As a Midwife the number one reason I hear from my pregnant clients in between their regular check-ups is because they are experiencing bleeding or spotting. As a Mother and a Midwife I am aware of what they are thinking, am I having a miscarriage? Of interest bleeding in pregnancy is much more common then you may think studies suggest that one in three women experience spotting or bleeding in pregnancy. Only 50% of these go on to have miscarriages, the majority in the first trimester. Often this is reassuring when one realizes that anyone who is pregnancy has a 33% chance of seeing bleeding at some point in their pregnancy. While pregnancy can end in miscarriage, approximately 40% of pregnancies end up in miscarriage, and most of these are before 4 weeks of pregnancy (i.e. 2 weeks post conception, when you would miss your period). In these cases the woman may not even realize she was pregnant, she may think her period is "late" . After a positive pregnancy test, 4 weeks from your LMP, the miscarriage rate goes down to 15%. In addition, once your baby’s heartbeat has been heard(10-14 weeks) or seen on ultrasound (as early as 6-7 weeks), the chance of miscarriage goes down to 5%. Part of the reason that so many pregnant women experience spotting is that there is a tremendous increase in blood volume, which means that capillaries in the cervix are easily disturbed causing bleeding. This is the equivalent of having your gums bleed after brushing or starting a nosebleed by blowing your nose – both things that many pregnant women also experience for the same reason. An average non-pregnant woman has about 4 litres of blood. COMMON CAUSES OF BLEEDING AND/OR SPOTING IN PREGNANCY • Implantation spotting (i.e. as the fertilized egg attaches itself to the uterus it may cause some irritation and bleeding) • Ectopic pregnancy (i.e. the embryo is growing outside the uterus) • Miscarriage SECOND & THIRD TRIMESTERS • Abruption (the placenta is lifting away from the uterine wall) • Cervical dilation • Early labor “show” (a sign of cervical dilation starting to happen) WHAT SHOULD I DO IF I AM BLEEDING OR SPOTTING? Miscarriage cannot be predicted, only diagnosed. If you are having signs of a threatened miscarriage, your midwife or doctor may be able to send you for some testing: • Ultrasound will be able to determine if the embryo is implanted inside the uterus, and once you are past 6-7 weeks, if there is a heartbeat. • Early in the first trimester, bloodwork that is repeated every 48 hours will be able to demonstrate whether your pregnancy hormones are increasing at an expected rate. • If you are beyond 10-14 weeks gestation, your midwife or doctor may be able to find your baby’s heartbeat in the clinic with a Doppler. WHEN SHOULD I CONTACT MY MIDWIFE OR DOCTOR? You should let your careprovider know whenever you experience bleeding or spotting in pregnancy. Depending on the severity or your symptoms a decision can be made on the best way to assess the situation. |
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CategoriesAbout MeHomebirth Labour & Birth Pregnancy Care VBAC |
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