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Implantation Bleeding Miscarriage Ectopic Pregnancy

The first trimester can feel like a wild ride. Some women may experience extreme morning sickness, while others may not notice anything out of the ordinary. However, if you’re experiencing spotting during your first trimester, pay attention to what’s going on with your body.

Here are some reasons you may experience first trimester bleeding:

Implantation Bleeding

Implantation bleeding is a result of a fertilized egg attaching to the lining of the uterus, which can break down small blood vessels and cause a small amount of bleeding.1 Implantation bleeding can be normal and should not pose any problems for the developing baby. It typically occurs 10 to 14 days after conception (about four weeks pregnant).1

Implantation bleeding is considered an early pregnancy symptom and differs from menstruation in a few ways:1

  • The colour is usually light pink to dark brown, and there should not be clotting.
  • The amount of blood during implantation bleeding should be a few spots or a very light flow, not enough to fill a pad or tampon.
  • The bleeding or spotting shouldn’t last more than a few days. Many people may find that it’s over within a few hours.

Miscarriage

Sadly, miscarriages are incredibly common, especially within the first 8 weeks of pregnancy.2 In fact, 15-20% of pregnancies may result in miscarriage.2 Miscarrying can be a traumatic event for mothers, and having one does not imply that you aren’t able to have a healthy baby in the future. Bleeding in the first trimester is common and happens in 15-25% of pregnancies.5 Bleeding during pregnancy should be evaluated, as it may indicate a potential miscarriage. Fortunately, the risk of miscarriage decreases after the first trimester.2,3

Apart from bleeding, some other signs of miscarriage include: 2

  • Passage of blood clots and tissue.
  • Cramping and pain in the back and lower pelvis.
  • Some people have no symptoms at all.3

Typically, a miscarriage will happen on its own over the course of a few days.2 While there is no treatment that can stop a miscarriage once it’s begun, you should reach out to your doctor for guidance during this difficult time. You should schedule an appointment with your healthcare provider for a physical exam and ultrasound to ensure that there is no remaining tissue left inside you.2,3 If you experience any signs of infection, like fever or heavy blood loss, please contact your healthcare provider as soon as possible.2

Ectopic Pregnancy

During a normal pregnancy, a fertilized egg will travel through a fallopian tube, attach itself inside the uterus and grow into a healthy baby. But during an ectopic pregnancy, the fertilized egg will implant itself somewhere other than the uterus.4 In most cases, the egg will stay inside the fallopian tube, but it can also stay inside an ovary or implant in the cervix.4 Any location other than the uterus is inhospitable to a growing baby, and ectopic pregnancies are incredibly dangerous for mothers because they can lead to a rupture in the fallopian tube as well as internal bleeding.

The key indicators of an ectopic pregnancy include:4

  • Vaginal bleeding that may be heavy or severe.
  • Pain in the pelvis or belly that may be sharp on one side and may worsen when you move or strain.
  • Dizziness, lightheadedness and fainting due to internal bleeding.

Talk to your doctor right away if you’re experiencing bleeding coupled with abdominal pain. An ectopic pregnancy must be diagnosed by a medical professional who may conduct a pelvic exam, draw some blood to check your hormone levels and conduct an ultrasound, which can pinpoint the location of the fetus and show what’s going on inside you.4

If you think you have an ectopic pregnancy, you should see your doctor as soon as possible. If left to grow, the fetus can become large enough to cause dangerous internal bleeding. If you feel dizzy or experience severe pain or bleeding, seek immediate medical attention.4

Bleeding during the first trimester of pregnancy is tricky: it can be totally painless and nothing to worry about if it’s implantation bleeding, but it can also be a sign of a miscarriage or an ectopic pregnancy. Listen to your body and trust your gut. Vaginal bleeding during pregnancy should be assessed, especially if it’s coupled with pain and discomfort. It’s also important to remember that if you’re experiencing a miscarriage or an ectopic pregnancy, the fact that this is happening is not your fault. Take care of your physical and mental health. If you feel concerned about anything that’s happening with your body during your pregnancy, call your doctor as soon as possible.

  1. https://americanpregnancy.org/pregnancy-symptoms/what-is-implantation-bleeding/
  2. https://www.pregnancyinfo.ca/your-pregnancy/special-consideration/miscarriage/
  3. https://myhealth.alberta.ca/Health/Pages/conditions.aspx?hwid=hw44090
  4. https://www.healthlinkbc.ca/health-topics/ectopic-pregnancy
  5. https://www.acog.org/womens-health/faqs/bleeding-during-pregnancy
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