Episode 103: Bleeding in the First Trimester of Pregnancy

First-trimester bleeding can be concerning, but it’s something many women experience during early pregnancy. While some causes are normal, others may indicate a more serious issue. As women and mothers, having the right knowledge can help us make informed decisions and confidently navigate our pregnancies.

In this episode of Healthy As A Mother, Dr. Leah Gordon and Dr. Morgan MacDermott break down 10 possible causes of first-trimester bleeding—ranging from light spotting to heavier flow—so you can understand what might be normal and when to seek medical support.

Common Causes of First Trimester Bleeding

1. Implantation Bleeding

One of the most common and harmless causes of early pregnancy bleeding is implantation bleeding. This happens when a fertilized egg attaches to the uterine lining. It’s usually light pink or brown and lasts just a few days.

2. Chemical Pregnancy

A very early miscarriage that occurs shortly after implantation, often before a woman even realizes she’s pregnant. This can cause heavier bleeding, similar to a period.

3. Ectopic Pregnancy

A dangerous condition where the fertilized egg implants outside the uterus, typically in a fallopian tube. Symptoms include sharp abdominal pain, heavy bleeding, and dizziness. Immediate medical attention is necessary.

4. Subchorionic Hemorrhage

A collection of blood between the placenta and uterus. While it can cause spotting or moderate bleeding, many women go on to have healthy pregnancies.

5. Low Progesterone Leading to Threatened Miscarriage

Progesterone is crucial for maintaining pregnancy, and if levels are too low, it can cause spotting and increase the risk of miscarriage. In some cases, progesterone supplementation can help.

6. Molar Pregnancy

A rare condition where abnormal tissue grows instead of a fetus. This can lead to significant bleeding and requires medical intervention.

7. Cervical Irritation

During pregnancy, increased blood flow to the cervix can make it more sensitive. Spotting can occur after sex, a pelvic exam, or vaginal ultrasound, but this is usually harmless.

8. Infections

Bacterial infections, yeast infections, or sexually transmitted infections (STIs) can cause irritation and bleeding. If you experience unusual discharge or discomfort, consult your provider.

9. Vanishing Twin Syndrome

In some cases, a woman initially conceives twins, but one stops developing early on. The body may absorb the non-viable twin, leading to some bleeding.

10. Placental Abnormalities

Although more common later in pregnancy, issues with the placenta—such as partial detachment—can sometimes cause early bleeding.

When Should You Be Concerned?

While spotting can be harmless, there are times when bleeding may indicate a serious problem. If you experience any of the following symptoms, seek medical care immediately:

• Heavy bleeding with clots
• Severe abdominal or pelvic pain
• Dizziness, fainting, or shoulder pain (potential signs of an ectopic pregnancy)
• Bright red bleeding that continues for multiple days

How to Handle First Trimester Bleeding

• Stay calm and assess. Note the amount, color, and frequency of the bleeding.

• Rest and hydrate. Sometimes, taking it easy can help ease minor bleeding episodes.

• Call your provider. Even if the bleeding is light, it’s always best to check in with your healthcare team.

Key Takeaways from This Episode

• First-trimester bleeding is common, but the cause can range from normal (implantation bleeding) to serious (ectopic pregnancy or miscarriage).
• Understanding the differences between spotting and heavy bleeding can help you determine when to seek medical attention.
• Low progesterone, infections, and subchorionic hemorrhages are some of the less serious causes that can often be managed.
• If you experience heavy bleeding, severe pain, or dizziness, seek immediate medical care.
• Always consult with your provider to ensure you and your baby are safe and supported during early pregnancy.

Final Thoughts

Experiencing bleeding in the first trimester can be scary, but understanding the possible causes can help ease some of the anxiety. The more you know, the more empowered you can feel in your pregnancy journey.

Resources From This Episode:

• Episode #31 - The Power of Progesterone: An Essential Fertility Hormone 
• Episode #53 - Miscarriage Mystery Decoded with Dr. Aumatma
• Episode #100 - Ok You're Pregnant - Now What?!

Stay Connected With Us:

• Healthy As A Mother: www.healthyasamother.com
• Instagram: @healthyasamotherpodcast
• Dr. Leah: www.womanhoodwellness.com
• Instagram: @drleahgordon
• Dr. Morgan: www.milkmedicine.com
• Instagram: @morganmacdermott

This episode is sponsored by:

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