Featuring Dr. Elise Balaisis, MD, FRCPC

Duration: 3 minutes

So, oftentimes, we get questions and calls about bleeding in the third trimester. If there – if you have bleeding in the third trimester, you definitely should contact your maternity care provider.

For the most part, bleeding can signal the beginning of labor and it can just be your bloody show. So, for the most part, it's not concerning; however, it still needs to be discussed with your maternity care provider.

There are many causes of bleeding in the third trimester, and there are some that are more common and some that are more concerning, and it just needs to be teased out. So, the common causes of bleeding in the third trimester, far and away, is bloody show, which is just the shedding of the cervical mucus plug. And when the cervix starts to dilate, it bleeds a little bit. This is usually just a little bid of blood mixed with mucus.

However, there are some other causes such as placental bleeding and these are ones that we'd want to make sure and rule out before – just to make sure that everything is okay. So, the placental causes include – sometimes, the placenta can overlie the opening of the uterus and that can cause a little bit of bleeding. Occasionally, if you're getting pain at the same time as bleeding, it can be caused from a separation of the placenta, and this is associated with pain and needs to be – you need to call your care provider immediately if this is happening.

So, apart from bloody show, other common causes can be just cervical trauma. Sometimes, after sex, women can bleed a little bit and this is normal, but still needs to be discussed with your care provider. There is also, occasionally, some cervical polyps that can bleed or other cervical lesions that, just by being present on the cervix, they can bleed. And, sometimes, with a little bit of friction they can bleed, again, as well.

Occasionally, but very, very, very rarely, it can be bleeding from the fetus, in which case, there would be some other changes as well. But the most important thing is to contact your maternity care provider, whether – if you should have any bleeding in pregnancy.

The color or aspect of the – or texture of the bleeding doesn't really indicate anything different. It's more quantity: if there's a lot of it, versus a small amount. Any kinda bleeding, though, needs to be discussed with your maternity care provider, just to make sure that – to be reassured for the most part.

You know, if it's – if there's profuse bleeding, then, you probably should go to the emergency department immediately – if there's cups, and cups, and cups. But, otherwise, a good – a call or a visit with your maternity care provider can sort out what most bleeding is.

Presenter: Dr. Elise Balaisis, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor