Seeing red ... There are a number of things that can cause spotting or bleeding in pregnancy.

Seeing red ... There are a number of things that can cause spotting or bleeding in pregnancy.

So you’re pregnant and have noticed a few spots of blood in your undies or the toilet bowl. It’s your nightmare come to life – you must be miscarrying, right? Well, no. It’s actually thought that one out of every three pregnant women experience some bleeding – the majority of which will go on to have healthy babies. Here’s what you need to know about bleeding and spotting in pregnancy.

What is spotting?
Spotting is light bleeding that’s pink or brown in colour, and is different to menstruation blood in both volume and texture. Wearing a maternity liner can help you see how much blood there really is.

Spotting is usually nothing to worry about, but it’s still a good idea to get advice from your doctor or midwife 

Spotting is usually nothing to worry about, and if the blood loss is intermittent and faint it’s not too likely there’s a problem. But it’s still a good idea to get advice from your doctor or midwife, even if it’s just to give you piece of mind.

When should I see a doctor?
Bleeding that’s more concerning is likely to be heavy and dark in colour, and might contain clots or clumps of tissue. This is a good time to wear a maternity liner, (as you shouldn’t use tampons while pregnant as they can increase your chances of infection), to help you see how much blood you’ve lost.

When the amount of blood is the same or more than you’d lose during a period, it’s important to get medical advice. It can help to take your used liners to show the doctor how much blood you’ve lost. If you have cramping as well as bleeding, it’s important you see a doctor or go to hospital as soon as you can.

What causes bleeding?
There are a number of things that can cause spotting or bleeding in pregnancy, including the following.

  • Implantation bleeding occurs in the two weeks after conception, once an egg has been fertilised and is implanted into the uterine wall. The bleeding will be very faint and resemble coloured discharge.
  • Ectopic pregnancy occurs when the fertilised egg is implanted outside the uterus, usually in the fallopian tubes but sometimes in the ovaries, cervix or somewhere else in the pelvis, such as the bowel. The resulting internal bleeding can bring about spotting and cramping. An ultrasound can check for ectopic pregnancy, but if you’ve already had a scan and it was fine, this wasn’t the cause of the bleeding and cramping.
  • Infections such as urinary tract infections, which develop easily during pregnancy, can sometimes lead to blood in the urine from the bladder. Treatment is crucial as urinary tract infections have the potential to turn into a kidney infection, which can lead to premature labour.
  • Minor vaginal tearing during sex can lead to a small amount of blood loss. You might also get cramps after sex, particularly after an orgasm, because hormones are released that cause the uterus to contract.
  • Sub-chorionic hematoma causes bleeding between the placenta and the wall of the uterus, or within the layers of the placenta. It has the potential to lead to miscarriage, and can be detected with an ultrasound.
  • Other medical conditions, such as appendicitis and kidney stones, can lead to bleeding, so don’t always assume miscarriage is the cause. These symptoms may be completely unrelated to the pregnancy, but it’s a good idea to get them treated to avoid any pregnancy complications.