20 | SEPTEMBER 2019 | L&L
How does the
decidua help with
labour and birth?
About three days before labour begins,
birthing hormones are released. One
of these is oxytocin (which helps
the womb contract), some of which
comes from the decidua. After the
birth, the placenta and membranes
need to be expelled. The decidua
acts like “post-it” glue and allows
these to peel off easily. A few days
after giving birth, the decidua comes
away as a brown discharge.Does this mean a
woman should have
her period during
pregnancy?
Not at all. Periods during pregnancy,
called vaginal bleeding, are not
the same as cyclical, menstrual
bleeding. This can take the form of
spotting (similar to when starting the
contraceptive pill). This should soon
stop when the hormonal changeover
has settled. There can be a slight,
short bleed at the time of your next
period called an implantation
bleed, when the egg burrows into
the endometrium. Periodic ongoing
vaginal bleeding often indicates a
problematic placenta. Either there is
a slight tear where it’s attached to the
womb, or it’s in the wrong position.
Heavier bleeding can be caused by
a polyp (a non-cancerous growth)
or fibroids (usually non-cancerous
tumours of the womb). Very serious
vaginal bleeding indicates an ectopic
pregnancy (or pregnancy outside
the womb) that starts with sudden
heavy bleeding, severe pain and signs
of shock. This is an emergency and
needs immediate medical attention.
In a nutshell, all vaginal bleeding
during pregnancy needs to be taken
seriously and should be investigated.
Bleeding during pregnancy can
damage the decidua and cause
problems with the placenta and
membranes after giving birth.