Bleeding During Pregnancy - Why It Happens and What To Do About It
Vaginal bleeding during pregnancy can often cause us to freak out and start thinking the worst. However, there are a multitude of less serious and more common reasons for light bleeding at this time, such as:
A burst of a tiny blood vessel in the vagina or cervix engorged from pregnancy hormones (especially with local infections, during the friction of sexual intercourse, internal exam or pap smear, and when there are vaginal varicosities).
Cervical polyps (often benign growths on the cervix that usually increase in size during pregnancy).
Hormonal fluctuations, especially around the time of usual monthly periods.
The normal implantation of the fertilized egg within the uterus (occurs 1-2 weeks after conception, around the time of your expected period, and lasts just a few days).
Bloody show at the beginning of labor (a welcome event only if your baby is at least 37 weeks, but more concerning if preterm).
Vaginal bleeding in the first trimester of pregnancy affects approximately 25% of all pregnant women. Less than half of these bleeding women actually miscarry. And once the fetal heartbeat is detected at the prenatal visit or on sonogram, miscarriage is rare and unlikely, especially in a healthy pregnancy where there is no prior history of problems like recurrent pregnancy loss. about 1 in 10 pregnant moms will have some bleeding in the third trimester. More often, the cause of bleeding is never found, the bleeding stops and the pregnancy continues to a happy conclusion.
Vaginal bleeding during the second half of pregnancy can infrequently indicate potentially serious complications such as:
The placenta partially to completely separating from the uterine wall before birth (placental abruption).
A placenta that is located close to or over the cervix instead of higher in the uterus (placenta previa). A note of reassurance is that while approximately 45% of placentas are classified as “low lying” during the second trimester, the majority “migrate” upwards far enough away from the cervix by the third trimester, and are not a cause for worry.
The umbilical cord first inserts into the fetal membranes, then the exposed blood vessels without the protection of the cord travel to the placenta (velamentous insertion).
When To Call The Midwife or Doctor
You should be evaluated by your midwife or physician any time there is bleeding during pregnancy in order to rule out anything concerning or deal with something that is treatable. Call your practitioner if bleeding is light but lasts more than 3 days, is heavy like a period or a continuous flow (you completely soak through a regular sanitary pad in an hour or less), or accompanied by any of the following:
Pain in your pelvic area, abdomen, back or shoulder
Rhythmic uterine cramping
The passage of tissue or clots bigger than a 50 cent piece
Foul smelling discharge
A gush of fluid from the vagina
Symptoms of a urinary tract infection - like feeling you have to urinate frequently, but only little amounts come out, burning or foul smelling urine, low mid pelvic pain when you pee
Fever or chills
Decreased fetal movements
Weight loss, premature resolution of early pregnancy symptoms like nausea, vomiting, fatigue, and breast tenderness, or the return of your normal breast size
You have a history of ectopic pregnancy, miscarriage, molar pregnancy, placenta previa or abruption, or other significant health problem
You simply feel that something isn’t right
Once A Serious Cause of Bleeding During Pregnancy Has Been Ruled Out
Once you have been evaluated and the more serious causes of the bleeding have been ruled out or dealt with, you should do the following.
Make sure any issues that can be treated, like infections, MTHFR mutations or low progesterone, have been addressed.
Do what you love, what brings you joy, and use your imagination to make routine tasks more enjoyable - even by turning on the music and dancing while you work.
Take it easy and avoid heavy lifting until a few days after the bleeding subsides, with frequent breaks in a comfortable lounge chair, bed or couch.
Limit non- essentials, delegate and ask for extra help from family and friends.
Stock up on some good books, inspirational podcasts and movies, practice deep breathing and progressive relaxation exercises several times a day.
Put nothing in the vagina (this includes no sexual intercourse) until 1-2 weeks after the bleeding has stopped.
Eat warm foods, drink fresh ginger tea (steep a piece of raw ginger in a quart mason jar of boiling water for several hours), and limit cold and frozen foods
For a friable cervix that bleeds easily, small amounts of bleeding from a subchorionic hematoma, or persistent spotting from placental implantation, eat foods high in vitamin C. Good choices are citrus fruits, berries and dark leafy greens, as well as many other fresh produce. You may need to supplement with 500-1000 mg vitamin C with bioflavonoids, and add vitamin E (alpha-tocopherol) 400 - 800 IU daily for a few weeks only, to support stronger placental adherence to the uterus in early pregnancy. Chasteberry can enhance pregnancy hormones, and natural progesterone can be prescribed if levels are low in the first trimester. There are natural supplements recommended like whole food B complex with 2-3 mg l-methylfolate, and at least 400 mg DHA/EPA Omega threes for those with the MTHFR mutation, as well as low dose baby aspirin (81 mg) that can thin the blood enough to help it circulate through the tiny vessels of the early placenta without clotting, and prevent miscarriage if that is the issue.
If You’re Cramping But Not Bleeding
If all more serious causes have been ruled out, and you are simply having a lot of cramping without bleeding, make sure you are drinking enough fluids, and are getting plenty of calcium and magnesium in your diet. Start by eating lots of green leafy and seaweed veggies, ground sesame seeds (tahini), wild caught fish like salmon, almonds, whole grains, and organic yogurt and cheese. Avoid excessive cow dairy intake, coffee and soda, even spinach, which decreases calcium absorption. You may need additional supplementation - at least 400 mg magnesium and 1200 mg calcium daily in 2-3 divided doses; or make your own infusion of nettles and red raspberry leaf tea, using the recipe here.
Also, helpful herbs to reduce cramping are cramp bark, black haw, and wild yam. You can experiment with one of them at a time, or use all together in combination. Take 1 - 5 cc of each tincture every 30 minutes to few hours, depending on how often and intense the cramping is.
If There’s A Threat of Miscarriage
Women can bleed and cramp and still have a healthy pregnancy. But not all miscarriages can be prevented. Miscarriage is actually pretty common, and rise with age and the more pregnancies a woman experiences. About 10-20% of women with known pregnancies miscarry before 20 weeks. Many miscarry around the time of the first missed period, before they even realize they are pregnant.
Heavy bleeding with cramping, lower abdominal or back pains and/or passage of tissue or fluid from the vagina during early pregnancy usually indicates that a miscarriage is in progress and there is little that can be done to stop it. In most cases, a miscarriage is your body’s natural way of rejecting an unhealthy or abnormally implanted fetus.
Once you know you are pregnant, it is still often experienced as a huge loss and the grief can be intense. I am sorry if that is what is happening and I encourage you to mourn as you need to, tap into your strength, look for the silver lining, and notice how you have grown as you heal.
Other less-common reasons for an isolated miscarriage include infection, dehydration, poor nutrition, severe trauma, and exposure to significant doses of hazardous substances (toxic industrial or environmental chemicals, drugs, alcohol, smoking, and radiation). It is still important to get evaluated, though, to be sure what is going on, and get treatment if needed..
If you have been informed that a miscarriage is threatening, follow the suggestions above for treatment of bleeding, plus:
Drink a small glass of wine or beer, or a shot of whiskey in juice to lessen the cramping at night if interfering with sleep, but alcohol should be used in very limited amounts during pregnancy.
Keep well hydrated with plenty of fluids (at least 8-10 glasses of water daily).
Light some candles and take relaxing warm baths with your favorite essential oils.
Take 200 IU of Vitamin E 3-4 times per day for no more than 3 weeks to strengthen placental attachment and reduce spotting.
Take 500 mg of Vitamin C with bioflavonoids twice a day during the crisis period.
Do a yoga nidra, mindfulness practice or a progressive relaxation meditation to stay calm inside. Whenever worrisome thoughts occur, use them as an opportunity to practice being present in the now and doing breathwork. For example, for 5- 10 minutes twice a day, do slow deep extended exhalation breaths (inhale for a count of 3, exhale for a count of 6), while allowing yourself to feel whatever you feel.
Tune into what is true for you, and what you really want. If it is your heartfelt desire to continue the pregnancy, let that feeling expand, as that will enhance whatever else you are doing. You can send loving thoughts to your baby and visualize your womb surrounded by love, light and spiritual protection; affirm that baby is welcome in your life, you and your baby are healthy and vibrant, your placenta is strongly attached to your uterus, you are providing safety, security and nourishment to your baby…as well as mama love, a love like no other.
You and your partner can place one hand on each other’s heart, the other hand on your womb, and imagine enhancing your family bond. Send love from your hearts to one another and to your baby. Focus on deepening and strengthening your love and connection, especially if there is tension between you. Never underestimate the close relationship of the mind and heart to the body, and the power of love and harmony to heal, and transform...and even prevent miscarriage if the pregnancy is healthy. This can be a wonderful opportunity of healing and transformative for all of you.
It helps to love yourself unconditionally and with compassion, to have a clear intention to release all self judgement and blame. Visualize the blame leaving you with each exhalation or melting away from your body, sinking down into the earth beneath you.
Connect to other wise women, in sisterhood - those who uplift, inspire and support you. Have a good cry, a good laugh and a good hug several times a day.
It also helps to pray, and as much as possible. Then let go, surrender to what is greater and wiser than us all, the benevolent infinite, and release trying to control what is not in your control. Can we embrace what is, even when we do not understand the whys?
If you are interested in herbal remedies to help prevent a threatened miscarriage, you can make your own infusion or tincture combination by mixing the following bulk dried herbs or the same herbs in tincture form:
Combine equal amounts of partridge berry, cramp bark, black haw, false unicorn root, wild yam, and chasteberry, with a dash of lobelia. Take 2.5 to 5 cc of the mixture every ½ to few hours until symptoms resolve, then a few times per day for a week. This mixture can be taken prophylactically twice a day in the first trimester, if you have a history of miscarriage in prior pregnancy. These herbs are said to aid the miscarriage if the fetus is not normally formed, but prevent it if it is strong and healthy.
Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. If you need more personal guidance, I am happy to help. You can set up a consultation with me here.
For extra support in pregnancy and relief of common aches and pains, wear an abdominal binder. Bellefit makes a fine one as pictured above. They also make postpartum support girdles . I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote. But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch.
I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected.
Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation.
Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.