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Bleeding in Early Pregnancy

This can be one of the most frightening things for a mom to go through due to the uncertainty of how the baby is doing. Most of the time fortunately, all turns out to be ok.  I’ll explain some of the common causes and what can be done about it.

Bleeding comes from various sources including the chorion (bag of water at implantation), the cervix and the placenta. The first two are common in approximately one in three pregnancies in my experience and do not increase the odds of miscarriage though can be mild spotting to heavy bleeding. The placenta site bleeding is associated with only a mild increased risk but resolves most of the time and rarely causes an issue. The final possibility is an abnormal pregnancy such as a miscarriage or ectopic pregnancy.

If you have had your first ultrasound already then, we have ruled out the possibility of ectopic pregnancy or pregnancy in the tubes. Unfortunately, when faced with heavy bleeding a mom really has no way of knowing for sure of the cause and miscarriage is a real possibility. There to date is nothing in modern medicine to stop a miscarriage that is in progress. Our office knows to make room to get moms experiencing this in to be seen as soon as possible to calm any fears and to get to an answer quickly, good or bad.

Cervical bleeding is probably the most common cause of bleeding during all of pregnancy. This is due to increased blood flow to the cervix and structural changes it undergoes to allow it to dilate later down the road. Spotting can occur randomly though it often can be triggered by intercourse or after an examination in the office. It’s usually light and seen as pink to bright red spotting or streaks on toilet paper. I advise abstinence and decreased straining for 48 hours after this happens as it should resolve. If it resolves, it’s ok to wait till your next regularly scheduled visit. Of course, if you are worried or concerned we will be happy to make room to work you in and check it out.

If bleeding happens after hours there are a few things to look out for that can keep you safe while you wait for the office to open. Our attention is on your health. Remembering that what’s done is done, good or bad, we want to be sure that the bleeding is not too severe. Bleeding less than an amount that saturates a pad every 30 minutes for more than 4 hours is generally safe. More than this, day or night, you likely need to be seen to be sure you have not lost too much blood. If this happens you can call our office number at 936-560-2666 and you will be directed to an on-call nurse who can better help direct, you on what to do. Often, patients are able to wait at home and can show up or call our office when it opens at 8am and be seen right away.

In summary, bleeding is common and is ok most of the time. Keep our office posted and reach out to be seen with any concern. While waiting for an answer, have faith that all is likely ok and, if it turns out not to be, have faith it will all be ok in the long run.

Kyle P McMorries, MD, FACOG


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