First Trimester Bleeding - Kamm McKenzie OBGYN

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First Trimester Bleeding

First trimester bleeding is very common.  Once someone is pregnant and has spotting or bleeding, they have, by definition, at least a threatened miscarriage.  The reason this term is given is that the likelihood of miscarriage increases slightly with first-trimester bleeding. 

About 30-40% of women have some bleeding in the first 20 weeks of gestation; and half of these women will go on to miscarry and the other half have normal pregnancy.  If the bleeding is only a day or 2 then the risk of miscarriage is low as opposed to 3+ days of bleeding.


  • implantation bleeding
  • threatened miscarriage
  • subchorionic hemorrhage (a fancy way of saying there is a small amount of blood behind the placenta)
  • cervical bleeding.  Cervical bleeding is more common after intercourse, as the cervix is more vascular with pregnancy and is easily irritated.  If you notice this, refrain from intercourse for 1-2 weeks to allow the cervix to heal. 

What To Do If You Have 1st Trimester Bleeding

If you are having bleeding in the first trimester, we understand that it will make you anxious. 

If you have an intrauterine pregnancy (that we have already verified by ultrasound) and the office is open, please call and see if we can add you on that day for an appointment.  If it is in the evening, and you are bleeding less than one pad per hour, you can safely wait until the office opens and call first thing in the morning for an appointment. 

If you are bleeding more than a pad an hour and it is after hours, please page the on-call MD. 

If you have not yet had a documented intrauterine pregnancy, then you can still follow the aforementioned guidelines; however, if you begin to have severe lower abdominal pain, we need to hear from you immediately.

Please know that 15-20% of women with normal, healthy pregnancies and deliveries will have had some bleeding in the first trimester.

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