Does Vaginal Bleeding Mean a Miscarriage in Early Pregnancy?

It can be SUPER scary to look down at your panties or when you wipe and see some blood when you are pregnant.  While vaginal bleeding in early pregnancy does not always mean a miscarriage, it should make you call your provider to figure out your next steps.

But, how do I know so much about bleeding during pregnancy? — Hi I’m Hilary The Pregnancy Nurse®.  I’ve been a nurse since 1997 and I have 20 years of labor and delivery experience.  I’ve seen a LOT of bleeding in my time and I am a good resource for you on this one.

Note: This post will be about bleeding in the first half of your pregnancy.  Towards the second half it means other things, and you can read my post on bleeding at 20 weeks or spotting at 38 weeks for more info.

Does Vaginal Bleeding Always Mean a Miscarriage?

No, not at all.  It can be a miscarriage (and that’s something you need to be aware of) but it can be caused by:

• The placenta attaching to your uterus (called implantation bleeding)
• Issues with how the placenta growing (which may resolve)
• Sex or an exam (the vaginal walls have more blood floor and may bleed more easily during pregnancy)
• The baby growing or your cervical changes
• Issues with your urethra or a bladder/kidney issue

Sometimes they will find a subchorionic hematoma — which is where the chorionic sac detaches from the uterus. It can either heal or it can get worse. You may be given specific precautions like pelvic rest or bedrest to help it heal. Learn more about it here.

If there is a LOT of vaginal bleeding you need to get yourself to the emergency room ASAP.  It is possible to bleed-out from pregnancy bleeding, so you want to be safe and see them if you feel like it’s “a lot”.

Let’s talk about what you should do if you find yourself bleeding.

What to do if you find early pregnancy bleeding:

You’re going to want to call your provider (most providers have someone on for them 24/7 that can answer calls).

When you make that call — they’ll want to know:

• How much bleeding is it (it’s good to compare it to money — is it a penny size, or more like a quarter — or if it’s more what % of a pad did it fill?)
• When did you see it — was it on your panties or did you only see it when you wiped
• What color is it — is it bright red or brown?
• Is there any other discharge besides the blood
• What time did you notice it
• Do you have any other symptoms like cramping or bleeding, headache etc.
• If you frequently feel your baby are you feeling them now?

If they haven’t seen you, they’re also going to want to know your last menstrual period to know how far along you are.

Most often they’re going to want to order an ultrasound to check on the baby and see how things are going.  It will be your best indicator of baby’s well-being at that point. This can be done in their office or at an ultrasound clinic (or the hospital).

It’s going to feel like a lot and you likely have many worries if you’re going to miscarry but taking the steps along the way will be best for you and baby.

You may also think “this isn’t a big deal” and may want to ignore it.  However, most providers do want to be contacted if you have any bleeding in your first trimester especially.  Even if it is just a spot. 

Here are a few other good resources for bleeding during pregnancy:

• Bleeding during pregnancy from American College of Gynecologists
• Bleeding during pregnancy from the March of Dimes

Good luck — and give your provider a call.  I hope everything’s OK but just taking each step along the way is in your best interest.