Bleeding in the third trimester or in late pregnancy may be a sign of impending delivery if all earlier complications are ruled out. If no, it could be a lot of things, some to worry about and some to just prepare. How do you know that this is normal? If you are very near the date given by your delivery, and you get some bleeding and also some pain in your back or lower abdomen or menstrual cramp like pain, this could be an alert for you to go to your doctor all prepared for delivery.

If your date is still far away, and this happens, it could be a signal of preterm labour and your baby could need specialized care and you need to prepare accordingly.

Sometimes, when the mother’s blood pressure is too high, there is bleeding behind the placenta, partially detaching it, cutting or decreasing the blood supply to the baby [1], so you may suddenly feel decreased movements of the baby no movements at all. This is an EMERGENCY. You need to get to the hospital as soon as possible as this is a condition that is life threatening for both the mother and child.

A similar thing may happen if the placenta is low lying , but this should have been diagnosed long before the third trimester. In any case, at the very least, if you have bleeding late in pregnancy, you just have to go to the emergency room, without any delay.

Other than these pregnancy related problems, there could be other local causes, as discussed in the earlier article - infection, cervicitis, or cervical cancer.

Once you are at the hospital, you will be examined, the condition of the baby will be determined, local problems will be looked for, placental condition will be seen, probably by sonography and then you will get to know what is happening in your body.

Your part in the whole event is to not lose your cool, be prepared to follow instructions and also to ask any questions that will help you to keep relaxed. Remember, the key to a healthy pregnancy and delivery is- keeping relaxed and breathing normally.

I hope this has been able to answer at least some of the questions that keep coming in the mind like unwelcome guests.

[1]	https://www.msdmanuals.com/home/women-s-health-issues/complications-of-pregnancy/placental-abruption

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