Third Trimester Bleeding: When Is It a Red Flag That Requires Hospitalization?

Prenatal Care and Childbirth

Third Trimester Bleeding

When you’re in the throes of pregnancy, you’re prepared to welcome plenty of changes to your body, from hormone fluctuations and swollen feet to morning sickness and back aches. And although it can be scary to see, sometimes even a bit of bleeding is normal throughout your pregnancy. However, the difference between light spotting and a heavier flow can mean a world of difference for the health of you and your baby, especially later on in your pregnancy. Read on to find out what you should expect with bleeding during your third trimester, and when it’s a serious case that requires immediate medical attention.

What Is a Normal Level of Pregnancy Bleeding in the First Two Trimesters?

Spotting is a very light amount of red, pink or dark-brown blood, which you might notice during a trip to the bathroom. It’s much lighter than the heavy bleeding of your period, and it does not require a tampon or pad to keep it from getting through your clothing the way menstrual blood does. During pregnancy, spotting can be caused by a number of factors.

  • During the first trimester: Roughly 25% of women experience light bleeding during these first few weeks. It’s commonly attributed to implantation bleeding, which is a sign that the embryo is implanting into the wall of the uterus. Not all women experience implantation bleeding, but for those who do, it’s often one of the very first signs of pregnancy. Implantation bleeding lasts anywhere between a few hours and a few days and will resolve on its own.
  • During the second trimester: Spotting and/or light bleeding during this stage is usually caused by irritation to the cervix, which — because of its sensitivity — is common after sex or a cervical exam. Another possible cause is a cervical polyp, a harmless growth on the cervix. In this case, spotting may result from an increased number of blood vessels in the tissue around the cervix and is not considered a cause for concern.

However, although these instances of spotting are common, heavier bleeding that more closely resembles menstrual flow is a definite cause for concern and could be indicative of something more serious, such as premature labor, late miscarraige or placenta previa. The latter can cause severe bleeding during labor and birth, putting the health of you and your baby in danger. If you experience anything more than light spotting in your first or second trimesters, you should let your doctor know right away and seek emergency care.

Third Trimester Bleeding: What’s Normal and What’s Cause for Concern?

In the final weeks of pregnancy, there are a couple of common reasons why you might experience bleeding, including:

  • Cervical irritation. As previously mentioned, cervical tissue is very sensitive, which is why it’s common to experience spotting or light bleeding after sex or a cervical exam.
  • The start of labor. Also known as the “bloody show,” this refers to the pink or bloody discharge that occurs at the end of your pregnancy. It’s a sign that your mucus plug has loosened or already has been dislodged, which means it’s safe for your baby to leave the womb. Despite its name, this can be very slight blood-tinged discharge — so little that you might not even notice it. Normally, it will be a very small amount that will not require you to wear a pad or even a panty liner.

However, late-term bleeding may also be indicative of more serious complications, including:

  • Placenta previa. This occurs when the placenta grows in the lowest part of the womb, covering all or part of the cervical opening. It can cause severe bleeding during labor and birth.
  • Placenta abruption. This complication arises when the placenta detaches from the inner wall of the uterus before birth, which can deprive the baby of oxygen.
  • Vasa previa. Although very rare, this occurs when the fetal blood vessels cross the internal opening of the uterus, which can be fatal to the baby.
  • Miscarriage. Light spotting to heavy bleeding during the third trimester can also be a sign of a terminated pregnancy.

As you can see, it’s common to experience light spotting throughout a pregnancy at different times and for different reasons. However, it’s always best to immediately consult with a doctor if you experience bleeding of any kind during the third trimester. Depending on your other symptoms, a medical evaluation may be necessary for the safety of you and your child. Your physician will be able to gauge whether or not you should proceed to the emergency room or to the labor and delivery area of your hospital.


If you have legal questions about the medical care you received from an OBGYN or other practitioner, we’re here to help. The Cerebral Palsy Family Lawyers at Janet, Janet & Suggs have expertise in personal injury and medical malpractice law — in fact, we have been helping families across the United States with their birth injury claims for four decades, securing record-breaking verdicts and settlements on their behalf. Contact us today for a free, no-obligation consultation to learn more about your rights and legal options.

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