The risks of bleeding later in pregnancy are significant – one-third of fetuses die when bleeding occurs after 20 weeks. This is because bleeding at this point usually indicates a problem with the placenta, the cervix or the early onset of labor.

Injury to the belly can damage the placenta, causing it to tear from the uterus, resulting in pain and bleeding. This dangerous condition, called abruptio placentae, or abruption, endangers the fetus because it affects its supply of nutrition. Even minor trauma, like a fender-bender accident, can cause shear forces that damage the placenta. This is why it is important to monitor the baby closely after any trauma, especially if you experience any abdominal pain or cramping. Smoking, advanced maternal age (over 35) and cocaine use also increase the risk of abruption.

During your ultrasound, your doctor may have mentioned the position of the placenta. If the placenta is low-lying, or covers the cervix, it is more likely to cause painless bleeding. If your placenta is low-lying, your physician will have warned you that you may experience some spotting.

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