Placenta previa
Placental abruption
Vasa previa

Vaginal bleeding during middle to late pregnancy is always of some concern. Significant bleeding (soaking a pad or more) after 20 weeks of pregnancy is referred to as an Antepartum Haemorrhage (APH). Lesser amounts of blood loss may be referred to as spotting or scant loss PV (per vagina).

An antepartum haemorrhage can be caused by bleeding from the cervix or vaginal area (about 50 - 60% of cases), placenta previa (about 20- 25%), placental abruption (about 20- 25%) or vasa previa (very rarely).

Bleeding not associated with the baby or placenta

About 50 to 60% of vaginal bleeding during pregnancy is caused by bleeding from the woman's cervix or vaginal area, not associated with the unborn baby or placenta. Bleeding commonly presents as bright spotting (fresh bleeding), or brown spotting (bleeding that happened a day or so ago) and may appear as a stain on the underwear, or something noticed when wiping with toilet paper.

NOTE: Any vaginal bleeding should be communicated to your caregiver so that possible health concerns can be investigated and ruled out. In many cases, the cause of bleeding is not serious or is unknown, and the pregnancy continues as normal.

There are many possible reasons for vaginal bleeding during pregnancy. These can include:

Polyps, or small pieces of tissue overgrowing inside the vagina. Just as skin tags can appear on the skin during pregnancy (due to an increase in the woman's metabolism), so too can skin tags grow in the vaginal area. Polyps may start to bleed on their own, or through rubbing with sexual intercourse. The caregiver may use a speculum to look inside the vagina after bleeding happens, discovering the polyps. They are not a problem and will usually reduce in size and/or disappear within a few months after the birth.