Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Subchorionic hematoma

12 December, 2013

Question:

I am currently 13 weeks pregnant with my second child, and I just had a bleeding episode – subchorionic hematoma, bleeding in the membranes between the placenta and uterus. It looks like everything is okay now and the fetus is okay. I did pass bright red blood, on cotton underwear that was white with colored polka dots, and had light bleeding for a few days (dark red/brown).

I am wondering if this puts me in a state of niddah, and what I should do. Is this like a wound in the uterus, since doctors think this is a blood clot from the result of implantation of the uterus, or the placenta tearing away slightly from the uterus? – a kind of trauma?

Thank you so much!


Answer:

BeSha'ah tovah!  We are happy to hear that the fetus is all right and wish you a refuah sheleimah and a safe continuation of your pregnancy.

A subchorionic hematoma is typically a sort of clot between the placental membrane and uterine wall. The halachic status of a wound (makkah) in the uterus is a matter of halachic debate. On the one hand, in theory, a makkah even in the uterus does not make a woman niddah. On the other hand, halachic authorities are hesitant to rule leniently in such cases, as it can be difficult to pinpoint the source of a woman's bleeding to a wound. For example, bleeding from detachment of the placenta is considered dam koshi.  Dam koshi does make a woman niddah.

In general, a woman with bleeding from a subchorionic hematoma is considered a niddah and must immerse in the mikveh.  Accordingly, if you had a stain larger than the size of a gris (approximately an Israeli shekel or US dime) on the white portion of your underwear, or if your bleeding was a "flow" and not just staining, you are niddah and should make a hefsek taharah, observe seven clean days, and immerse.  If you have any difficulty with becoming tehorah, please contact us with details.

Since the laws of stains also apply to stains from placental bleeding, and to bleeding during the seven clean days, a review of our site's articles on stains, "Ketamim" and "Toilet Paper", may prove helpful.

Please don't hesitate to write back with any further questions.


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