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Here's The Deal With Spotting During Pregnancy

by Kelly Mullen-McWilliams

Before I got pregnant, I remember thinking how great it would be to not have a period for nine whole months. What I didn't know was that cramping, spotting, and even bleeding is relatively common during pregnancy, and that I'd be more tuned into my body and its sensations than ever before. So is spotting during pregnancy safe? For Dr. Eva Martin, the founder of Elm Tree Medical Inc., the bottom line if you're spotting is, "don't panic, but call your doctor."

While it's tempting to turn to the internet for answers, Google can't evaluate your condition. Only a doctor can do that. If you're looking for quick reassurance, though, know that according to the American Congress of Obstetricians and Gynecologists (ACOG), 15 to 25 percent of women bleed during their first trimester, and in many cases, the cause is entirely harmless. You've probably already heard about implantation bleeding, and Baby Center notes that one in four women spot during pregnancy. However, bleeding in the first trimester can also be serious, with miscarriage the worst-case scenario. Like so much about pregnancy, spotting represents an unknown, and your doctor will want to hear about any first trimester bleeding right away.

"Women see bleeding and they think, 'I'm scared and I don't want to get evaluated, I don't want to know,'" Dr. Martin says. The best thing is to go in anyway. A doctor can easily find out with an ultrasound and an exam if something's gone wrong.

According to Martin, the cervix becomes highly sensitive, or friable, as pregnancy progresses, when "blood vessels live a little closer to the surface," and the slightest jolt can cause bleeding (sex can, too). Though bleeding is still usually benign, you could also be looking at more serious scenarios. Meaning pre-term labor, placenta previa, or placental abruption. So again, it's important to get checked out.

If you're only spotting lightly, should you still call?

"Always, always, always call and get that evaluation," advises Martin, noting that even serious conditions can present with just a small amount of spotting. Martin reports that many women who visit her for bleeding often worry that they've bothered her unnecessarily. There's no need to apologize. Doctors want to evaluate you, and it's a source of concern in the medical community that many pregnant women are getting their information solely from the internet, and neglecting to contact healthcare providers.

In week 24 of my pregnancy, I experienced a heavy bleed. Here's what went down, step-by-step. It was just after midnight, and I admit, I hesitated to make the call. But my body gave me no choice. My OB met the fear in my voice with calm reassurances, asking questions about the nature of the bleeding. Was it heavy? Light? Dark brown or bright red? Did I feel dizzy at all? Erring on the side of caution, she decided to send me to the ER. My husband drove me to the hospital, where the doctor-on-call performed an ultrasound and speculum exam. Neither test identified a clear cause of the bleed, which is actually good news. In all likelihood I suffered only a minor tear, already healed. My husband and I now think of this time as the first early-morning hours we'd spend together as frightened parents.

My OB checked up on me the next day. She was so glad I called.

Regardless of how much you're bleeding or how heavy your spotting is, don't hesitate to call your doctor. If all you get is peace of mind, that's enough.