Pregnancy is an important phase in the life of any couple. There are a number of physical changes that occur for the woman, and a number of psychological, emotional and logistical changes that occur for the couple. All this change makes it all the more crucial to monitor every aspect of the pregnancy. There are many alarming signs in pregnancy, such as the decreased movement of the fetus, low fetal heart rate, etc. But bleeding is something that you have to be extremely cautious about. Bleeding can be harmless, or it can be an indicator of a serious underlying problem. To provide the best care for the mother and fetus, any bleeding is considered to be serious till the actual cause is found.

What are the things to consider if there is vaginal bleeding during the second half of pregnancy? Vaginal bleeding is something to be taken very seriously during the first trimester, as it may point to a miscarriage. But once you enter the second trimester, the causes of vaginal bleeding vary. Here are few things to note if you are bleeding in the second trimester:

• Check the quantity of bleeding: if it is minor spotting and little staining on the underwear, there is usually nothing to worry about.
• If the bleeding is painless, then there is no cause for concern.
• Check if the bleeding is momentary or constant
• Check how long it is bleeding. Bleeding for hours together is detrimental to the health of both the mother and fetus.
• You must seek medical attention if the bleeding is painful, associated with abdominal contractions, fever, cramps, etc.
• Check if there is a proper explanation for the bleeding. Bleeding after sex is normal, and it will usually subside in some time.
• If there is unexplained bleeding, it might point to an imminent preterm labor, preterm birth, placental problems, etc.

What if the bleeding is close to due date?
If the bleeding is seen close to the end of pregnancy, it might be a sign that your body is getting ready for the labor. Close to your due date, the mucus plug that seals the opening of the uterus gives way, leading to some bleeding mixed with the thick mucous discharge. This is called a bloody show. This is a sign that tells that you are physically ready for labor. It is a sign that you should mentally prepare yourself for delivery. Sometimes this will happen a few days before the due date. In that case, you can approach your physician to prepare you for the delivery. Along with this bloody show, you will also have abdominal pain, pelvic pressure, low backache, stomach cramps, tightening and relaxation of the uterus.

What if there is bleeding three weeks before due date?
If you see these signs three weeks before the actual due date, it might be a sign of preterm labor. This requires immediate medical attention. If the labor is preterm, the baby is also not fully developed. This calls for a pediatrician at the time of delivery. To be precise, a neonatologist is a person who will be able to handle the baby. You must also prepare for an incubator if required.

What to do in case of bleeding due to sex?
Sex during the second half of pregnancy is not completely prohibited, except in certain cases. In that case, try to have sex in a comfortable position where the trauma will be minimal. If you engage in rough sex, you are sure to injure the mucosal walls of the vagina and cervix. This will lead to inflammation and bleeding. When this happens, there is nothing to worry about. Just lie down flat. Drink water, relax and take deep breaths. The bleeding will stop automatically. And avoid sex for a few days to allow the wound to heal.

What if there is heavy bleeding?
Usually, bleeding will be in the form of spotting that can be ignored; but when the bleeding is heavy, then you must definitely act immediately. In most such cases, it is an indication of an underlying problem with the placenta.
There are two main problems with the placenta that are serious – placental abruption and placenta previa.
Normally, the placenta that connects the baby to the uterine wall does not detach before delivery. It usually takes thirty minutes after delivery for the placenta to detach. But when it detaches before or during labor, it leads to severe bleeding called abruptio placentae. The condition is serious because the baby loses oxygen supply and goes into respiratory distress, which is very dangerous.

Another condition called placenta previa is the condition where the placenta lies close to the cervix. It leads to painless bleeding. But the bleeding will be heavy.

The best way to avoid these is to look for any risk factors in the first half of pregnancy. The trimester scans will give you an idea of where the placenta is. If you have any such risk factors, you must monitor your pregnancy carefully.
In any case, you must visit your physician or consult an obstetrician if there is bleeding. As mentioned earlier, you may never know what causes the bleeding. So every event of bleeding requires immediate attention.

Armed with these facts, you should be able to handle any problems that arise on your path to the successful completion of your pregnancy.