Breakthrough Bleeding And Pregnancy | 9 FAQs

After the joy of finding out you’re pregnant, the sight of blood can make your heart sink.

Not all types of bleeding, though, mean you’re having a miscarriage.

Breakthrough bleeding is something you might know about from your normal menstrual cycle.

During pregnancy, it happens around the time your expected period is due.

Let’s take a look at breakthrough bleeding and what it means during pregnancy.

What causes breakthrough bleeding in early pregnancy?

Breakthrough bleeding refers to vaginal bleeding that occurs between menstrual periods or when you are pregnant.

Here are some of the causes of bleeding:

Hormonal changes

You might get some light bleeding around 4-8 weeks into your pregnancy, and this can be really confusing. It’s caused by the changes to your estrogen and progesterone levels and is more common than you think.

Implantation bleeding

This is also another confusing situation that occurs around the time of your expected period.

This type of bleeding happens when the embryo burrows into the lining of the uterus and disturbs the blood vessels. It’s often a rusty brown color, as it can take some time to leave the uterus.

For more information, read our article on Implantation Bleeding – Everything You Need To Know.

Uterine fibroids

Uterine fibroids are benign tumors that grow from muscle tissue in the uterus.

Only around 10% of women with fibroids experience breakthrough bleeding in pregnancy. It is thought to be triggered by the increasing levels of estrogen.

Please read more information about Fibroids And Pregnancy – 8 Things You Need To Know.

Ectopic pregnancy

An ectopic pregnancy is when the fertilized egg implants itself outside of the uterus, usually in one of the Fallopian tubes.

This generally causes pain down one side of your abdomen and vaginal bleeding. It needs to be treated urgently, as the Fallopian tube can rupture.

Ectopic pregnancies can be life-threatening if left untreated and ongoing bleeding should be investigated.

For more information, read our article on Ectopic Pregnancy – Symptoms, Signs and Treatment.

Subchorionic hematoma

This is essentially a blood clot that builds up near the fetal membrane (chorion) next to the placenta.

Research shows the occurrence is between 1.3% and 62% among different groups of pregnant women. It can lead women to experience breakthrough bleeding that is irregular in duration and amount.

Molar pregnancy

This is a non-cancerous tumor that develops in the uterus as a result of a non-viable pregnancy at implantation.

A molar pregnancy might seem like a normal pregnancy at first, but most molar pregnancies cause specific signs and symptoms, such as irregular vaginal bleeding.

Sensitive cervix

The cervix blood vessels are more sensitive and will bleed much more easily during pregnancy, if touched or irritated.

Irritation can be caused by sex or by having a vaginal exam.

For more information, please read Bleeding After Sex During Pregnancy.

Miscarriage

Around 1 in 4 pregnancies ends in miscarriage, most often due to a chromosomal problem that means the pregnancy couldn’t develop.

Early miscarriage bleeding may be accompanied by symptoms similar to your menstrual cycle.

For more information, read our article on Early Miscarriage – Signs, Symptoms and What To Expect.

You might also like to read our article about bleeding during pregnancy, to find about the various reasons you might bleed during pregnancy.

Breakthrough bleeding and pregnancy – 9 FAQs

By about 6-8 weeks of pregnancy, the placenta is developed enough to start taking over the job of making pregnancy hormones. This is known as the luteal-placental shift and sometimes causes a drop in progesterone.

This is what leads to the spotting or bleeding that happens around the time you’d normally have a period. You may experience menstrual symptoms, such as dull backache, feeling bloated, and even cramps.

As long as the placenta starts to make enough progesterone, the pregnancy is safe and will continue.

Here are the answers to 9 frequently asked questions about breakthrough bleeding:

#1: How long can breakthrough bleeding last in early pregnancy?

Breakthrough bleeding or spotting can last for around three months. After this time, the placenta has completely taken over hormone production from your ovaries.

Some women may experience bleeding or spotting throughout their pregnancy and still have healthy babies.

Always report any bleeding to your doctor or midwife.

#2: Can exercise cause breakthrough bleeding in pregnancy?

When you are not pregnant, your regular workout routine can cause tiny changes to your hormone levels. This can interfere with the way your uterine lining builds up and sheds, and cause breakthrough bleeding.

Although it’s not known whether it has the same effect during pregnancy, heavy exercise or lifting should be avoided as it can lead to bleeding during pregnancy.

#3: What’s the difference between implantation bleeding and breakthrough bleeding?

When a fertilized egg implants into the uterus, it can result in light bleeding or spotting called implantation bleeding.

Usually, the implantation bleeding lasts only a day or two and occurs around the time of implantation, or when your period would have been due.

When this happens, some mothers mistakenly think they have simply had a light period, and don’t realize they are pregnant.

#4: Does breakthrough bleeding cause cramps?

If the breakthrough bleeding is due to the luteal-placental shift, it’s possible to feel cramps or aches similar to those you would have when expecting your period.

You can feel implantations cramps but you might not notice any spotting for a day or so after.

If cramps become regular or the pain increases, and bleeding during pregnancy gets heavy, contact your healthcare provider immediately.

#5: What color is breakthrough bleeding in early pregnancy?

The color of breakthrough bleeding is usually either light red or dark reddish-brown, much like the bleeding at the beginning or end of a period. Implantation bleeding is often rusty in color.

However, depending on the cause, bleeding could resemble regular menstrual cycle bleeding and be heavier.

Seek medical advice if you’re unsure of the color of the spotting or bleeding. Wear a pad or panty liner to catch some bleeding to show your doctor or midwife.

#6: Can breakthrough bleeding cause miscarriage?

Light bleeding is usually not something to worry about, and is more common in the first trimester than most people realize.

More than half of women with bleeding or spotting go on to have healthy pregnancies and babies.

Bleeding doesn’t necessarily cause miscarriage but can be a sign that something isn’t right, such as an ectopic pregnancy.

Always seek the advice of your doctor or midwife if you’re concerned about bleeding.

#7: Can you have breakthrough bleeding and still be pregnant?

Vaginal bleeding in early pregnancy is very common, with about 1 in 4 women experiencing bleeding or spotting during early pregnancy.

It usually occurs between weeks 4 and 8, and is a sign the placenta is starting to take over making pregnancy hormones.

#8: What is the difference between breakthrough bleeding and heavy bleeding in pregnancy?

Heavy bleeding is usually classed as soaking a sanitary pad in an hour.

You might also be able to see or feel the flow of blood and will possibly be passing clots. Heavy bleeding is often accompanied by other symptoms, such as severe cramps or backache.

Heavy bleeding needs immediate medical assistance, as rapid blood loss can be dangerous. Your doctor will want to investigate what’s causing the bleeding – for example, an ectopic pregnancy or other condition.

Below are links to all types of vaginal bleeding in pregnancy:

• Spotting During Pregnancy – How Much Spotting Is OK?
• Early Pregnancy Bleeding | How Much Bleeding Is Normal?
• Early Miscarriage – Signs, Symptoms and What To Expect.

#9: Can you bleed like a period in early pregnancy?

As mentioned above, it’s not uncommon to experience spotting or bleeding in early pregnancy. The causes vary, but most often a sign of hormone shifts or an implantation bleed.

This bleeding may be mistaken for a period, and it can occur around the time your period is due.

If you have any concerns about bleeding, or any pain and other symptoms that accompany bleeding, please don’t hesitate to seek medical advice from your doctor or midwife.