Vaginal bleeding is any bleeding from your vagina and is different from your menstruation or period cycle. Menstruation is the monthly loss of unwanted uterine tissues from your body in the form of blood through your vagina (an elastic, muscular canal with a soft, flexible lining, which is a part of the female reproductive tract). 

Vaginal Bleeding During Pregnancy

Vaginal bleeding or spotting during pregnancy is very common and has many causes. Bleeding refers to blood flow that is heavy enough to require wearing a sanitary pad. Spotting usually refers to a few drops of blood that would not cover a pad or panty liner. 

Bleeding in early pregnancy does not signal a major problem. Bleeding later in pregnancy can be more serious.

In this article, we will look at the causes of vaginal bleeding during early pregnancy. Before we look at the reasons, let’s first understand how pregnancy happens.

How Does a Pregnancy Occur?

Pregnancy, also known as gestation, is the time during which one or more offspring (the young ones of living organisms) develops inside your womb or the uterus (a hollow, pear-shaped organ located in your lower abdomen). It usually lasts for about 40 weeks (9 months) and is divided into 3 primary segments or trimesters:

  • 1st trimester: Week 1 to the end of week 12 

  • 2nd trimester: Week 13 to the end of week 26 

  • 3rd trimester: Week 27 till the end of your pregnancy

A pregnancy starts with fertilization, when your egg (primary female gamete), released by the ovaries, joins with a man's sperm (primary male gamete). Fertilization usually takes place in your fallopian tube that links your ovaries to the uterus. If the fertilized egg successfully travels down the fallopian tube and implants in your uterus, an embryo (fetus) starts growing.

Causes of Vaginal Bleeding in Early Pregnancy

As mentioned earlier, light bleeding during the first trimester is common. About 20 percent of women experience it and there is nothing much to worry about. 

However, if your bleeding is heavy, it is important to seek medical help. To be able to do that, you will have to know the causes of vaginal bleeding during your pregnancy, which are as follows:

1. Implantation Bleeding. Bleeding due to the attachment of the newly formed fertilized mass of cells that are destined to form the baby to the womb, is called implantation bleeding. It usually occurs at the time of your monthly expected period. It is normal and does not cause heavy bleeding.

2. Miscarriage. Miscarriage is the spontaneous loss of your fetus before 20 weeks of pregnancy and vaginal bleeding is one of the most common symptom of a miscarriage. 

1 in 5 pregnancies (20%) has the risk of miscarriage in the first three months. Most miscarriages occur as a  cause of chromosomal problems. Chromosomes are tiny thread-like structures that make your body cells. A genetic defect confined to your chromosomes represents the most common cause of miscarriage.

Other causes of miscarriage are increasing age, health problems like poorly controlled diabetes (a chronic condition in which there is excess sugar in your blood), and lifestyle factors like smoking and heavy drinking. 

3. Ectopic Pregnancy. An ectopic pregnancy occurs when the fertilized egg implants outside of your uterus, where the blood supply is inadequate to sustain the growth of a normal pregnancy. Ectopics usually occur in fallopian tubes (also known as uterine tubes, which are a pair of long narrow ducts which connect the ovaries and the uterus). Sometimes these pregnancies can rupture your fallopian tube, leading to significant blood loss.

You may also experience other symptoms like pain in your lower abdomen, pain in the tip of your shoulder, an upset stomach, and severe body pain. 

4. Molar Pregnancy. Molar pregnancy, also known as gestational trophoblastic disease, is an abnormality of fertilization that results in the growth of abnormal tissue within the uterus. It is a very rare condition where your placenta (an organ that develops in your uterus during pregnancy) is abnormal. 

A molar pregnancy cannot result in a normal fetus or delivery and vaginal spotting or bleeding can be a symptom of molar pregnancy.

5. Vaginal Infection. During pregnancy, your body undergoes a lot of hormonal changes and these changes can result in vaginal infections. A vaginal infection (a fungal infection that causes irritation and itchiness of the vagina) may cause spontaneous vaginal bleeding during pregnancy. 

When to Seek Medical Help

While light vaginal bleeding is common, consult your gynaecologist/obstetrician if you have the following symptoms:

  • Heavy bleeding

  • Severe pain not relieved by pain-relieving drugs

  • Smelly vaginal discharge

  • Shivering or flu-like symptoms

  • Feeling faint

  • Pain in your shoulder

On meeting your doctor, he/she will collect details of your symptoms, date of last menstrual period, and your medical history. A vaginal examination will be conducted to see where the bleeding is coming from. A vaginal examination is safe and will not lead to a miscarriage. Depending on your reports, your doctor will advise you further.

To summarize, be careful and watch out for any abnormal or heavy bleeding that you might experience during the early stages of your pregnancy, and consult your gynaecologist/obstetrician immediately. 

Disclaimer: This article is written by the Practitioner for informational and educational purposes only. The content presented on this page should not be considered as a substitute for medical expertise. Please "DO NOT SELF-MEDICATE" and seek professional help regarding any health conditions or concerns. Practo will not be responsible for any act or omission arising from the interpretation of the content present on this page.