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Missing your menstrual periods is one indicator that you may be pregnant. You then cross-check using pregnancy kits (pregnancy tests at home), blood tests and other methods.

But can you have your menstrual periods when you are pregnant?

No! You can definitely not have periods during pregnancy.

Although, in early pregnancy, some light bleeding, called 'spotting', is a sign of foetus implantation in the wall of your womb. This is also known as 'implantation bleeding' and usually happens around the time that your first period after conception would have been occurring.

But there may be other reasons for bleeding during pregnancy. So, it is natural to get worried when you see blood spots while you are pregnant.

Vaginal bleeding is a frequent complication during the first trimester, which is more serious in the following trimesters. Hence, it is important to make an appointment with your doctor and find the exact cause of bleeding at the earliest.

  1. Vaginal Bleeding during pregnancy
  2. Bleeding during the first trimester
  3. Bleeding during the second and third trimester

Bleeding during pregnancy occurs for various reasons which would vary as per the gestation period.  These reasons are at times serious, and at times harmless. Few of the reasons are mentioned below.

Implantation bleeding

Bleeding during the first trimester is common. Mild spotting can be a sign of implantation. This implantation bleeding is accompanied with light cramps, headache, mood swings, breast tenderness or lower backaches. This type of spotting is often confused with menstrual bleeding because it occurs at the time when the woman is expecting her normal periods.

Miscarriage or Ectopic pregnancy

During the first three months (12 weeks) of pregnancy heavy vaginal bleeding can also be a sign of miscarriage or ectopic pregnancy i.e. when fetus implants outside the womb. This type of bleeding is heavier than usual menstrual periods and presents with more painful cramps.

In case of an ectopic pregnancy, one may experience dark, watery bleeding, accompanied by sharp pain in the lower abdomen experienced on a single side. This is often accompanied by feelings of nausea and vomiting.  This requires immediate attention and visit to a doctor.

Other reasons for bleeding during this period include infection, subchorionic haemorrhage (bleeding occurring between the uterine wall and the placenta) or gestational trophoblastic disease (rare tumours inside the uterus) that may lead to pelvic cramps and fever.

Bleeding continuing after the first trimester is often indicative of an alarming situation. However, one may also experience minor bleeding after cervical examination procedure by a doctor.

Various reasons for bleeding during second and third trimester are listed below.

  1. Placenta Previa
  2. Placental abruption
  3. Vasa praevia
  4. Rupture of uterus

Placenta Previa

Placenta previa refers to a condition when the placenta is attached close to or covers the cervical opening. According to the Children’s Hospital of Wisconsin, there is a greater risk of bleeding if more of the cervical os is covered with the placenta. Risks involved with placenta previa are abnormal implantation of the fetus, slow growth of the fetus, preterm birth and post-delivery infection.

Placental abruption

This condition refers to the separation of the placenta and uterine lining. It can occur anytime after the 20th week of pregnancy and is experienced by nearly one per cent of the pregnant women. According to the American Pregnancy Association, about 80% of the pregnant women experience vaginal bleeding during this condition, which is accompanied by uterine tenderness, abdominal pain and abnormal heart rate of the fetus.

Once this condition is diagnosed, additional care needs to be taken depending upon the gestational period, bleeding and the condition of the foetus. Blood transfusions may be needed in case of severe blood loss.

Vasa praevia

This refers to a condition when blood vessels of the foetus cross or run near the internal opening of the uterus. These blood vessels are at a risk of rupturing along with the supporting membranes. Although this condition mostly occurs without any symptom, at times, vaginal bleeding during the second or third trimester may be seen.

Rupture of uterus

Uterine rupture is a rare complication, which often results in a life-threatening situation for both the mother and the foetus. The condition occurs when a muscular wall of the uterus breaks down during pregnancy and childbirth.  It is generally seen with a uterine scar developed during previous c-section deliveries or fibroid surgeries. Vaginal bleeding accompanied by sharp pain between contractions, a bulge under the pubic bone or abnormal fetus heart rate are the common symptoms.

So, the bottom line is that there are no menstrual periods during pregnancy. If a woman is experiencing bleeding, whether mild, moderate or severe, she needs to visit a doctor immediately. Timely diagnosis and treatment would help to keep you and your baby safe and healthy.

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References

  1. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; REPRODUCTIVE HEALTH AND THE WORKPLACE
  2. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy - bleeding problems
  3. National Health Service [Internet]. UK; Vaginal bleeding in pregnancy.
  4. National Health Service [Internet]. UK; Miscarriage.
  5. Harville EW et al. Vaginal bleeding in very early pregnancy. Hum Reprod. 2003 Sep;18(9):1944-7. PMID: 12923154