WHY DOES THIS HAPPEN?

One would think that a pregnancy starts the moment the sperm and egg collide, but actually a pregnancy is only secure when the conceptus attaches itself to the lining of the uterus.

In order for a blastocyst (the result of the union of the sperm and the egg) to survive and grow into an embryo, it needs to find a place in the wall of the prepared uterus. Between five to seven days after ovulation the level of the hormone progesterone is at its highest, and this stimulates the growth of the blood vessels that supply the endometrium, which is the lining of the uterus that comes away every month if a pregnancy does not occur. This is then recognised as your period.

When attachment of the blastocyst does take place in the lining of the womb, it is called implantation and usually occurs about nine days after fertilisation. The blastocyst attaches itself by burrowing into the spongy uterine wall. Some women will experience a bit of spotting that is known as implantation bleeding. It occurs because the tiny blood vessels in the endometrium become disturbed at the site where the implantation happens and a small amount of blood dribbles down through the cervix. This is normal and no cause for alarm, even if you experience some mild cramping.

Bleeding from an implantation site is very different from the regular bleeding from a full period, which occurs when the entire lining of the uterus (the endometrium) comes away as the body signals that no pregnancy has taken hold and the womb sweeps itself clean and starts preparing once again for the possibility of new life during the next cycle. Implantation bleeding is usually light and scanty and may last one or two days.

Because implantation bleeding occurs at about the same time that your period may start, many women think this is a small, light period and are surprised to find out that they are indeed pregnant – and further along than they thought.

Once the next period does not occur, and you know you are indeed pregnant, your doctor may have to use other methods to date your pregnancy, especially as you are likely to be unsure of the last date of your proper period.

Also at this stage you have had no other signs of pregnancy. Your breasts have not started to enlarge and there are no outer visible signs that you are pregnant. Some women have reported nausea at this early phase, due to the changes in hormones.

WHEN TO WORRY?

Implantation bleeding has no ill effects on the embryo, but bleeding in the first twelve weeks can make you worry about the wellbeing of your baby and the possibility of a miscarriage.

Almost all women think about the possibility of a miscarriage during pregnancy, but in fact only about 20 percent of all pregnancies are lost to miscarriage, most within the first three months. In most cases the cause is unknown, but reasons could include: chromosomal problems (problems with the early development of the baby), hormonal problems, extreme emotional distress, uterine abnormalities, infections, cigarette smoking, trauma, alcohol, problems with an incompetent cervix, as well as some drugs and Rhesus incompatibility.

Bleeding or spotting, if associated with cramping, fever or chills and pain that comes and goes and is felt in the small of the back radiating to the lower abdomen with loss of bloody tissue, is cause for concern.

If you suspect that you may be having a miscarriage, or you are unsure why you are bleeding, contact your doctor or midwife immediately or go to be checked at the hospital where you are planning to have your baby.

It is always a good idea to check out any bleeding at any stage of your pregnancy, if only for reassurance. YP Another huge consideration for a pregnant woman is ectopic pregnancy. This occurs when the pregnancy grows in the fallopian tube instead of the uterus. Ectopic pregnancies occur in one out of every 60 pregnancies, and can be life-threatening to the mother. Serious pain and internal bleeding can occur with ectopic pregnancies, so it needs to be checked out.