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Experiencing spotting or bleeding during your first trimester? Here’s what you need to know.

Light bleeding during the first trimester is common. In fact, about 20 percent of women experience it, so if it’s happening to you, don’t worry — everything is probably fine.

However, bleeding can sometimes be a sign of something serious, so it’s important to know what to look for and when to seek medical help.

Potential causes of bleeding during the first trimester

You may experience some spotting when you expect to get your period. This is called implantation bleeding and it happens around 6 to 12 days after conception as the fertilized egg implants itself in your womb. This bleeding should be light — perhaps lasting for a couple of days, but it’s perfectly normal.

Since miscarriages are most common during the first trimester, it’s normal to worry about bleeding early in your pregnancy. But as Dr. Alexis Svokos, an OBGYN at Geisinger explains, “Once a heartbeat is seen on an ultrasound, more than 90 percent of women who experience first trimester vaginal bleeding do not miscarry.”

During pregnancy, extra blood is flowing to the cervix. Intercourse or a Pap test, which cause contact with the cervix, can trigger light bleeding.

What are the signs of a miscarriage?

Call 911 or go to an emergency room immediately if you have any of these signs of miscarriage:

  • Severe pain or cramps low in the abdomen
  • Severe bleeding, with or without pain
  • Vaginal discharge containing tissue
  • Dizziness or fainting
  • Chills
  • Fever higher than 100.4° F

“If you have heavy bleeding during pregnancy, don’t use a tampon. Wear a pad and don’t change it before heading to the emergency room,” says Dr. Svokos. “Doctors need to know how much you’re bleeding; whether the blood is pink, brown or red; and if it’s smooth or full of clots. Be sure to bring any tissue that passes through your vagina in for testing, too.”

Your doctor will use vaginal and abdominal ultrasounds to determine the cause of your bleeding. If a miscarriage does occur, it often means the baby wasn’t developing normally.

Most women who miscarry go on to have healthy pregnancies, but having a miscarriage is one of the most challenging things a woman and her partner can go through. Don’t rush the grieving process. Finding a support group or counselor can help a lot.

Getting pregnant after miscarriage

You can ovulate and become pregnant as soon as 2 weeks after a miscarriage, but many healthcare providers recommend waiting a bit longer. Abstaining from sex for a few weeks after a miscarriage due to a risk of infection is also a good idea. Ask your doctor what’s best for you.

If you experience two or more consecutive miscarriages, your doctor might recommend testing to determine if there’s an underlying cause. A simple blood test can be used to detect potential issues with your hormones or immune system. Other blood tests can be done on you and your partner to see if genetics are a factor. Testing for uterine problems may also be recommended.

Preventing miscarriage next time

“Since most miscarriages are caused by genetic abnormalities or other health factors that are beyond anyone’s control, it’s important for women to understand that it isn’t their fault,” says Dr. Svokos. “There isn’t much you can do to prevent miscarriages. But staying healthy while trying to conceive — and while pregnant — is definitely the best approach.” Her recommendations?

  • Eat a nutritious, well-balanced diet
  • Exercise regularly
  • Avoid alcohol, recreational drugs and cigarettes
  • Reduce caffeine intake to one cup a day
  • Get regular prenatal visits
  • Take your prenatal vitamins 

By the end of week 12, your chances of miscarriage drop considerably. Entering your second trimester means you’ll probably be feeling better and (hopefully) worrying less.

Next steps:

Learn about pregnancy care at Geisinger