Understanding Persistent Bleeding in Pregnancy: Causes & Concerns

Question
Hi,
im 28 & 10 weeks pregnant. this is my second pregnancy, during the first i spotted on & off, normally for a few days every couple of weeks during the first trimester then less later on. i had a bleed at 27 weeks as well (which was much heavier than the spotting) & was in hospital for a few days. no reason was ever found for the spotting/bleeding & i had a normal natural birth at 41 weeks gestation (they did do a blood test at 27 weeks and did find the baby's blood in mine though they didnt know where it came from).

now with this pregnancy i am spotting/bleeding again. it started when i was about 5 weeks pregnant & has been fairly constant since. at first it was most days with a day or two off every now & then & it was only once per day mainly on the toilet paper (mainly after a bowel movement). now though its every day & pretty much all day long. most days it isnt heavy, just when i go to the toilet but some days i have to wear a liner or even a pad because it gets a bit heavier (probably equivalent to one of the last days of my period). it seems that over all its getting slighly heavier as the pregnancy progresses. i have no cramps. i havent had sex since the bleeding started (or probably since i got pregnant).

i have previously (in 2000) had an abnormaly pap smear & a cone biopsy. my last pap smear was almost 2 years ago & she did say there looked like there was some transition stuff but the results came back all clear. my understanding from the gyno was that when the cone biopsy was done the cells grew back a little bit weird (the mucus cells on the outside or something) but that it wasnt a problem.

i have had all types of blood, fresh, old stuff, discoloured discharge & clots. I had an ultrasound at 6 weeks & there was a heart beat & they couldnt see anything that was causing the bleeding.

so my question is - what could the possible causes of my bleeding be? i believe that if i had a cervical cyst or something that may cause bleeding, but that i wouldnt be getting clots from that. (i have only had clots a few times & they were relativly small). ive seen a gp quite a few times but no one has ever given me a physical exam & they always just tell me that spotting during pregnancy can be normal & that i should rest (rest doesnt seem to make a difference).

i just want to know the reasons this could be happening, i know alot of the main reasons for bleeding during pregnancy but most of the major ones have been ruled out & ive just been left with 'it just happens' but it really doesnt seem normal & is worrying me quite alot.

at first i just thought it meant i was going to miscarry which ofcourse wasnt ideal but i would have delt with it, but now im thinking there is something wrong with me, i am sooooo exhausted all the time (i am taking iron supps) and the bleeding just seems to get slowly heavier with no possible reasons given why. are there any other things i can ask my doctor about or any tests that i could ask for that arent routine?
any responce you could give would be greatly appreciated!!!
thanks!
mel :D

Answer
Mel,
It sounds like you are having quite a tough time with this pregnancy. Sometimes we don't know where bleeding come from in pregnancy. It is frustrating for us and you because we want to give you answers. I think your doctor should do some blood work if you are feeling more tired lately. He can look to make sure your hemaglobin and hematocrit aren't too low. Good luck to you!