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Hi there. I am just going come on and say hello, and I wanted to talk to you about bleeding in pregnancy. It's incredible. A lot of people online, on my social media pages, are asking me about bleeding in pregnancy - and they're freaking out. Of course, they're freaking out. It's scary. I get it. And in my own practice, when people call me and tell me they're bleeding, they’re scared.

I totally get it. 

But what I wanted to do is reassure you that in the first trimester, 25% of women will bleed. And many times, the causes are benign. Like nothing to worry about, easy to treat if needed, or monitor, kind of watch and wait. 

Sometimes the causes are more serious, so definitely if you have bleeding in pregnancy, you can post it on my Facebook group or post it on Instagram, you can tell me about it. But I really want you to check it out with your provider.

Let me go over some of the common things. First of all, I would say about half of people who bleed in the first trimester miscarry. So that means 50%, they're not going to miscarry. A lot of times miscarriages go unnoticed if people aren't tracking their cycles. It's just like, you have a heavier or a late period. But there are people that track cycles and they see bleeding, and that's scary. 

So, the first thing is that when the fertilized egg implants in the uterus, around the time of the missed period, that's implantation bleeding, and that might last a day or two, a little bit of spotting. Nothing to worry about. Okay. 

Also, some people have a little vaginal or cervical inflammation or infection, like a yeast infection, for example. Many infections or inflammation can cause a little bleeding and that's easy to treat holistically. It's easy to deal with. 

Sometimes, first of all, in pregnancy, your blood volume is doubling. You are so vascular. There’s just many more blood vessels in the area.

So that's how come people tell me they have bleeding and I said, did you have sex?, and they'll say, oh yes. Well, that's what it is.

Now, it's not dangerous to have sex, but if you notice a little bleeding after sex, intercourse, that's just a little tiny blood vessel in the vaginal area or the cervix that just broke, and you'll just have a little spotting, a little bright red blood, and then brown the next day or something like that, and then it will go away. 

If you had an internal exam that can cause bleeding. So first of all, I’d question why you're having internal exams, but many times I find that people are having way too many internal exams that are necessary, but that can cause bleeding. A pap smear can cause bleeding. And this kind of bleeding does not endanger the pregnancy. Yes, if you need to have a pap smear in pregnancy, you can absolutely have one, it does not affect the pregnancy. It's just scraping the little cells on the top of where the cervix is. That doesn't go inside the cervix or into the uterus, okay, but that can cause bleeding. I've even had moms that have had varicose veins vaginally, and have noticed some bleeding with that. 

So, these are all sort of innocuous things that can cause bleeding. 

Another is it benign growth, like polyps. It could be uterine or cervical, can cause a little bleeding. They have nothing to do with the pregnancy, it’s just that it's more in engorged, more likely to bleed. So these are just normal, nothing to worry about.

There is something called sub chorionic hematoma. I don't know if you've ever heard of it? I definitely want to hear in the comments your experience with bleeding in pregnancy too, because I want everyone to feel that they're not alone.

I want people to be able to share and to know how common it is to have bleeding in pregnancy. 

A sub chorionic hematoma is kind like a bruise, or like a collection of blood between the placenta and the uterus, and most of the time, the vast majority of times, it's something that might've occurred at implantation or somewhere after that. Most of the time, it just resolves, and does not affect the pregnancy. 

So, if you're in the first trimester, I definitely would check with your provider because there's some basic blood tests that we can do, and sometimes you need an ultrasound.

I'm not talking about routine ultrasound; I'm talking about if we're concerned about something. Sometimes an ultrasound can help us determine what's going on.

Anytime there's bleeding in the first trimester, we want to make sure that it's not an ectopic pregnancy. Ectopic pregnancy is potentially life threatening. It's rare, thankfully, one in fifty pregnancies, twenty in a thousand pregnancies. I've seen it, I've detected it myself, and that's something that we want to detect before it actually ruptures.

So thankfully it's rare. What's more common of the serious is a miscarriage. And a miscarriage is most often related to a pregnancy that's just not meant to be, a chromosomal abnormality in the fetus, and it's sort of nature's way of releasing that. Sometimes it could be a low progesterone and the pregnancy is healthy, so that can be treated with natural progesterone. 

There's so many that are involved, but you know, years ago, before we had all this testing, and people weren't using birth control, and people were having sex, and I would say, just about everybody who gets pregnant will have, in their lifetime, one miscarriage at least. That's how common miscarriage is. 

Once we get the heartbeat of the baby, it's rare. So if you have a fetal heart rate, miscarriage is rare. But anytime there's bleeding again, just check it out. 

Now, in the second half of pregnancy, we start thinking of, we’re not thinking of ectopic pregnancy anymore, or a threatened miscarriage, we are thinking if there is bleeding in the second half of pregnancy, in addition to possible bleeding after sex, or a little inflammation or infection, thinking also about a placenta previa, which means the placenta is implanted partially or directly over the cervix. That is something that we need to watch and monitor, and you do not want to have any internal exam if that happens. And thankfully it's rare, but we just want to make sure that that's not what it is. 

Also, placental abruption; if the placenta is partially separating from the uterus. That can cause bleeding.

Preterm labor; because look, as the cervix dilates, tiny blood vessels will disrupt and cause bleeding. 

In labor; labor, there's blood. You have bloody show and as you dilate you bleed, right? 

So, these are just some of the many reasons that you can have some bleeding in pregnancy, and I just love so many times we just don't find out the reason. All right? And then everything's just fine. 

But it's always better to just check it out. 

So that's what I have to say today. I would love to hear from you your experience with bleeding in pregnancy, whether it's your personal experience, the experiences of your clients, or people that you know, so that all of you will just realize how common it is, and that you're so not alone. Okay? 

And if you found this interesting or helpful share it ok?

Love to you all. Namaste. Have a good afternoon, or day, or evening wherever you are in the world.

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