Q: “I am about six weeks pregnant. This morning, I lost a few spots of red blood. I don’t have any pain, but I can’t help feeling worried. What may be happening?”
A: Many women experience bleeding in early pregnancy and it does not necessarily indicate that anything is wrong. In fact, out of every 10 women who have bleeding in the first 12 weeks, only one woman will actually miscarry.
Some women lose a little blood around the time of their missed periods. This is called “decidual bleeding”, since it comes from the lining of the uterus not yet involved in the pregnancy. It is generally much lighter than a period, and usually stops after the first 2-3 months.
Other women notice a little fresh bleeding after intercourse. This may be from a cervical “ectropion” (or “erosion”). An ectropion is a small area of moist, soft cells on the cervix. Many women have a small ectropion, often without knowing about it. The hormonal changes of pregnancy (and at other times), causes the ectropion to become more friable and vascular (rich in blood). As a result, it may bleed when touched. Your doctor will be able to tell if you have an ectropion by just looking at your cervix.
Often, we have no idea why there is bleeding in the early weeks. But, as I said earlier, it does not necessarily mean that there is a problem.
Sometimes, of course, bleeding is the first sign of a miscarriage. Experts reckon that at least 15% of pregnancies end in a miscarriage. It seems to be nature’s way of ensuring that each baby born has the best possible start in life.
A miscarriage is almost never caused by anything that you did – or did not – do.
Contrary to what most people think, there are no links between sensible exercise and
activity (including sexual intercourse) and the loss of a healthy pregnancy. (Having said
this, most women who experience bleeding feel instinctively that they want to take things
easy at home until the bleeding has stopped.)
If you are Rhesus negative, do tell your doctor or midwife about the bleeding today. An injection of “Anti D” may be needed. And, whatever your blood group, do phone for advice if you feel very anxious – and certainly if you get severe backache, low abdominal pains and/or heavy, “lumpy” bleeding. You should also seek advice if you stop “feeling pregnant”, even if the bleeding has ceased. Just occasionally, a pregnancy can end without the physical loss of the embryo.
Even if things settle down completely and all is well, it’s a good idea to tell your doctor or midwife what has happened next time you attend for an antenatal check-up.
Hannah Hulme Hunter, Babyworld Midwife.
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