What is Breakthrough Bleeding in Pregnancy?

Bleeding while pregnant can be extremely worrying, especially during your first pregnancy, as your mind goes straight to the worst-case scenario. However, bleeding doesn’t necessarily lead to a miscarriage and isn’t always a sign that you are having one or that something is going wrong.

Something called “breakthrough bleeding” can happen during your pregnancy.

What is breakthrough bleeding?

Breakthrough bleeding refers to any kind of bleeding or spotting that occurs outside of your normal menstrual period or while you are pregnant.

Breakthrough blood tends to be pink to dark, rusty brown, as you may see at the beginning or end of your normal period. In some cases, will look like normal menstrual blood.

Breakthrough bleeding can be heavy enough to need a pad or tampon or just be spotting that will not even saturate through normal underwear.

What causes breakthrough bleeding?

There are a number of different causes of breakthrough bleeding, not always related to pregnancy. These are:

  • Switching to a new method of hormonal contraceptive or different pill – breakthrough bleeding is thought to be the way in which your body adjusts to the new hormone levels.

  • As the result of an STI or other inflammatory infection – this can typically be treated with antibiotics.

  • Due to having a sensitive cervix – the cervix becomes soft during pregnancy and so can bleed after being irritated by a vaginal exam or sex.

  • As the result of hemorrhage during pregnancy – these can be large, with a lot of bleeding, or small, with only spotting, most of which are not harmful.

  • Due to a miscarriage or ectopic pregnancy.

  • As the result of fibroids – these are growths in the uterus caused by genetics or hormones.

Clearly, some of these situations are more stressful than others. Remember that many of the more concerning causes on this list will often come with other symptoms.

How common is breakthrough bleeding in pregnancy?

Breakthrough bleeding is common during the first trimester of pregnancy and so doesn’t mean that there is a problem, although miscarriage can never be ruled out.

According to the National Institutes of Health, around 20% to 30% of pregnant women have experienced breakthrough bleeding during the early stages of pregnancy, with 50% of these instances resulting in a miscarriage.

Some pregnant women experience breakthrough bleeding around the time that their usual menstrual period would have occurred, along with the typical symptoms of a period, such as cramps, backache, and bloating.

Can you have breakthrough bleeding and still be pregnant?

Yes, you can have breakthrough bleeding and still be pregnant. When you are pregnant, your pregnancy hormones will prevent your usual monthly cycle from occurring. In some instances, these hormone levels do not get high enough within the first trimester to prevent your period, so it occurs in the form of breakthrough bleeding.

In fact, research has shown that around 1 in 4 women are found to experience breakthrough bleeding to some extent during the first 12 weeks of their pregnancy.

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What does breakthrough bleeding look like when pregnant?

Breakthrough bleeding when pregnant tends to be a very light flow of blood or just spotting. If you experience anything heavier than this while pregnant, you should seek medical advice from your doctor or OB/GYN as soon as possible. It’s always best to be safe than sorry, and you don’t want to have additional stress simply from the worry.

Can you spot every day while pregnant?

Spotting occurs most commonly during the first trimester of pregnancy; it can however occur during any stage of pregnancy. If you experience spotting after your first trimester, this may be an indication that there is an issue with the placenta or cervix and so you should see a medical professional.

This said, some women will have spotting throughout their entire pregnancy and will still give birth to perfectly healthy babies, with regular check-ups from their doctor.

You can also have light spotting if you have sex while you are pregnant, although this tends to only last a few hours.

How long does breakthrough bleeding last in early pregnancy?

Breakthrough bleeding can last for up to 3 months, i.e. the length of the first trimester, each time lasting about the number of days as your usual period would. After these 3 months, the hormone production within the ovaries is taken over by the placenta, and breakthrough bleeding should subside.

When should I be concerned about spotting?

Any bleeding throughout your pregnancy should be reported to your doctor or OB/GYN to ensure that there is no issue with the pregnancy itself. That being said, if you experience spotting only during the early stages of your pregnancy it is likely that your doctor will simply advise you to take it easy and that it is nothing to worry about.

If your spotting lasts longer than the first trimester, this is when you should be more concerned and must see a medical professional. The same goes for if your bleeding is heavier with clotting and pain. If in doubt, talk to your doctor.

Is spotting at 8 weeks normal?

Yes, spotting at 8 weeks is normal, as well as at 12 weeks, as this is when your normal period would have been due.

It is also normal to find spotting at 6 weeks. This is the time when the majority of women find out that they are pregnant. Just make sure that you monitor this spotting and tell your doctor or OB/GYN at your first prenatal appointment.

When should I go see a doctor about spotting during pregnancy?

Make sure that you let your doctor know about all bleeding that you experience, even if it is only spotting. They will be able to tell you whether your bleeding should be monitored or that it is a normal part of your pregnancy.

If you have any changes to the intensity of the blood flow within the first trimester you should check in with your healthcare professional straight away, and if you experience bleeding anytime during your second and third trimesters you should seek immediate medical attention.

Breakthrough bleeding is often nothing to worry about and it is simply your body continuing with its normal menstrual cycle during pregnancy. However, it is important that you always seek the advice of your doctor or OB/GYN when any bleeding occurs so that you can keep you and your baby healthy throughout your pregnancy.

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