Vaginal bleeding may happen occasionally during pregnancy. Vaginal bleeding could range from some spotting to a hemorrhage that requires immediate medical attention. In any case, even if it is just some spotting, it should be checked because it could be a symptom of certain complications.  

Causes of slight bleeding

Slight bleeding is when there is some brownish, dark red or pink spotting. Some of the most frequent causes of this type of bleeding are:  

• Implantation. A few days after the egg is fertilized it embeds itself in the wall of the uterus. On doing so it could break some capillaries and cause spotting. This could happen during the time that your period was expected.  

• After a physical. During pregnancy there is a greater blood flow to the area of the cervix. An internal exam could cause some capillaries to bleed and some spotting to happen.

• After having sex. For the same reasons as before, now being at a higher risk in the area, it is possible for some spotting to happen.

In any event, it is important that you tell your doctor about this spotting so that he may rule out any other kind of problem.  

Causes of heavy vaginal bleeding

It is considered heavy vaginal bleeding if, even though the bleeding is not excessive, it doesn’t stop for one whole day, or if the bleeding requires more than one sanitary pad per day.  Heavy bleeding could be due to one of the following:

• Ectopic pregnancy. This is when the fertilized egg doesn’t embed in the uterus, but remains in the fallopian tubes or elsewhere. When the egg grows, it causes the tube to rupture and, as a consequence of that, internal bleeding that must be stopped immediately. You must go to the hospital as soon as possible or phone the ER if the bleeding happens along with acute intense pain in the abdomen or the shoulder.  

• Miscarriage. Most miscarriages happen in the first three months. If the bleeding comes with a grey or pinkish tissue, store it in a Ziploc back so that your doctor may determine whether it is a miscarriage.  

• Placental abruption. In the second half of the pregnancy, when the placenta is larger, it could partially break off from the uterus wall, and this causes profuse bleeding. You must go to the hospital and be seen by a doctor immediately.  

Although it may appear that after a while, the hemorrhage stops, you should contact your doctor as soon as possible or go to the hospital to find out the cause of the bleeding and what to do to stop it if it is abundant.  

Bleeding before and after delivery  

When delivery is imminent, the mucous plug that was sealing off the cervix sometimes comes out and you may see some blood (bloody show). This is normal. But if the bleeding is heavy, then you must go to the hospital to rule out placental abruption.

Once you deliver your baby, you will bleed for a few days. But if the bleeding gets heaver or especially if it has an unpleasant odor, you must contact your practitioner to rule out an infection due to remains of the placenta or other causes.