Ask an Expert: Can I have my period and still be pregnant?

Answer from Angela Keating, M.D., obstetrics and gynecology, Providence Women's Clinic, Providence St. Vincent Medical Center:

It is not uncommon to have bleeding in early pregnancy but it is not considered to be a true period. A period happens about 14 days after ovulation (when the egg is released by the ovary) if the egg is not fertilized by the sperm.

During a period, the inside lining of the uterus (the endometrium) breaks down and bleeding occurs. If your period seems different to you–a lighter period than usual or your period is later than what is expected or you have pregnancy symptoms (nausea, significant fatigue, headaches, more significant breast tenderness)–then you should check a pregnancy test and contact your provider if it is positive. Remember that even if using birth control regularly, you can get pregnant; no birth control is 100 percent effective.

Bleeding in early pregnancy can occur for multiple reasons. It usually is different in the amount of bleeding or in the timing of the bleeding compared to a regular period; it is often lighter or it may be delayed. 

One common source of bleeding in pregnancy is implantation bleeding (this comes from the inside lining of the uterus when the fertilized egg implants into the inside lining). You may also get bleeding from the cervix if it is rubbed or irritated (during intercourse or with a vaginal exam in the clinic) because the cervix gets softer in pregnancy and is more likely to bleed when touched. Less commonly, there may be a polyp or growth or sore on the cervix that can cause bleeding (this can occur when not pregnant also).

Another cause of bleeding in early pregnancy is a miscarriage; 15-20 percent of pregnancies end up as a miscarriage.  Bleeding may start as spotting and then increase as the miscarriage progresses. 

Ectopic pregnancy (when the pregnancy occurs outside of the uterus) is a less common cause of bleeding in early pregnancy but can be dangerous to you if not addressed (about 2 percent of pregnancies can be ectopic pregnancies and the most common place is in the fallopian tube). 

You should call your provider if you have any spotting or bleeding in early pregnancy to rule out the more concerning pregnancy problems like ectopic pregnancy and miscarriage. Testing usually includes blood draws and an ultrasound, but you would need to speak with your provider to see what testing would be needed in your specific case if you have bleeding in pregnancy.

The bottom line is to be aware of any changes in your period, and to check a pregnancy test if you experience any changes in your period. If you already know you are pregnant and you are getting spotting or bleeding, or have bleeding anytime during your pregnancy in general, you should call your provider.

Updated August 2016

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