Early Pregnancy Bleeding

Dread, concern, panic, confusion--these are the feelings women have when they see that they are bleeding during a desired pregnancy. But first trimester bleeding is not unusual. About one in four women has some bleeding before 12 weeks. Half go on to miscarry, and the other half have babies. This may sound cold, but it is important to realize that once first trimester bleeding has started, the outcome of the pregnancy is already determined-and nothing you do, not bedrest, not medications, not any other treatment you can think of, is going to prevent the loss of a pregnancy that is destined to miscarry.

Women who are bleeding in early pregnancy should adhere to what we euphemistically call "pelvic rest," which really means don't put anything in your vagina-no douching, no tampons, and no intercourse. The purpose of pelvic rest is to avoid introducing germs into the uterus, which could lead to a serious infection.

Severe pain, bleeding heavier than a period, or fever should lead you to seek immediate medical attention. Pain can indicate an ectopic (tubal) pregnancy, and heavy bleeding can lead to excessive blood loss. Fever may indicate infection. All of these can become medical emergencies. Ultrasound, physical examination and blood tests can often shed light on the situation.

Anxiety is a miserable feeling, and not knowing the outcome of your pregnancy can be immensely distressing. As much as it may feel like an emergency because you want an answer now, the answer won't change the course of events, and a trip to the emergency room is generally not warranted for a small amount of early pregnancy bleeding in the absence of pain or fever. A call to your midwife or doctor the next day can get you set up for evaluation, which hopefully will give you the reassurance you are seeking.