pregnant bleeding

Common Causes of Bleeding in Pregnancy

Featured image: Photo by Sierra St John on Unsplash

Featured image: Photo by Sierra St John on Unsplash


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Hi there. I am just going come on and say hello, and I wanted to talk to you about bleeding in pregnancy. It's incredible. A lot of people online, on my social media pages, are asking me about bleeding in pregnancy - and they're freaking out. Of course, they're freaking out. It's scary. I get it. And in my own practice, when people call me and tell me they're bleeding, they’re scared.

I totally get it. 

But what I wanted to do is reassure you that in the first trimester, 25% of women will bleed. And many times, the causes are benign. Like nothing to worry about, easy to treat if needed, or monitor, kind of watch and wait. 

Sometimes the causes are more serious, so definitely if you have bleeding in pregnancy, you can post it on my Facebook group or post it on Instagram, you can tell me about it. But I really want you to check it out with your provider.

Let me go over some of the common things. First of all, I would say about half of people who bleed in the first trimester miscarry. So that means 50%, they're not going to miscarry. A lot of times miscarriages go unnoticed if people aren't tracking their cycles. It's just like, you have a heavier or a late period. But there are people that track cycles and they see bleeding, and that's scary. 

So, the first thing is that when the fertilized egg implants in the uterus, around the time of the missed period, that's implantation bleeding, and that might last a day or two, a little bit of spotting. Nothing to worry about. Okay. 

Also, some people have a little vaginal or cervical inflammation or infection, like a yeast infection, for example. Many infections or inflammation can cause a little bleeding and that's easy to treat holistically. It's easy to deal with. 

Sometimes, first of all, in pregnancy, your blood volume is doubling. You are so vascular. There’s just many more blood vessels in the area.

So that's how come people tell me they have bleeding and I said, did you have sex?, and they'll say, oh yes. Well, that's what it is.

Now, it's not dangerous to have sex, but if you notice a little bleeding after sex, intercourse, that's just a little tiny blood vessel in the vaginal area or the cervix that just broke, and you'll just have a little spotting, a little bright red blood, and then brown the next day or something like that, and then it will go away. 

If you had an internal exam that can cause bleeding. So first of all, I’d question why you're having internal exams, but many times I find that people are having way too many internal exams that are necessary, but that can cause bleeding. A pap smear can cause bleeding. And this kind of bleeding does not endanger the pregnancy. Yes, if you need to have a pap smear in pregnancy, you can absolutely have one, it does not affect the pregnancy. It's just scraping the little cells on the top of where the cervix is. That doesn't go inside the cervix or into the uterus, okay, but that can cause bleeding. I've even had moms that have had varicose veins vaginally, and have noticed some bleeding with that. 

So, these are all sort of innocuous things that can cause bleeding. 

Another is it benign growth, like polyps. It could be uterine or cervical, can cause a little bleeding. They have nothing to do with the pregnancy, it’s just that it's more in engorged, more likely to bleed. So these are just normal, nothing to worry about.

There is something called sub chorionic hematoma. I don't know if you've ever heard of it? I definitely want to hear in the comments your experience with bleeding in pregnancy too, because I want everyone to feel that they're not alone.

I want people to be able to share and to know how common it is to have bleeding in pregnancy. 

A sub chorionic hematoma is kind like a bruise, or like a collection of blood between the placenta and the uterus, and most of the time, the vast majority of times, it's something that might've occurred at implantation or somewhere after that. Most of the time, it just resolves, and does not affect the pregnancy. 

So, if you're in the first trimester, I definitely would check with your provider because there's some basic blood tests that we can do, and sometimes you need an ultrasound.

I'm not talking about routine ultrasound; I'm talking about if we're concerned about something. Sometimes an ultrasound can help us determine what's going on.

Anytime there's bleeding in the first trimester, we want to make sure that it's not an ectopic pregnancy. Ectopic pregnancy is potentially life threatening. It's rare, thankfully, one in fifty pregnancies, twenty in a thousand pregnancies. I've seen it, I've detected it myself, and that's something that we want to detect before it actually ruptures.

So thankfully it's rare. What's more common of the serious is a miscarriage. And a miscarriage is most often related to a pregnancy that's just not meant to be, a chromosomal abnormality in the fetus, and it's sort of nature's way of releasing that. Sometimes it could be a low progesterone and the pregnancy is healthy, so that can be treated with natural progesterone. 

There's so many that are involved, but you know, years ago, before we had all this testing, and people weren't using birth control, and people were having sex, and I would say, just about everybody who gets pregnant will have, in their lifetime, one miscarriage at least. That's how common miscarriage is. 

Once we get the heartbeat of the baby, it's rare. So if you have a fetal heart rate, miscarriage is rare. But anytime there's bleeding again, just check it out. 

Now, in the second half of pregnancy, we start thinking of, we’re not thinking of ectopic pregnancy anymore, or a threatened miscarriage, we are thinking if there is bleeding in the second half of pregnancy, in addition to possible bleeding after sex, or a little inflammation or infection, thinking also about a placenta previa, which means the placenta is implanted partially or directly over the cervix. That is something that we need to watch and monitor, and you do not want to have any internal exam if that happens. And thankfully it's rare, but we just want to make sure that that's not what it is. 

Also, placental abruption; if the placenta is partially separating from the uterus. That can cause bleeding.

Preterm labor; because look, as the cervix dilates, tiny blood vessels will disrupt and cause bleeding. 

In labor; labor, there's blood. You have bloody show and as you dilate you bleed, right? 

So, these are just some of the many reasons that you can have some bleeding in pregnancy, and I just love so many times we just don't find out the reason. All right? And then everything's just fine. 

But it's always better to just check it out. 

So that's what I have to say today. I would love to hear from you your experience with bleeding in pregnancy, whether it's your personal experience, the experiences of your clients, or people that you know, so that all of you will just realize how common it is, and that you're so not alone. Okay? 

And if you found this interesting or helpful share it ok?

Love to you all. Namaste. Have a good afternoon, or day, or evening wherever you are in the world.

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Learn ways to calm yourself, and holistic modalities you can do depending on the cause, and so much more….in my Natural Birth Secrets book second edition.

Learn ways to calm yourself, and holistic modalities you can do depending on the cause, and so much more….in my Natural Birth Secrets book second edition.

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Bleeding in Pregnancy

 

Bleeding During Pregnancy - Why It Happens and What To Do About It

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Vaginal bleeding during pregnancy can often cause us to freak out and start thinking the worst. However, there are a multitude of less serious and more common reasons for light bleeding at this time, such as:

  • A burst of a tiny blood vessel in the vagina or cervix engorged from pregnancy hormones (especially with local infections, during the friction of sexual intercourse, internal exam or pap smear, and when there are vaginal varicosities).

  • Cervical polyps (often benign growths on the cervix that usually increase in size during pregnancy).

  • Hormonal fluctuations, especially around the time of usual monthly periods.

  • The normal implantation of the fertilized egg within the uterus (occurs 1-2 weeks after conception, around the time of your expected period, and lasts just a few days).

  • Bloody show at the beginning of labor (a welcome event only if your baby is at least 37 weeks, but more concerning if preterm).

Vaginal bleeding in the first trimester of pregnancy affects approximately 25% of all pregnant women. Less than half of these bleeding women actually miscarry. And once the fetal heartbeat is detected at the prenatal visit or on sonogram, miscarriage is rare and unlikely, especially in a healthy pregnancy where there is no prior history of problems like recurrent pregnancy loss. about 1 in 10 pregnant moms will have some bleeding in the third trimester. More often, the cause of bleeding is never found, the bleeding stops and the pregnancy continues to a happy conclusion.

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Vaginal bleeding during the second half of pregnancy can infrequently indicate potentially serious complications such as:

  • The placenta partially to completely separating from the uterine wall before birth (placental abruption).

  • A placenta that is located close to or over the cervix instead of higher in the uterus (placenta previa). A note of reassurance is that while approximately 45% of placentas are classified as “low lying” during the second trimester, the majority “migrate” upwards far enough away from the cervix by the third trimester, and are not a cause for worry.

  • The umbilical cord first inserts into the fetal membranes, then the exposed blood vessels without the protection of the cord travel to the placenta (velamentous insertion).

When To Call The Midwife or Doctor

You should be evaluated by your midwife or physician any time there is bleeding during pregnancy in order to rule out anything concerning or deal with something that is treatable. Call your practitioner if bleeding is light but lasts more than 3 days, is heavy like a period or a continuous flow (you completely soak through a regular sanitary pad in an hour or less), or accompanied by any of the following:

  • Pain in your pelvic area, abdomen, back or shoulder

  • Rhythmic uterine cramping

  • The passage of tissue or clots bigger than a 50 cent piece

  • Foul smelling discharge

  • A gush of fluid from the vagina

  • Symptoms of a urinary tract infection - like feeling you have to urinate frequently, but only little amounts come out, burning or foul smelling urine, low mid pelvic pain when you pee

  • Fever or chills

  • Decreased fetal movements

  • Weight loss, premature resolution of early pregnancy symptoms like nausea, vomiting, fatigue, and breast tenderness, or the return of your normal breast size

  • You have a history of ectopic pregnancy, miscarriage, molar pregnancy, placenta previa or abruption, or other significant health problem

  • You simply feel that something isn’t right

Once A Serious Cause of Bleeding During Pregnancy Has Been Ruled Out

Once you have been evaluated and the more serious causes of the bleeding have been ruled out or dealt with, you should do the following.

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  1. Make sure any issues that can be treated, like infections, MTHFR mutations or low progesterone, have been addressed.

  2. Do what you love, what brings you joy, and use your imagination to make routine tasks more enjoyable - even by turning on the music and dancing while you work.

  3. Take it easy and avoid heavy lifting until a few days after the bleeding subsides, with frequent breaks in a comfortable lounge chair, bed or couch.

  4. Limit non- essentials, delegate and ask for extra help from family and friends.

  5. Stock up on some good books, inspirational podcasts and movies, practice deep breathing and progressive relaxation exercises several times a day.

  6. Put nothing in the vagina (this includes no sexual intercourse) until 1-2 weeks after the bleeding has stopped.

  7. Eat warm foods, drink fresh ginger tea (steep a piece of raw ginger in a quart mason jar of boiling water for several hours), and limit cold and frozen foods

For a friable cervix that bleeds easily, small amounts of bleeding from a subchorionic hematoma, or persistent spotting from placental implantation, eat foods high in vitamin C. Good choices are citrus fruits, berries and dark leafy greens, as well as many other fresh produce. You may need to supplement with 500-1000 mg vitamin C with bioflavonoids, and add vitamin E (alpha-tocopherol)  400 - 800 IU daily for a few weeks only, to support stronger placental adherence to the uterus in early pregnancy. Chasteberry can enhance pregnancy hormones, and natural progesterone can be prescribed if levels are low in the first trimester. There are natural supplements recommended like whole food B complex with 2-3 mg l-methylfolate, and at least 400 mg DHA/EPA Omega threes for those with the MTHFR mutation, as well as low dose baby aspirin (81 mg) recommended by fertility specialists that can thin the blood enough to help it circulate through the tiny vessels of the early placenta without clotting, and prevent miscarriage if that is the issue. If you want to avoid the potentially toxic medication, ask your provider about using a natural ginger supplement instead.

If You’re Cramping But Not Bleeding

If all more serious causes have been ruled out, and you are simply having a lot of cramping without bleeding, make sure you are drinking enough fluids, and are getting plenty of calcium and magnesium in your diet. Start by eating lots of green leafy and seaweed veggies, ground sesame seeds (tahini), wild caught fish like salmon, almonds, whole grains, and organic yogurt and cheese. Avoid excessive cow dairy intake, coffee and soda, even spinach, which decreases calcium absorption. You may need additional supplementation - at least 400 mg magnesium and 1200 mg calcium daily in 2-3 divided doses; or make your own infusion of nettles and red raspberry leaf tea, using the recipe here.

Also, helpful herbs to reduce cramping are cramp bark, black haw, and wild yam. You can experiment with one of them at a time, or use all together in combination. Take 1 - 5 cc of each tincture every 30 minutes to few hours, depending on how often and intense the cramping is.

If There’s A Threat of Miscarriage

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Women can bleed and cramp and still have a healthy pregnancy. But not all miscarriages can be prevented. Miscarriage is actually pretty common, and rise with age and the more pregnancies a woman experiences. About 10-20% of women with known pregnancies miscarry before 20 weeks. Many miscarry around the time of the first missed period, before they even realize they are pregnant.

Heavy bleeding with cramping, lower abdominal or back pains and/or passage of tissue or fluid from the vagina during early pregnancy usually indicates that a miscarriage is in progress and there is little that can be done to stop it. In most cases, a miscarriage is your body’s natural way of rejecting an unhealthy or abnormally implanted fetus.

Once you know you are pregnant, it is still often experienced as a huge loss and the grief can be intense. I am sorry if that is what is happening and I encourage you to mourn as you need to, tap into your strength, look for the silver lining, and notice how you have grown as you heal.

Other less-common reasons for an isolated miscarriage include infection, dehydration, poor nutrition, severe trauma, and exposure to significant doses of hazardous substances (toxic industrial or environmental chemicals, drugs, alcohol, smoking, and radiation). It is still important to get evaluated, though, to be sure what is going on, and get treatment if needed..

If you have been informed that a miscarriage is threatening, follow the suggestions above for treatment of bleeding, plus:

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  • Drink a small glass of wine or beer, or a shot of whiskey in juice to lessen the cramping at night if interfering with sleep and you do not have a history of alcohol addiction, but alcohol should be used in very limited amounts during pregnancy.

  • Keep well hydrated with plenty of fluids (at least 8-10 glasses of water daily).

  • Light some candles and take relaxing warm baths with your favorite essential oils.

  • Take 200 IU of Vitamin E 3-4 times per day for no more than 3 weeks to strengthen placental attachment and reduce spotting.

  • Take 500 mg of Vitamin C with bioflavonoids twice a day during the crisis period.

  • Do a yoga nidra, mindfulness practice or a progressive relaxation meditation to stay calm inside.  Whenever worrisome thoughts occur, use them as an opportunity to practice being present in the now and doing breathwork. For example, for 5- 10 minutes twice a day, do slow deep extended exhalation breaths (inhale for a count of 3, exhale for a count of 6), while allowing yourself to feel whatever you feel.

  • Tune into what is true for you, and what you really want. If it is your heartfelt desire to continue the pregnancy, let that feeling expand, as that will enhance whatever else you are doing. You can send loving thoughts to your baby and visualize your womb surrounded by love, light and spiritual protection; affirm that baby is welcome in your life, you and your baby are healthy and vibrant, your placenta is strongly attached to your uterus, you are providing safety, security and nourishment to your baby…as well as mama love, a love like no other.

  • You and your partner can place one hand on each other’s heart, the other hand on your womb, and imagine enhancing your family bond. Send love from your hearts to one another and to your baby. Focus on deepening and strengthening your love and connection, especially if there is tension between you. Never underestimate the close relationship of the mind and heart to the body, and the power of love and harmony to heal, and transform...and even prevent miscarriage if the pregnancy is healthy. This can be a wonderful opportunity of healing and transformative for all of you.

  • It helps to love yourself unconditionally and with compassion, to have a clear intention to release all self judgement and blame. Visualize the blame leaving you with each exhalation or melting away from your body, sinking down into the earth beneath you.  

  • Connect to other wise women, in sisterhood - those who uplift, inspire and support you. Have a good cry, a good laugh and a good hug several times a day.

  • It also helps to pray, and as much as possible. Then let go, surrender to what is greater and wiser than us all, the benevolent infinite, and release trying to control what is not in your control. Can we embrace what is, even when we do not understand the whys?

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If you are interested in herbal remedies to help prevent a threatened miscarriage, you can make your own infusion or tincture combination by mixing the following bulk dried herbs or the same herbs in tincture form:

Combine equal amounts of partridge berry, cramp bark, black haw, and wild yam, false unicorn root, and chasteberry, with a dash of lobelia. Take 2.5 to 5 cc of the mixture every ½ to few hours until symptoms resolve, then a few times per day for a week. This mixture can be taken prophylactically twice a day in the first trimester, if you have a history of miscarriage in prior pregnancy. These herbs are said to aid the miscarriage if the fetus is not normally formed, but prevent it if it is strong and healthy.

Most of the supplements and herbal remedies I recommend are available on my customized online holistic apothecary. Find the best supplements that have gone through my thorough screening process at the Holistic Apothecary. Look in the category for miscarriage or search them individually. My online dispensary is a convenient way for you to purchase my hand-picked, professional-grade, whole food supplements and other natural health products. Ordering is simple, and the products will be shipped directly to your home or work within a few days. Some samples for threatened miscarriage from my online holistic apothecary are listed at bottom of this blog.

If you need more personal guidance, I am happy to help. You can set up a consultation with me here.

For extra support in pregnancy and relief of common aches and pains, wear an abdominal binder. Bellefit makes a fine one as pictured above. They also make postpartum support girdles . I have a holistic approach to life, including healing after pregnancy and birthing. Nothing replaces abdominal toning and exercise for restoring muscle strength and tone - which I encourage for all mamas as soon as they feel up to it postpartum. Nothing replaces touch, slow deep abdominal breathing, and a 'love your postpartum body' perspective that I promote.  But I have found many mamas simply feel comforted by this support garment, especially early postpartum and temporarily as needed....to be used without forfeiting abdominal toning and strengthening exercise, breathing well and touch. 

I have found Bellefit supportive garments to help like they use belly binding around the world such as in Indonesia. They do aid in early postpartum healing and provide support many mamas feel comforted by. I deal with human beings and the reality is many postpartum mom's struggle with body image, feel frustrated that getting back to themselves takes longer than expected.

Being into holistic health and healing includes being sensitive to real human struggles - the mind, body, heart and soul of each person and their unique situation. 

Having helped countless women with these issues after having a baby as a midwife, I have found many still love that binding and feel better with this support, and ability to fit into their pre-pregnancy clothes comfortably and sooner than they would if they went through a C-section or natural childbirth recovery without it - especially when they have to dress up and fit into a certain favorite outfit for a special occasion or wedding not long after having a baby.

For more info on the Bellefit girdle, check out my blog about it here.

 

Have a Great Pregnancy and Postpartum Recovery (with a little help from Bellefit)!

 

Remedies for Threatened Miscarriage: