The first trimester of pregnancy, 0-12 weeks, can be a more emotionally charged time in pregnancy, with highs, lows, and everything in between. The most common, prevalent worry a person has during this time is: "Is everything ok with my pregnancy/baby?" Being so early in pregnancy, there isn't the reassurance you have later in pregnancy with baby's movements. In the first trimester, you have to rely on other physical symptoms (which are often variable and uncertain), gut instinct, and medical advice.
Spotting and bleeding in the first trimester, while very common and sometimes harmless, is cause for worry. The truth is, there are "normal" and safe reasons you might experience bleeding or spotting in the first trimester, and other times, it signals a problem. Let's take a look at the common reasons and and symptoms behind spotting and bleeding in the first trimester. As you read through these, keep in mind that none of this is in place of a consultation or examination from your care provider. It's always a good idea in pregnancy to call your OB or midwife in the event of spotting or bleeding.
Normal/Safe Causes of Bleeding in the First Trimester
Implantation bleeding - When the fertilized egg implants itself into your uterus, it can cause some spotting or light bleeding. Often, this happens without notice and before you even know for sure you're pregnant. Implantation typically takes place about 9 days after ovulation, or 6-12 days after fertilization (whether through intercourse or insemination). So, if you experience light spotting around that time, it's most likely implantation bleeding. While it's referred to as "bleeding," it resembles early period spotting -- light brown or pink.
Cervical changes - In the first trimester, your cervix is growing ripe with tiny capillaries all over, which means it's more susceptible to bleeding and spotting when disturbed, like from intercourse or a pap smear. This kind of bleeding also looks more like spotting and can range from light to bright pink to or brown.
Problematic Causes of Bleeding in the First Trimester
Miscarriage or threatened miscarriage - Bleeding -- bright or dark red blood -- that is more than spotting can be a sign of miscarriage or threatened miscarriage (a potential miscarriage that ultimately carries on as a healthy pregnancy). Miscarriage symptoms include bleeding (from light to heavy) along with cramping. If you think you are miscarrying, call your midwife or OB right away. Further examination can confirm if you are having a miscarriage.
Ectopic pregnancy - An ectopic pregnancy is one in which the egg attaches itself to a location other than the uterine wall, usually somewhere in the fallopian tubes. Symptoms of an ectopic pregnancy include bleeding, from light to heavy (like a period), pelvic pain that is sometimes sharp and stabbing, and abdominal pain and lightheadedness or feeling faint. An ectopic pregnancy cannot continue and its symptoms should not be ignored. If you're experiencing these symptoms, call or go into your care provider right away.
Molar pregnancy - A molar pregnancy is a pregnancy where the placenta develops abnormally and instead forms cysts. A fetus may or may not develop, and if so, will not be able to survive. Symptoms of a molar pregnancy include dark brown or bright red bleeding, nausea, and pelvic pain or pressure. A molar pregnancy requires early medical treatment, as it can cause additional medical problems.
Bleeding in the first trimester can be very common, and many times it can be a sign of a typical and healthy pregnancy. It's important to know the symptoms of all kinds of bleeding in pregnancy, and to call your OB or midwife if any of these signs appear.