Pregnancy care really matters. Ask any woman who’s also a mother, and she’ll tell you just how her body changed during and after pregnancy. It’s not just the shape of your body that changes to accommodate your little bun in the oven, but the volume of blood your heart pumps shoots up just like your hormones do. Some of the changes women go through during this beautiful journey—like that glow your skin gets during the second trimester—seem more positive and easier to handle. Others often lead to anxiety and worry, not just about the health of your baby, but also your own. This is precisely the reason why pregnancy care and awareness is important. This is especially true when it comes to bleeding during pregnancy.
The fact of the matter is, you’re not supposed to get your period when you’re pregnant. This is, after all, the most easily recognisable symptom of pregnancy, and almost every girl and woman knows it to be the very basis of pregnancy care. But, your body is changing constantly during pregnancy to support another life, and even a spot of blood in your panties can cause a pregnant woman to worry.
While worrying is natural, you can overcome a lot of your fears by becoming more aware of how your body is changing during pregnancy, what it implies, and what bleeding and vaginal discharge during pregnancy can mean. So, we talked to Dr Asha Dalal, the director of the department of obstetrics and gynaecology, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai. Here’s everything she wants you to know about bleeding and vaginal discharge during pregnancy, and how to make it a part of your pregnancy care and awareness.
Understanding vaginal discharge
“It is normal to have discharge at various stages of the menstrual cycle and during pregnancy,” Dr Dalal explains. “Healthy vaginal discharge, also called leucorrhoea, is thin and clear, or white, and has only a mild odour. There is no need to worry when it is leucorrhoea.” However, if your vaginal discharge shows any of the following symptoms during pregnancy, Dr Dalal says you need to go see your doctor immediately.
• If you experience an increase in clear discharge that leaks continuously, or becomes thick and jelly-like. These changes may suggest preterm labour.
• Vaginal discharge that is lumpy, and either white or off-white, resembling curd can indicate a yeast infection. Other symptoms include itching, burning, and painful urination.
• Green or yellow vaginal discharge is not healthy, and suggests an infection, such as chlamydia or trichomoniasis. Other possible symptoms include redness or irritation in the genitals.
• Grey vaginal discharge may indicate a vaginal infection called bacterial vaginosis, particularly if it also has a fishy smell.
• Brown discharge during pregnancy is due to old blood and generally, is not a cause for concern. However, pregnant women who experience dark brown discharge should contact their doctor.
Bleeding during pregnancy: What it may mean
“Bleeding during pregnancy is relatively common, and doesn’t always mean there is a problem,” Dr Dalal explains. “The cervix may bleed more easily during pregnancy because more blood vessels are developing in this area. It is not uncommon to have spotting or light bleeding after sexual intercourse, or after a Pap test or pelvic exam.”
“However, if you have bleeding from the vagina at any time in pregnancy, you should always contact your doctor immediately.” To explain the various types of bleeding you may experience during pregnancy—and what to do when it does happen—Dr Dalal provides the following explanation.
Spotting in early pregnancy: In early pregnancy, you might get some light bleeding, called 'spotting', when the foetus plants itself in the wall of your womb. This is also known as 'implantation bleeding'. This is normal but consult your doctor in any case, especially if the bleeding turns heavy.
Signs of a miscarriage: Bleeding till the first 12 weeks into your pregnancy may be a sign of miscarriage, or ectopic pregnancy (where the foetus grows in the fallopian tubes instead of the uterus). If you experience any bleeding during this time, you should contact your doctor immediately.
Light bleeding in late pregnancy: Causes of light bleeding later in pregnancy include having sex—or even having an internal (pelvic) examination by your doctor. This type of bleeding may also occur if you have inflammation of or growths on the cervix.
Heavy bleeding at any point: Heavy bleeding is a more serious sign of a problem during pregnancy, and you should head to an emergency room or hospital, and contact your primary doctor immediately. Heavy bleeding may be caused by a problem with the placenta. Any amount of bleeding may also signal preterm or premature labour.
Bleeding during labour: Bleeding at the time of labour is very common, and it’s called ‘show.’ You will be constantly monitored at the time of labour, so getting to a hospital where proper care can be provided is necessary.
Bleeding and discharge after delivery
Dr Dalal points out that whether you have a vaginal delivery or Caesarean section, you'll have vaginal bleeding and discharge after birth. This is known as lochia. “The lochia is a combination of mucous, tissue and blood that your womb sheds as it replaces its lining after you’ve given birth,” she explains. “During the first two-three days after delivery, the amount will be slightly more. Any heavy bleeding with passage of clots should be reported immediately to your doctor.”
This is very important, as postpartum haemorrhage, though rare, is a leading cause of maternal deaths around the world. Nowadays, better medication and medical supervision after birth make this issue more easily controllable. But bringing heavy bleeding to the immediate attention of your doctor is very important.
The removal of lochia usually takes some time, but it tends to recede after a while. “The amount will reduce to spotting after seven to 10 days,” Dr Dalal says. “You may have light bleeding or spotting for up to six weeks after delivery.” Your normal menstrual cycle usually resumes after the lochia has cleared up.