Bleeding during pregnancy is worrisome no matter when it happens, but it doesn't always mean that you're going to have a miscarriage. If you experience bleeding in the first trimester, Obstetrical Nurse Wanda F Steele
Wanda Steele, RNC

Bleeding during pregnancy is worrisome no matter when it happens, but it doesn't always mean that you're going to have a miscarriage. If you experience bleeding in the first trimester, Obstetrical Nurse Wanda F Steele has some information to help address your concerns.Your question
What causes bleeding during the first trimester? Does it mean I am miscarrying? - Cathy, Bay Village OH

The expert answers
Many pregnant women will have bleeding or spotting during the first twelve weeks of their pregnancy. This does not necessarily mean they are miscarrying.

If you are bleeding, there are several things that may be checked. A pelvic exam may be done to see if the cervix (opening from the vagina into the uterus) has opened or softened. A blood test will check the level of HCG (human chorionic gonadatrophic hormone) and should be repeated several times, because this level should increase as the pregnancy continues. Ultrasound can also be used to look for a fetal heartbeat and also to find the cause of the bleeding. However, all of this testing may NOT find the reason.

As alarming as the bleeding may be, it does not necessarily mean miscarriage. About half of the women who have bleeding in early pregnancy do NOT miscarry. If you have bleeding, low abdominal cramping or pain, or pass any tissue through the vagina, there is a chance of miscarriage. Twenty percent of all pregnancies end in miscarriage during the first 12 weeks.

Many women who have bleeding do not experience the cramping pain and the pregnancy continues. Most miscarriages cannot be prevented, and are seen to be the body's way of dealing with a pregnancy that was not developing normally. This does not necessarily mean that you have a health problem or that you cannot have more children. Two or three miscarriages in a row suggests the need for more tests to be performed to look for a possible cause. And to answer another common question, there is no evidence that physical activity or sex causes miscarriage.



An ectopic pregnancy (pregnancy outside of the uterus, usually in the fallopian tubes) can cause bleeding and cramping in early pregnancy but are much less common than miscarriages. There can be a rupture of the involved fallopian tube which can cause internal bleeding, weakness, fainting and even shock. This is an emergency situation and requires prompt treatment. An ever rarer reason for bleeding in early pregnancy can be a molar pregnancy, which results in the growth of abnormal tissue in the place of the embryo. This requires treatment with special medications and removal of the abnormal tissue.

Many women with bleeding in early pregnancy are found to have minor conditions that require no treatment, whereas in others, it can signify a serious problem. All bleeding needs to be reported to your caregiver. The health of you and your baby may depend on prompt treatment.PregnancyAndBaby.com

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