Approximately one third of pregnant women bleed or spot during the first three months of pregnancy. In the majority of cases, the bleeding is due to implantation, the pregnancy tissue attaching into the wall of the uterus. Such bleeding from placental tissue or the uterine wall usually stops in days or weeks and does not turn into the loss of pregnancy.

For some women, bleeding early is their sign for an impending miscarriage, or pregnancy loss. Miscarriages are more common than women realize, occurring in at least one of every four pregnancies. Some are so early that women think that they are having a late or heavy period. As an individual choice, some women prefer not to announce that they are pregnant until 10 to 12 weeks along.

As long as you continue to bleed in early pregnancy, we will follow you closely with ultrasounds, also called sonograms, and possibly additional blood tests as indicated. We also ask that you check in with our nurses on a weekly basis with your symptoms so we can monitor the pregnancy and be available at all times. Once the spotting or bleeding has resolved and we are able to hear a fetal heart tone with a fetal doppler machine, you will no longer need serial sonograms. Fortunately, the majority of miscarriages occur early in the first 12 weeks.

There is limited information that treatments for a threatened miscarriage are of any help, but based on your history and some test results, our practice may decide to recommend certain treatments for you on an individual basis.

It may take one or two weeks of testing to determine if the bleeding in early pregnancy is from a normal vigorous growing pregnancy or a destined miscarriage. During this observation time, a pregnant woman may continue nonstrenuous work unless she is too emotionally and physically stressed. Bed rest does not cure or treat the bleeding, but will allow the woman to see less blood since the spotting will have a chance to reabsorb before leaking out.

To increase your comfort, we suggest that you:

• Avoid intercourse, tampons, or douching until the bleeding has stopped.
• Avoid strenuous work and exercise until bleeding has stopped for one week.
• Call our office nurse every week to report in on your status.

It is normal to worry or feel sad about the possibility of a miscarriage. If the pregnancy does result in a miscarriage, you and your partner need to understand that. Studies on miscarried tissue show that the genetic content is abnormal in most cases. There is nothing a woman or partner can do to prevent or cause the pregnancy outcome. The chance of a completely normal pregnancy after a miscarriage is exactly the same as for any other couple.

Despite the folklore you may hear, we want to emphasize that a pregnancy loss is not caused by something you said, did or ate. Exercise, intercourse or stress in itself does not cause miscarriages. It is natural to fell a variety of emotions after a miscarriage, please let us know if you need additional support.

If the bleeding resolves and the pregnancy continues, rest assure that the health of the baby is unharmed and identical to any other pregnancy that did not have any bleeding. If a miscarriage results, the earliest you might try to get pregnant is approximately 2 months. You do not need to wait any longer than 2 months to attempt pregnancy again.