During pregnancy, vaginal bleeding can be a source of significant concern for many women. Here are some common reasons why women experience bleeding and some guidelines on whether you need to go to the emergency department or wait until you can see your doctor in the office.

1. Ectropion – This is when the cells that are normally found within the cervix grow onto the outside and are now exposed. The vagina is an acidic environment, which these cells are not used to, and they become red and inflamed. They may be easily disrupted via sexual intercourse or during a vaginal exam.

2. Cervical polyp – This is usually a benign growth of connective tissue that can be bleed when touched or disrupted. Polyps are typically small, easy to see during a speculum exam, and can be removed if needed.

3. Possible miscarriage – This is obviously the most worrisome cause of bleeding, occurring about 15-20% of all pregnancies. The vast majority of women with spotting or light bleeding in the first trimester do not miscarry, though this sign puts you at higher risk of having a miscarriage than someone who did not have bleeding.

Your OB/GYN should be aware if you are bleeding, however these common causes rarely warrant a trip to the emergency room. A good rule of thumb is to measure the amount of blood on your sanitary pad. If you are completely soaking through a moderate to heavy maxi pad in 1-2 hours, then go to emergency department. In early pregnancy, a miscarriage might cause this kind of significant bleeding, which might require a surgical procedure known as a dilation and curettage to clean out the uterus. Additionally, if you have symptoms like headache, dizziness, shortness of breath, persistent palpitations, and/or loss of consciousness, you should seek medical attention immediately.

Vaginal bleeding is a big source of anxiety for pregnant women. In the absence of severe signs and symptoms, it does not require an emergency room visit and may be evaluated by your OB/GYN at the earliest available appointment.

The good news is that for most women with light bleeding, the pregnancy will be just fine.