Topic Overview

The following guidelines will help you determine the severity of your vaginal bleeding.

• Severe bleeding means you are passing clots of blood and soaking through your usual pads or tampons each hour for 2 or more hours. For most women, passing clots of blood from the vagina and soaking through their usual pads or tampons every hour for 2 or more hours is not normal and is considered severe. If you are pregnant: You may have a gush of blood or pass a clot, but if the bleeding stops, it is not considered severe.
• Moderate bleeding means that you are soaking more than 1 pad or tampon in 3 hours.
• Mild bleeding means that you are soaking less than 1 pad or tampon in more than 3 hours.
• Minimal bleeding means "spotting" or a few drops of blood.

Vaginal bleeding can be a sign of miscarriage or premature labor during pregnancy in the first trimester. During the first trimester of pregnancy:

• Up to 25% of pregnant women have some spotting or light vaginal bleeding. Of these women, about 50% do not have a miscarriage. Vaginal bleeding during pregnancy is more common among women who have been pregnant before than in women who are pregnant for the first time.
• Very early spotting sometimes occurs when the fertilized egg implants in the uterus. Implantation takes place 6 to 10 days after fertilization, which usually occurs on the day of intercourse.

Bleeding in the second or third trimester of pregnancy may mean a problem is present, such as:

• Placenta previa. Normally, the placenta is attached to the top portion of the uterus. In placenta previa, the placenta has attached low in the uterus, and partially or completely covers or blocks the cervix.
• Placenta abruptio. Normally, the placenta is firmly attached to the uterine wall until birth. If the placenta separates from the uterus before the baby is delivered, this is called placenta abruptio or abruptio placenta or placental abruption. Placenta abruptio usually occurs in the third trimester of pregnancy, but it can occur any time after the 20th week.