Bleeding During the First Trimester

I am not a medical professional. The information I share is meant to supplement the information given you by your doctor. If you feel your doctor is not doing enough for you or not willing to listen to your concerns, I strongly encourage you to take what you've learned here and get a second opinion.

I don't want you to have to dig through this page looking for the reason you may be bleeding, so right up front, here are the most common reasons I've found.

The less serious bleeding cases

Sex Your cervix is very sensitive and tender right now. Any contact with it can cause spotting or bleeding.

Internal Exam Again, your cervix may become irritated during the exam. It is not uncommon for women to tell me spotting started within 24 to 48 hours of an exam

Transvaginal Ultrasound Again, your cervix is a bit irritated. And, if you have a tilted uterus, techs tend to really shove everything around in there to get a view. Don't be alarmed if you look a week or two behind or cannot see the baby. This is common with a retroverted uterus. Toward the end of the first trimester, dates will be right on again.

Bowel Movement So many women have told me they've been constipated and really straining. As a result they've noticed spotting or even heavy bleeding during the next day or so.

Progesterone Supplements
Many women have reported harmless spotting or bleeding while taking progesterone supplements.

Implantation
Sometimes spotting or bleeding will occur around the time your period was due. Often women will report it as a light period or spotting.

More serious reasons for bleeding that require care if you are to continue your pregnancy

Infection
Whenever you have any unusual discharge, you should be examined. Bleeding does not always accompany an infection but it is always a possibility. If you have any pain, tenderness, foul-smelling discharge or fever, be seen as soon as possible.

Urinary Tract Infection
UTIs can cause spotting. Be seen right away because an untreated UTI can compromise the pregnancy.

Dehydration
Some women have experienced spotting with dehydration. Sometimes their hCG levels will temporarily plateau or dip but once they are hydrated will jump back up again.

Vanishing Twin
Due to the frequent use of early ultrasound, researchers now know that up to 1 in 10 pregnancies start off with multiples and end up with a single baby. Most often women will not know they have a 'vanishing' twin. They may show signs of miscarriage however. Their hCG levels may plateau or drop, sometimes by quite a bit. Bleeding ranges from spotting to what appears to be an actual miscarriage. I've had women tell me they thought they completely miscarried only to go back a few weeks later and find out there was still a baby.

The more serious reasons for bleeding

Miscarriage
With roughly one in five (or six) pregnancies ending in miscarriage, there is the chance that this is an actual miscarriage. Often this bleeding will be associated with cramping but keep in mind, many women cramp during viable pregnancy as well.

Molar Pregnancy
This is the growth of abnormal tissue. If you have hCG levels that are abnormally high and you are bleeding, your doctor may suspect a molar pregnancy. An ultrasound can catch this fairly early. Rather than a gestational sac, the image will look like a bunch of grapes or have a snowstorm look to it.

Ectopic Pregnancy
If you experience any stabbing pains, whether it be in the lower abdomen, shoulder, neck or chest, even without bleeding be seen.

Research indicates that up to 1 in 3 women will bleed during pregnancy. Of those women who spot and bleed, many continue their pregnancies.

You should always contact your physician if you have had bleeding. Definitely be seen immediately if you show signs of infection, fever, heavy clotting, dizziness, pain whether abdominal or in the chest, shoulder or neck, urination pain, passing of tissue and dehydration. Some physicians are more pessimistic. Please, expect that up front. I cannot tell you how many women have been told to expect a miscarriage (myself included) and have gone on to finish the pregnancy. This is why you need to educate yourself. If you know dehydration is an issue, hydrate yourself. If you've recently had an exam or sex, try not to do anything further to irritate the cervix. If you have an infection, be treated immediately. Sad to say but some doctors will try to do a D&C. Unless there is a serious complication, like molar pregnancy, serious infection or ectopic pregnancy, you can ask to wait. Just take it easy, as much as possible and be seen if you show any of the above signs of complication.

My Own Misdiagnosed Blighted Ovum Story
- After turning down the D&C twice, we found my baby at nearly nine weeks!
My First Misdiagnosed Miscarriage
- During my first pregnancy, we believed I was miscarrying at 12 weeks

A collection of Misdiagnosed Miscarriage stories

Bleeding during the First Trimester

What your Doctor may not know about your pregnancy after IVF

Coping With A Miscarriage

Miscarriage News and Research

hCG levels and Pregnancy FAQ

When You've Been Diagnosed with a Miscarriage

Tilted Uterus and Early Pregnancy

16 Days Past Ovulation (DPO) and hCG levels

Blighted Ovum FAQ

Infant Survival Rates during Pregnancy

Progesterone and Miscarriage

Asherman's Syndrome: Why you may want to rethink your D&C

So You've Been Told You Have A Blighted Ovum

Non-Doubling hCG Levels in the First Trimester Do Not Mean Inevitable Miscarriage!

Can Stress Lead to Miscarriage?

The First Trimester: Enlarged Yolk Sac

Getting a Second Opinion about a Miscarriage Diagnosis

Why You May Want an Ultrasound Right Before Your D&C

Is This Really an Ectopic Pregnancy?
High hCGs and No Baby?

Intravenous Iron Infusion and Me