St. Petersburg College and majored in Management and Organizational Leadership.
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