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Bleeding in pregnancy: It may not be a miscarriage

16 October, 2021 . 0

The last thing an expectant mum wants to see is blood – yet bleeding in pregnancy isn’t always a miscarriage. Here’s what you should know about this common symptom.

The sight of blood while pregnant can be unnerving for even the most chilled-out mother-to-be, but it is important to realise it is fairly common and often no danger to the mum or her baby.

Obstetrician, gynaecologist and University of Melbourne senior lecturer Dr Alex Polyakov explains while bleeding in pregnancy is referred to as “threatened miscarriage”, this does not necessarily mean a pregnancy loss will occur.

“Bleeding in pregnancy is very common, and more common early in pregnancy rather than later,” Dr Polyakov says.

“It’s important to point out that just because there is bleeding, it doesn’t mean miscarriage will happen.”

What are the reasons for bleeding in pregnancy?

Bleeding in pregnancy can be due to miscarriage, or ectopic or molar pregnancies, however other common reasons include:

Implantation bleeding
Subchorionic haematoma
Shortened cervix
Placenta praevia
Placental abruption

Sometimes there is no known reason for bleeding.

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Will the bleeding stop?

In some instances, such as with a subchorionic haematoma, the bleeding can resolve by itself.

“A haematoma usually shrinks and gets reabsorbed,” Dr Polyakov says.

Ultrasounds should pick up on the presence of a haematoma and it will be measured – it may even grow before shrinking.

“A haematoma often self-resolves without compromising the pregnancy, however the size and location are significant,” Rhiannon says.

While implantation bleeding can occur very early on (even before you know you are pregnant), bleeding due to a shortened cervix, placenta praevia or placental abruption occur later in pregnancy.

In the case of moderate to severe placenta abruption – where the placenta detaches from the wall of the uterus – if the bleeding doesn’t stop you may need to deliver sooner than expected.

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What can help reduce bleeding?

Supplements

Supplements can play a part in reducing bleeding in some cases but rather, than self-prescribing, consult a trained naturopath to ensure you are receiving the correct doses and using quality products.

“Focusing on vascular integrity is key,” Rhiannon says.

“This may involve supplements including bioflavonoids and Coenzyme Q10.

“We also may suggest herbs traditionally considered to be anti-haemorrhagic in nature, which have been used for centuries for threatened miscarriage.”

Foods high in bioflavonoids – such as berries, red cabbage, purple carrots, beetroot and kale – contribute to vascular integrity, and cacao and green tea may help as well.

Rest

“There is also a good argument for old-fashioned rest,” Rhiannon says.

You may be recommended pelvic rest – which means no sexual activity – and to avoid heavy lifting or rigorous exercise, so now is not the time to worry about staying active during your pregnancy.

Progesterone

You might also be prescribed progesterone.

“Progesterone supplements like pessaries usually improve the outcome,” Dr Polyakov says. A 2020 study found vaginal progesterone reduced the risk of miscarriage and early pregnancy bleeding.

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When to seek help for bleeding

Knowing pregnancy bleeding is common in pregnancy can help alleviate your anxiety, but it should never be ignored.

Take note of the bleeding (such as the colour – red, pink or brown – the texture and flow), how you are feeling (if you are cramping and have a fever) and notify your hospital or GP.

You may need to be monitored, and have an ultrasound.

As the specialist might need to see the blood, pop in a pad – period undies are great for the environment, but they make it more difficult to inspect the bleeding.

Be alert not alarmed by changes throughout your pregnancy, and seek medical help if something doesn’t seem right.

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Written by Samantha Allemann.