Once the first three months of pregnancy are gone, both the doctor and the patient are relaxed, threat over. But is it? There are many things that can go wrong any time before the baby is born. Bleeding and its aftermath is just one of them. Here you are, happy four months are gone, waiting to feel he movements of the baby, now and then imagining a flutter in your abdomen, you go to the loo, and, you see blood! The shock is so great, you feel you will fall. What could have caused it?

Rule number one, don’t panic. Take a sterile pad, call your doctor and go to the hospital. A call will not cure you, examination will be required.

Once at the hospital you will be examined. The foetus will be examined for heartbeat, bleeding from the placenta by Doppler and sonography, and a speculum examination will be done to see if there is a cause unrelated to pregnancy for the bleeding.

The different causes of bleeding in second three months of pregnancy could be one of the following

Local Causes

  • Vaginal Infections
  • Cervical Infection, Ectropion or Cancer
  • Bleeding not from vagina, but bleeding Piles

Placental Causes

Molar Pregnancy

There is an abnormal pregnancy where instead of the baby, only grape like tissue is formed. This is normally detected in the first three months.

Demise of One Twin

When on twin is lost and the other is fine, there will be bleeding seen. Usually there is nothing to do but wait.

Threatened Abortion due to Incompetent Os

The Cervix is not able to keep closed with the advance of pregnancy and opens up, leading to some bleeding. This can be managed by medicines and suture in most cases and baby saved. 20% are so advanced in labour that they abort.


As you can see, causes are numerous and the management of each condition is different. The key to management is availability of services and service providers.

So, even if you do bleed in the second trimester, take heart, chances are high that you will have a healthy baby. And mostly management is possible, though there are no guarantees and there are no easy answers to why this happens to some, and not to others.

So, just be alert, and if anything out of the ordinary happens, do not delay the visit to your gynaecologist. It may be the difference between a safe and unsafe pregnancy.

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