Bleeding in Pregnancy

Bleeding During the First Trimester
The first trimester is the first 12 weeks of your pregnancy. During this time amazing changes are taking place in your body. This is the period of time that the placenta will make a solid connection to your uterus, the organs will develop in the baby, and you might feel the most sick. This is also the most common time for miscarriages and bleeding.

Not all bleeding occurs because a miscarriage is about to happen. Sometimes you will bleed if you have a vaginal infection. Other times bleeding occurs because you have reached a certain stage in your pregnancy. Examples are implantational bleeding, which occurs when the placenta forms its first attachment with the uterus, or bleeding when the hormones supporting the pregnancy stop coming from the ovary and start coming from the placenta. Implantation bleeding happens around four weeks and hormone bleeding comes at around eight weeks. Usually this is very light spotting or bleeding, and goes away in a few days. Also, this bleeding is rarely associated with really painful cramping.

Unfortunately, about 25% of pregnancies will end during the first trimester, and these are called miscarriages. Miscarriages can occur for a variety of reasons, but usually have nothing to do with your activities or lifestyle choices (such as exercise or what you ate). The most common reason miscarriages occur is because a genetic defect was present in either the egg or the sperm. There was enough correct information to start the pregnancy, but then the genetic code had an error and the pregnancy could not develop any further. Miscarriages will usually begin with moderate bleeding that continues to get heavier and is accompanied by very painful cramping.

Any light spotting and bleeding should be reported during office hours. We will probably order an ultrasound and you may need to come in to get a shot if you have a certain blood type. This is not an emergency and can be taken care of during office hours so please do not call the after-hours physician. Heavier bleeding, especially with cramping, needs to be evaluated on the same day. If heavier bleeding occurs during office hours please call us and our nurse will tell you what to do. If you begin bleeding heavily after office hours, or on the weekend, please go to the emergency room at North Kansas City Hospital for an examination. The physician who sees you in the ER will call us once they have evaluated the bleeding. Again, you do not need to call the after-hours physician, just head to the ER and they will call us after they have seen you.

Many people who experience bleeding during the first trimester go on to have a very healthy pregnancy, so do not lose hope if you begin to bleed. We understand that it is very scary to see bleeding and hope this information will help you to understand some of the reasons it occurs.