There is a lot of reproductive health ignorance and lack of knowledge, especially among young girls. According to the World Health Organization (WHO), at least 10 million unintended pregnancies occur each year among adolescent girls aged 15-19 in developing regions. 

Many young girls experience bleeding or spotting in early pregnancy, leading many to instantly believe that it is a miscarriage. A miscarriage is when a baby dies in the womb before 20 weeks of pregnancy. 

But bleeding and spotting in pregnancy doesn’t always mean there’s a problem, but it can be a sign of miscarriage or any other complication. It may not be caused by something serious, but a medical doctor needs to examine to be sure.

There is a difference between bleeding and spotting; it can happen any time, from the time a girl gets pregnant to right before she gives birth. Spotting is light bleeding, there a few drops of blood. Spotting is so light that the blood wouldn’t cover a panty liner. Bleeding is when the blood flow is heavy, enough that you need a panty liner or pad to keep the blood from soaking through underwear and clothes.

It’s normal to have some spotting or bleeding in early pregnancy. Bleeding or spotting in the first trimester may not be a problem. However, causes vary, like;

• having sex while pregnant 

• infection

• implantation—when a fertilised egg (embryo) attaches to the lining of the uterus (womb) and begins to grow

• hormone changes (hormones are chemicals made by the body) 

• changes in the cervix (the cervix is opening to the uterus that sits at the top of the vagina) 

• certain types of testing during pregnancy like an amniocentesis or Chorionic villus sampling (CVS)—these are tests that are done to check genetic abnormalities in the baby—genetic abnormalities are changes in the genes that are passed down to a baby from the parents 

• problems related to smoking (if you smoke, it’s best to stop before pregnancy or as soon as you know you’re pregnant).

Sometimes, bleeding or spotting in the first trimester is a sign of a serious problem, like; 

• miscarriage (almost all women who miscarry have bleeding or spotting before the miscarriage) 

• ectopic pregnancy (this is when a fertilised egg implants itself outside the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. It can cause serious, dangerous problems for the pregnant woman) 

• molar pregnancy (this is when a mass of tissue forms inside the womb, instead of a baby, but molar pregnancy is rare).

In all, call or visit a healthcare provider if you have any bleeding or spotting, even if it stops.

Dr Israel GITANGAZA, MBBS, is a researcher in Cardiology and Global Women and Children’s Health (Maternal Health), Founder of House of Medical Skills and Knowledge

israelgitangaza@yahoo.com