Chapter 8: Prenatal checkups
Ask if she has any bleeding fromthe vagina
• No bleeding.
• Very light bleeding or spotting for a few days during the first
months, with no cramps.
• Pink or slightly bloody mucus 2 to 3 days before labor begins.
This mucus is called show or the mucus plug.
Wa r nin g s ig n s
• Bleeding as much as monthly bleeding at any time
• Bleeding with pain at any time during pregnancy.
• Bleeding with no pain in the second half of pregnancy
B le e ding with cramps during the fi rst 6 months
If the mother has bleeding with cramps, she may be having a miscarriage. If the
bleeding is light (spotting), the risk is low.
Get medical help if:
• the bleeding is like a monthly bleeding or heavier.
• the mother is more than 3 months pregnant.
• the mother has a fever.
• there is severe pain or a bad smell from her vagina.
See Chapter 22 to learn how to help a woman with problems after a miscarriage.
Bleeding with no pain, especially in the second half of pregnancy, may mean the
placenta is covering, or partially covering, the
cervix instead of being near the top of the womb
where it should be. This is called placenta previa.
When the cervix starts to open near the end of
pregnancy, the womb side of the placenta is not
protected. It is like a raw wound. The mother’s
blood flows through the placenta and out the
vagina. This is very dangerous. The mother and
baby may die.
Never do a vaginal exam for a woman
who might have placenta previa.
Treat her for shock (see page 239) and
get medical help immediately!
A Book for Midwives (2010)