Last updated: March 9, 2020
Cherilyn Cecchini M.D.
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Vaginal bleeding experienced when a woman is pregnant can be alarming. Our physician Dr. Cherilyn Cecchini discusses what may lead to this symptom and what you need to know if you find yourself in this situation.
There are many reasons why a woman may experience vaginal bleeding after sex when she is pregnant. Bleeding during the first trimester can occur in up to 15 to 25% of pregnancies. One study determined that spotting is most common during the sixth and seventh week of pregnancy and the American Pregnancy Association noted that sex during a normal pregnancy is not a risk for miscarriage. Although vaginal bleeding when pregnant is common and often not a sign of a serious issue, it is important to check-in with your healthcare provider if you experience any amount of vaginal bleeding when pregnant.
Implantation bleeding is one common cause of vaginal bleeding that women may experience at the onset of pregnancy.
It is thought that implantation bleeding occurs when the fertilized egg attaches itself to the lining of the uterus. Although common, some women may not experience implantation bleeding or see any spotting early in the pregnancy. Both experiences are considered normal.
Implantation bleeding is usually light and only lasts a few days. It may be noticeably lighter than a woman’s normal menstrual period. Implantation bleeding generally occurs around 10 to 14 days after ovulation, which is around the time women are expecting their menstrual period. Given this, some women may mistake implantation bleeding for a lighter menstrual period, so be sure to keep this in mind if there is a chance you may be pregnant and experience blood flow that differs from your typical menstrual period around this time.
Bleeding Caused by Changes to the Cervix
The cervix is the circular band of muscle that separates the uterus from the vagina. The cervix experiences many changes during pregnancy.
When a woman conceives, the cervix moves and remains in a higher position in the vagina. Increased blood flow to the cervix when a woman is pregnant leads to a softer texture and increased sensitivity.
Changes to the cervix may be the underlying reason a pregnant woman experiences irritation and vaginal bleeding after sex.
Bleeding Caused by Infection
Vaginal bleeding experienced at any time when a woman is pregnant may be a sign of infection. Certain infections cause the cervix to become irritated or inflamed and vulnerable to bleeding, including:
- Yeast infections
- Bacterial Vaginosis
Bleeding Caused by Ectopic Pregnancy
In an uncomplicated pregnancy, the fertilized egg travels through the fallopian tubes and implants in the lining of the uterus. With an ectopic pregnancy, the fertilized egg implants outside of the uterus, most often in the fallopian tube. In rare cases, the egg may implant in an ovary or the cervix.
A quick An accurate and timely diagnosis of ectopic pregnancy is imperative, since this condition may be life threatening. If the fertilized egg implants in one of thefallopian tubes, it may cause the fallopian tube to rupture as it grows
An ectopic pregnancy may result after damage to the fallopian tubes, which is sometimes caused by:
- Pelvic inflammatory disease
- Prior surgery on your fallopian tubes
Fertility treatments, such as in vitro fertilization
Bleeding Caused by Placenta Previa
The placenta is an organ that forms during pregnancy to provide oxygen and nutrients from the mother’s bloodstream to the developing baby. In most pregnancies, the placenta implants at the top or on the side of the uterus away from the opening of the cervix.
Placenta previa occurs when the placenta implants at the bottom of the uterus and partially or completely covers the cervix.
Vaginal bleeding experienced by a pregnant woman after 20 weeks gestation may indicate placenta previa. Sexual intercourse may cause vaginal bleeding in women with placenta previa throughout the pregnancy. Since the placenta is implanted near the bottom of the uterus, it may start to separate and bleed as the uterus stretches to accommodate the growing baby.
Bleeding Caused by Placental Abruption
Placental abruption occurs when the placenta detaches from the uterus early in the pregnancy before the time of delivery. It commonly occurs around 25 weeks of pregnancy in roughly 1% of pregnancies. Placental abruption may lead to spontaneous vaginal bleeding in pregnant women unrelated to sexual intercourse or after sexual intercourse.
Bleeding Caused by a Subchorionic Hematoma
Subchorionic hematoma is also known as subchorionic bleeding, a condition that occurs when blood forms between the placenta and the uterus. It may lead to light spotting or it may cause no symptoms and it happens most often during the first trimester of pregnancy. Some subchorionic hematomas are diagnosed during routine ultrasounds. It typically resolves on its own without the need for any medical or surgical intervention.
Bleeding Caused by Miscarriage
Vaginal bleeding when pregnant may be a sign that a woman is experiencing a miscarriage or loss of pregnancy. Bleeding due to a miscarriage is often heavy and it may last for several days.
Signs and symptoms of a miscarriage also include:
- Loss of pregnancy symptoms such as nausea
- White-pink mucus
- Passing of clots of tissue-like material
- Lower back pain
Bleeding by Trimester
Vaginal bleeding experienced during the first trimester of pregnancy is more common than bleeding experienced in the second or third trimesters.
Light bleeding in the second trimester may be caused by irritation or inflammation of the cervix whereas heavy bleeding may related to the placenta.
Vaginal bleeding during the third r trimester may be a sign of preterm labor, full term labor, placenta previa or placental abruption. Certain infections may lead to vaginal bleeding at any time throughout the pregnancy.
If you experience any amount of vaginal bleeding at any point during your pregnancy, be sure to contact your healthcare provider immediately. Noting the amount of blood, the color of the blood and the duration of the bleeding are helpful in determining what may be the cause of the bleeding.
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Disclaimer: This article provides general information and is not intended to diagnose, treat or cure any disease or medical condition. If you require specific advice, please consult one of our medical professionals through the app. However, in case of an emergency, please call 911.
About Cherilyn Cecchini M.D.
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