Period while pregnant? A cautionary tale


Period while pregnant? A cautionary tale

When it comes to period during pregnancy, I’m an expert. Well, maybe just a specialist. Because until I hadn’t been through it myself, I didn’t know much about the fact that bleeding might be more than an inconvenience. It can also be a clear warning signal. A RED LIGHT in its most explicit form. Today I can say “I’ve been there” and share my story. There’s going to be blood, tears, fainting, ambulances, hospitals, and the longed-for happy ending. Hop in!

Paulina Pomaska

Published: 17.06.2021 9 minreading time

illustration period while pregnant

Illustration: Jarek Danilenko

“I had my period while I was pregnant”. How many times did you hear this MYTH from your friends, the people you know, or even don’t know? This cautionary phrase, passed down by word of mouth might do more damage than you’d think it could. Because period is nothing unusual, at least if it comes regularly. BLEEDING, on the other hand, is a reason for an immediate doctor’s appointment.

Next stop: motherhood

My story began on a city bus. It was early in the morning and the bus was full of people. I was standing by the window, closed – as usual – despite the pervasive stuffiness in this cramped tin can. Suddenly, I felt this familiar tingling in my cheeks and already knew what was going to happen. I turned to a woman standing next to me to ask for help. I knew I was going to collapse in a moment. As anticipated, I came to at a bus stop. I was lying on a bench, surrounded by a large group of strangers. I remember that I was nervously adjusting my dress which had gone up definitely too far and I was flashing my underwear. The strangers were asking me questions, like I was in Who Wants to Be a Millionaire? At that point, I had no idea that I was going to be answering tons of questions that day, and at the end of it, I was going to break the bank.

There was this ringing in my ears and I felt nauseous, but the man who waited with me for the ambulance told me that I’d fallen on people and had not hit my head. It was the first time when I felt appreciation for the squeeze on the bus. An elderly woman gave me her very sweet tea and a banana, winking at me and saying: “maybe you’re pregnant”. Wait a second. Pregnant? Pregnant how? Can you still have a period and be pregnant? Because I was having my period. A hefty one, for that matter. Definitely a period, not mere spotting. So I should be okay, right? Despite all that, the innocent “maybe you’re pregnant” question dinned in my ears. Pregnancy, pregnancy, pregnancy. I was almost convinced!

Having a period while pregnant?

In the ambulance they ran some basic tests and, once again, asked me if I was pregnant. I replied, once again, that I was on my period (does the whole world know by now?). And then I heard, FOR THE FIRST TIME IN MY LIFE, from the paramedic that, essentially, it can’t be a period but only vaginal bleeding because you can’t have your period while pregnant. YOU CAN’T HAVE YOUR PERIOD WHILE PREGNANT. Yeah, right… I know tons of such stories!

I was offered two choices then: “go home and do all the tests on your own or we’re taking you to the hospital, where you’ll have all the necessary consultations with various specialists even today”. Obviously, not knowing what I was bargaining for, I chose the second option. So I spent a couple of hours at the ED, waiting in endless lines in front of various doctor’s surgeries. First, the medical history, ECG, blood specimen collection for testing, then the neurologist stated that there was nothing out of place in my organism – the laryngologist said the same. I was referred to a CT scan. I waited by the designated surgery, where the doctor who had taken my medical history found me and said: “she claims that she’s on her period but don’t do the CT scan yet, not until her blood test results come in”. And after another hour the same doctor came to me and declared that I was pregnant, and the beta hCG results indicate the 7th week. She quickly sketched the causes of the bleeding and recommended a gynaecologist’s appointment as soon as possible. I was thrilled but only momentarily. If I’m two months pregnant, why do I experience such a heavy bleeding from my birth canal? On the same day I had an appointment with my gynaecologist to look for the causes of my “menstruation” (as I’ve heretofore thought about it).

Having a period while being pregnant – a myth!

Simply put: you can’t have your period while pregnant. Why? Because after conception, periodic bleeding (a.k.a. menstruation) stops. No exceptions. Despite the fact that internet message boards swarm with “I had my period while pregnant” stories.

So the period during pregnancy is…?

It’s a vaginal bleeding which should make us worry. Spottings or bleedings do occur in the first weeks of pregnancy but they’re always to be consulted with our ob-gyn. We always investigate the causes of bleeding.

Spotting, which is noticed on the underwear or toilet paper by even 40% of pregnant people, is a tiny amount of pink-, bright red-, or brown-coloured blood. It might be, for instance, implantation bleeding. It usually occurs between the second and fourth week since fertilisation. More specifically, when the fertilised egg implants in the uterine wall.

Spotting, not period, during pregnancy: causes

The most frequent cause of spotting is the corpus luteum failure. Another one is a urinary tract infection – then, the blood on toilet paper doesn’t come from the birth canal. Another issue is the cervical ectropion, erroneously referred to by many gynaecologists as cervical erosion which is a different disease. Cervical ectropion is the spreading of the glandular cells (darker in colour) to the outer layer of the cervix (which has the colour of blood vessels), which creates an impression of lesions on the cervix. Erosion, on the other hand, is a tissue defect in the cervical lining. Sometimes the cause of bleeding during pregnancy are previously undiagnosed haemorrhoidal varices. Each and every one of the health conditions mentioned above require an immediate consultation with a doctor. Even if we suspect that the causes of spotting lie in microdamage resulting from a gynaecological examination, it’d be better to talk about it with a specialist.

Bleeding during pregnancy

We already know that spotting doesn’t necessarily have to be something dangerous. What about bleeding during pregnancy? It’s the other way around – it’s usually a signal that there might be something wrong with the pregnancy. Which is why you mustn’t ignore it and should immediately visit your ob-gyn (or any gynaecologist who’ll run the necessary tests). The profile of bleeding during pregnancy is similar to the menstrual one: red or brownish blood with visible clots. Such heavy bleeding in the initial phase of pregnancy might, BUT DOESN’T HAVE TO BE, the first symptom of coming complications. So before you’ll get a heart attack at the sight of a few droplets of blood on your underwear: RELAX. Breathe. Take your phone and call your healthcare provider.

What are the doctors saying?

Any doctor, trying to identify the causes of the alleged “period” during pregnancy, will immediately take to determining the source of bleeding in order to rule out the possibility of an ectopic pregnancy. To do this, he or she will perform an examination with a speculum and then, during an ultrasound scan, will check all pregnancy parameters and assess the ovaries and fallopian tubes. An ectopic pregnancy happens when the fertilised egg nests outside the endometrium, for instance: in the fallopian tube (most often), the ovary, the cervical area, or the peritoneum.

Another reason for bleeding during pregnancy might be subchorionic haematomata. They’re quite common as every fifth pregnant person has to deal with them. Although the accompanying bleeding makes the parents-to-be’s hearts race, in about 90% of cases the haematomata reabsorb on their own. As far as symptoms are concerned, the closer to the opening of the vagina, the greater the likelihood of bleeding. There are, however, asymptomatic haematomata which don’t bleed. We discover their location only after an ultrasound scan during a gynaecological appointment.

What are subchorionic haematomata?

In technical terms, a haematoma can be described as an extravasation of blood (especially the parent’s blood) to the space between the chorion and the endometrium.

English please? If the blood accumulates between the uterine wall and the chorion, a subchorionic haematoma builds up. In the subsequent stages of pregnancy the chorion transforms into placenta and helps in the exchange of nutrients between the foetus and the parent. Usually, haematomata don’t grow beyond the size of an embryo and don’t affect the foetal development. Despite that, they should be constantly monitored, which is why it’s so important to be under continual doctor’s supervision. A pregnant person with diagnosed haematomata is always under extra special care. They shouldn’t strain themselves, lift heavy objects, or have sex. Some gynaecologists exaggeratedly recommend avoiding any activities. However, I’ve met with a doctor whose recommendation was to be physically active (reasonably, moderately active) because the complete lack of movement won’t neither accelerate the reabsorption of the haematoma, nor be good for the development of the pregnancy. Everything’s about proportions: perhaps you won’t paint the nursery on your own but resigning from day-to-day functioning won’t do you any good.

If the haematoma is big, it can cause chorionic and placental abruption from the uterus, which might be a serious threat for the pregnancy. If the exchange of nutrients between the parent and the foetus is hindered or rendered impossible, it affects the foetal development and might lead to miscarriage (if the haematoma spreads, instead of reabsorbing).

In case of severe chorionic abruption, the pregnant person must be highly responsive to abdominal pain and consult all unusual symptoms with their doctor.

As you’ve probably noticed by now, I keep telling you to stay in constant contact with your ob-gyn. This is because sometimes the symptoms, even if they’re not that nagging, might indicate a possible state of disease. Picking up the signals early on might be key to the development of your pregnancy.

Period during pregnancy – forget about it!

I’ve told the story of me finding out about my second pregnancy numerous times. And I’ve heard a lot of responses like: “oh, my sister-in-law had her period through the whole first trimester!”, “my friend had her period too, so she didn’t know she was pregnant until the second month”, or “oi, this ‘period while pregnant’ thing is so real”.

The case of the alleged pregnancy period is so important that it should be clarified on every occasion, so that no pregnant person who sees blood on their undies makes light of it, thinking: “it’s just my period”. You can’t have periods during your pregnancy. What would that even mean? To “have your period” means the possibility of getting pregnant. So, it appears that getting our period while we’re pregnant allows us to… get pregnant? Something’s definitely not right in this scenario. Which is why I’ve made it my mission to correct this erroneous concept. Period during pregnancy – nope. Bleeding – yes. And if so, it’s crucial to get in touch with your doctor ASAP and not laugh at mother nature that she messed something up. Every drop seeps for a reason and this should be a hint for us.


Pregnancy — who asks the way goes astray

“Are you pregnant?!” Ye, who’s never asked that question may first cast a stone. I have. Many times. Until one day I realised that it’s like tiptoeing on thin ice which covers a vast ocean of people’s drama.

Paulina Pomaska