Bleeding in pregnancy: is it normal? Understand causes and symptoms

During the months of gestation, everything from mother to baby deserves extra attention and care. This phase, despite being full of joys, is also very delicate, as several limitations may arise for the mother.

Medicines and aesthetic treatments are things that get on the list of most attention. It is not any substance or procedure that can be done.

In this phase, the body changes and, at times, it may show symptoms or signs that are common during pregnancy, but can make mothers worried. Vaginal bleeding is among them.

Most of the cases in which the woman notices spots of blood on her panties are not indications of anything very serious. However, it is always a warning sign.

Find out what are the most common causes and when it can be serious.


What can be bleeding in pregnancy?

Vaginal bleeding during pregnancy is common, although it is necessary to contact the doctor who accompanies the patient as soon as possible. Going to the bathroom and finding small bloodstains on your panties is not cause for despair in most cases.

Keeping calm is critical during these situations.

It is believed that, of 5 pregnant women, 1 or 2 suffer from this problem during pregnancy. Notifying the obstetrician, gynecologist or going to the nearest hospital is indicated for the problem to be diagnosed, ensuring the safety of the mother and baby.

The main causes of bleeding during pregnancy can be divided according to the gestational phase – beginning or end.

Common causes of bleeding in early pregnancy

Until the first half of pregnancy, approximately 4 or 5 months, the most common causes of bleeding include nesting , evidence of ectopic pregnancy and abortion.

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When the egg is fertilized and goes to the uterine wall, implantation bleeding can occur, lasting between one and two days. Most of the time, this bleeding occurs before the woman even finds out about the pregnancy.


Bleeding in the first half of pregnancy may indicate that abortion is unavoidable, or else it may be that the pregnancy occurs normally after it has occurred. If abortion is unavoidable, bleeding and severe cramps will occur, but if pregnancy occurs normally, the bleeding will be mild and the cramps will be mild.

Ectopic pregnancy

When ectopic pregnancy happens, the embryo is implanted outside the uterus, usually in the fallopian tube. This type of pregnancy usually brings a lot of pain in the lower abdomen and dizziness .


In some women, hormones cause bleeding at the same time that a woman should menstruate if she was not pregnant. That is why some women find out only long after they are expecting a baby.

Other causes of bleeding in pregnancy

Bleeding can occur at any time during pregnancy. As in the beginning, some are common and do not indicate anything serious, but others are more serious and may pose risks to pregnancy:


After having sexual intercourse during pregnancy, the blood flow to the vagina and cervix is ​​increased and vessels can rupture after the act or after making greater physical effort, without posing a risk to the baby.

Assisted reproduction

Women who needed to undergo assisted reproduction techniques, such as in vitro fertilization , are subject to minor bleeding in early pregnancy, especially when one of the implanted embryos does not become a fetus.

Transvaginal ultrasound or touch exam

After an invasive exam, such as a touch exam or ultrasound, bleeding can occur due to increased blood circulation in the cervix and vagina.

Anticoagulant medications

Women who have a chance of having a miscarriage may be recommended by doctors to use anticoagulant medications. Because of this, small bleeds can appear.

Infection in the vagina or cervix

The doctor should examine the patient and, if there is an infection, prescribe medication to treat the problem.

Fibroids and polyps

Fibroids are benign tumors located inside the uterus, and if the placenta fixates close to one of them, bleeding can occur.

Polyps are lumps that are born in the uterus or cervix and can bleed, but do not cause problems.

Start of labor

If the pregnancy has passed the 37th week, a little blood on the panties may be a sign that the labor has started. There is no need for despair if this occurs, as keeping calm is essential. Going to the hospital quickly should only be done if the bleeding is large.

Molar pregnancy

Abnormal tissue grows inside the uterus, in place of an embryo. This tissue can become cancerous and can spread to other parts of the body. Other symptoms of molar pregnancy, in addition to heavy bleeding, are vomiting, nausea and growth of the uterus in disproportion with the age of the pregnancy.

Placenta prev

The placenta previa occurs in only one in 200 pregnancies and occurs when the placenta develops in the lower part of the uterus, covering the opening part of the cervix. The placenta previa causes painless bleeding and requires immediate medical attention.

Uterine rupture

This type of bleeding only occurs after the second pregnancy, as it is the result of a previous cesarean section having been torn during pregnancy. This rupture in the uterus can become fatal and requires emergency surgery to get the baby out. Sensitivity in the abdomen and pain are common symptoms.

Previous Vasa

This condition is very rare and is characterized by blood vessels in the baby’s placenta, or umbilical cord, that pass through the opening to the birth canal. The vasa previa can be dangerous for the baby, because the vessels can tear causing it to receive almost no oxygen. Excessive bleeding and abnormal fetal heart rate are very common in this condition.

Premature detachment of the placenta

It is a very rare case, it occurs between half and 1% of pregnancies. The placenta detaches from the wall of the uterus before or during labor, causing bleeding. Other symptoms that may arise are: clots of the vagina, back and abdominal pain.

Risk factors

Risk factors are changes that can increase the risk of the problem occurring. In cases of bleeding in pregnancy, they can be:

  • Exposure to teratogens (chemicals, infections, drugs);
  • Patients who have already had an ectopic pregnancy;
  • IUD use when pregnant;
  • Smoking;
  • Pelvic inflammatory disease;
  • Consumption of alcoholic beverages;
  • Anterior pelvic surgery;
  • Abuse of toxic substances and drug addiction.


The main symptom is bleeding that occurs during pregnancy. In addition, symptoms such as fainting, dizziness, fever and chills may occur. Bloody vaginal discharge, severe bleeding with or without pain and cramps may also occur.

Is bleeding with clots during pregnancy normal?

In general, no. But whenever there is talk of bleeding during pregnancy, care must be taken so that the condition does not end up causing a worry, often unnecessary.

The presence of blood clots, in large quantities, can be a sign of miscarriage, that the endometrium is being eliminated.

With any sign of blood, you must report it to the doctor in charge.


Bleeding during pregnancy can be a sign of a problem, so it is very important to see a doctor. When repairing the bleeding, it is important to analyze its characteristics, such as its appearance and quantity.

As long as there is bleeding, sexual intercourse should not occur and the use of tampons should be avoided.

The doctor to be consulted must be the obstetrician or gynecologist. Going to the consultation with the indications mentioned above is essential for the diagnosis to be made more quickly.

Before the diagnosis is given, it is important to inform the doctor if an ultrasound scan has already been done to detect whether the pregnancy is taking place inside the uterus. This makes the diagnosis of ectopic pregnancy almost null.

Performing the cardiac exam and taking the cardiac pressure are standard procedures of the doctor. If the doctor asks for an examination of the abdomen, it is to rule out the possibility that it is just abdominal pain, such as appendicitis.

This procedure can be done until the first trimester of pregnancy, because after this period, the fetal heartbeat can be observed and the uterus can be palpated through the abdomen, ensuring that no abortion has occurred.

During the physical exam, the doctor analyzes the vulvar and anal region, trying to find lesions that may be the cause of the bleeding.

The specular examination is able to diagnose inflammatory processes, polyps, lacerations, tumors and warts . When the vaginal touch is done, the doctor can see if the size of the uterus is in accordance with the time of pregnancy.

Signs of pregnancy outside the uterus can be observed, as well as diagnosing whether the cervix is ​​closed or open.

There is also the transvaginal ultrasound exam, which assesses bleeding in pregnancy. Although it can only be done after 5 weeks of pregnancy, he is able to ensure that it is occurring inside the uterus or outside it, as well as discovering the number of fetuses in the patient and the heart rate present.

Treatment for bleeding in pregnancy

Treatment is done according to the cause of the bleeding. In some cases, there is no specific treatment.

No apparent cause

When the cause of the bleeding is not identified, the patient’s life is not at risk, the clinical examination is normal and the ultrasound confirms the characteristics of the pregnancy.

In addition to giving the characteristics, the doctor can give guidance on the new phase of the pregnant woman and possible symptoms that may arise during pregnancy.

Just as the bleeding arises, it stops spontaneously.

Assisted reproduction

Bleeds that occur due to the implantation of pregnancy in the uterus and those resulting from lesions of the vagina, vulva and cervix do not need treatment, only if the bleeding is severe or if the cause is a tumor in the cervix.

Ectopic pregnancy

Ectopic pregnancy, in most cases, requires emergency surgery. In other cases, treatment can be done with medications or, still, only with clinical observation.

In case of threat of miscarriage, it is necessary to be attentive, as the doctor often recommends only clinical observation. If the pregnancy is between 7 and 11 weeks and the pregnancy occurs in the womb with the baby’s heart rate correct, the chance of something occurring is less than 4%.

If the abortion occurred and there is still residue on the mother’s body, the use of medication or surgical methods may be necessary.


There are several ways to prevent bleeding during pregnancy, they are:

  • Go to appointments regularly;
  • Feed correctly;
  • Do not drink or smoke;
  • Practice low intensity activities;
  • Avoid places that may contain environmental hazards and substances that could harm health;
  • Practice safe sex.

Common questions

Can urinary infection in pregnancy cause bleeding?

It is uncommon, but it can occur. The urinary tract infection normally cause very similar symptoms in pregnant or not.

Therefore, it is common to experience an increased urge to urinate, burning, itching and vaginal burning. But bleeding is a warning sign and, if it occurs, it may indicate a greater impairment of the urinary tract.

Urine with blood in pregnancy

Bloody urine in pregnancy may be related to urinary tract infections. Sometimes, it can also occur due to small bleeds that occur in the vagina due to the sensitivity of the mucosa and mixes with the urine. In all cases, it is necessary to assess the condition, as there is a risk of placental detachment.

Lots of bleeding with cramps during pregnancy: is it serious?

Whenever there are any severe symptoms, whether cramping or bleeding, the doctor must be immediately alerted. The presence of large amounts of blood, large clots, strong cramps and malaise can be a warning sign, such as abortion.

Watching for signs of bleeding and doing prevention correctly can prevent the problem. Make your acquaintances also know about the topic and share this text with them!