The appearance of a “bloody show” is a common physical sign experienced late in pregnancy, often indicating that the body is making progress toward labor. Its presence signals a change in the cervix, which is the muscular neck of the uterus that must soften and open for birth to occur. This discharge is a normal and expected part of the biological process as the uterus prepares for delivery.
Physical Description and Cause
The bloody show is a vaginal discharge composed of mucus mixed with a small amount of blood. It often appears pink, brown, or light red, and its texture is typically thick, gelatinous, or stringy due to the heavy mucus content. This discharge is closely related to the release of the mucus plug, which is a collection of thick mucus that seals the cervical canal during pregnancy, serving as a protective barrier against infection.
The physiological cause of the bloody show is the beginning of cervical change, specifically effacement and dilation. Effacement is the process where the cervix thins out, and dilation is the process of the cervix opening. The cervix is a highly vascular structure, meaning it contains many tiny blood vessels. As the cervix softens, thins, and starts to open, these small capillaries can rupture, leading to minor bleeding. This slight bleeding then mixes with the mucus plug as it is dislodged from the cervix and passed through the vagina. It may be expelled all at once in a single clump or gradually over a few days as increased discharge with streaks of color.
Timing and Significance in Labor
The appearance of a bloody show confirms that physical changes are happening in the lower portion of the uterus, but it is not a precise signal that active labor is about to begin. It serves as an indicator of cervical ripening and readiness rather than an immediate call to head to the hospital. The timeframe between noticing the bloody show and the onset of regular contractions varies widely among individuals. For some, the bloody show may occur only a few hours before labor contractions become strong and regular, while for others, this discharge may be noticed several days, or even a couple of weeks, before the onset of active labor.
It is helpful to differentiate between the loss of the mucus plug and the bloody show. The mucus plug itself can be clear or slightly off-white when it is released, and in this case, it is generally not referred to as a bloody show.
Distinguishing Normal Bloody Show from Concerning Bleeding
A normal bloody show is characterized by a small amount of blood mixed with thick mucus, and the color is usually dull, such as pink, brown, or dark red. The amount should be minimal, generally not enough to soak a standard sanitary pad. Bleeding that is bright red, free-flowing, and heavy requires immediate attention from a healthcare provider. A good benchmark for concerning bleeding is any flow that is heavier than a normal menstrual period or that requires changing a pad within an hour.
Any bleeding accompanied by other concerning symptoms warrants immediate contact with a medical professional. These associated symptoms include severe abdominal pain, persistent cramping, a sudden rush of fluid, fever, or dizziness. It is especially important to seek prompt medical advice if any bleeding occurs before 37 weeks of gestation, as this may be a sign of preterm labor or other issues.