Vaginal bleeding during pregnancy: When to seek help?

Vaginal bleeding is normal during pregnancy, depending upon the stage at which it occurs. The discharge of blood from the vagina does not always indicate a problem. However, if it persists or seems abnormal, then it could be a sign of concern for the mother and her baby. For instance, up to 25% of pregnant women experience spotting in the early days of pregnancy, which is common. However, when this spotting turns into heavy bleeding, it becomes a major cause of concern and the mother has to see a doctor.

Vaginal bleeding can happen in the first 20 weeks of the pregnancy. There could be serious and non-serious reasons behind that as each woman has a different body and each pregnancy is different depending upon the woman's health. However, continued bleeding throughout the pregnancy is uncommon and the mother has to immediately see her doctor.

During the first trimester

The first trimester occurs from the 1st week and goes on to the completion of the 12th week of the pregnancy. If a woman experience spotting in these early days, then she should make her doctor aware of her condition. Spotting is light bleeding i.e. a few drops of blood that can be seen on the underwear liner. Any vaginal spotting that lasts longer than a day needs the immediate attention of the doctor. Furthermore, if the spotting turns into heavy bleeding that starts to cover the panty liner accompanied by cramping, abdominal pain, fever or chills, it could be a sign of a serious cause of concern and the mother-to-be must seek immediate help from the doctor.

During the second trimester

It is always advisable to seek medical care if the mother experiences heavy bleeding. Vaginal bleeding occurs when the flow of blood is heavier like in normal periods. The bleeding soaks more than one menstrual pad accompanied by abdominal pain and cramping. In addition, if a mother sees clots or tissues in her bleeding, she should immediately see a doctor as it could be a sign of miscarriage that happens in some cases.

There are different types of miscarriages that happen during pregnancy. A miscarriage can be threatening if it does not involve the expulsion of any fetal parts, yet bleeding continues to occur. The other type could be completed miscarriage which involves complete expulsion of the fetal parts while some cases of incomplete miscarriage involve partial expulsion of fetal parts. Therefore, pregnant women experiencing bleeding at any stage or week of the pregnancy must seek a doctor's advice to have a safe or healthy pregnancy.

During the third trimester

The third trimester starts from the 25th week and goes till the delivery i.e. the completion of 37 or 40 weeks. One out of ten women experience vaginal bleeding during the third trimester or late pregnancy. However, it always indicates a serious problem and the women without a delay should seek immediate doctor's attention. Bleeding during late pregnancy occurs when labor begins i.e. the cervix starts to open. It could indicate healthy labor when the bleeding is accompanied by pain and mixed with normal vaginal discharge. If the vaginal bleeding is pink or light red, it indicates impending labor.

Many people make assumptions during pregnancy and especially at the time of vaginal bleeding. They consider each pregnancy is same and can be treated in the same way but that's not true. Vaginal bleeding in the later stage or even in a healthy pregnancy needs medical intervention. Seeing a doctor for vaginal bleeding during the third trimester of the pregnancy could be a sign of emergency delivery or complication as well.

Even a small amount of spotting occurring during pregnancy needs medical intervention. If ignored for a long time, it can be life-threatening for the mother as well as her baby. Therefore, a doctor's intervention at every stage is necessary to avoid serious problems or complications. Even if the vaginal bleeding stops in a day, the mother should update her doctor over the call or during her next prenatal visit. Pregnancy is a lifetime experience for women and it should be cherished with no fear. Thus, medical intervention must be given due importance for preventing the risks associated with the baby and the mother's life.

(The author is a Consultant Obstetrics & Gynecology, Apollo Cradle & Children's Hospital, New Delhi)