Vaginal bleeding in pregnancy

If you bleed at this stage of pregnancy and the pregnancy ends, there is no reason for you not to go on to have a successful pregnancy.

Bleeding During Early Pregnancy

If you’ve had bleeding early in your pregnancy, you’re not alone. Many other pregnant women have early bleeding, too. And in most cases, nothing is wrong. But your healthcare provider still needs to know about it. They may want to do tests to find out why you’re bleeding. Call your provider if you see bleeding during pregnancy. Tell your provider if your blood is Rh negative. Then they can figure out if you need anti-D immune globulin treatment.

What causes early bleeding?

The cause of bleeding early in pregnancy is often unknown. But many factors early on in pregnancy may lead to light bleeding (called spotting) or heavier bleeding. These include:

Having sex
When the embryo implants on the uterine wall
Bleeding between the sac membrane and the uterus (subchorionic bleeding)
Pregnancy loss (miscarriage)
The embryo implants outside of the uterus (ectopic pregnancy)

If you see spotting

Light bleeding is the most common type of bleeding in early pregnancy. If you see it, call your healthcare provider. Chances are, they will tell you that you can care for yourself at home.

If tests are needed

Depending on how much you bleed, your healthcare provider may ask you to come in for some tests. A pelvic exam, for instance, can help see how far along your pregnancy is. You also may have an ultrasound or a Doppler test. These imaging tests use sound waves to check the health of your baby. The ultrasound may be done on your belly or inside your vagina. You may also need a special blood test. This test compares your hormone levels in blood samples taken 2 days apart. The results can help your provider learn more about the implantation of the embryo. Your blood type will also need to be checked to assess if you will need to be treated for Rh sensitization.

Warning signs

If your bleeding doesn’t stop or if you have any of the following, get medical care right away:

Soaking a sanitary pad each hour
Bleeding like you’re having a period
Cramping or severe belly pain
Feeling dizzy or faint
Tissue passing through your vagina
Bleeding at any time after the first trimester

Questions you may be asked

Bleeding early in pregnancy isn’t normal. But it is common. If you’ve seen any bleeding, you may be concerned. But keep in mind that bleeding alone doesn’t mean something is wrong. Just be sure to call your healthcare provider right away. They may ask you questions like these to help find the cause of your bleeding:

When did your bleeding start?
Is your bleeding very light or is it like a period?
Is the blood bright red or brownish?
Have you had sex recently?
Have you had pain or cramping?
Have you felt dizzy or faint?

Monitoring your pregnancy

Bleeding will often stop as quickly as it began. Your pregnancy may go on a normal path again. You may need to make a few extra prenatal visits. But you and your baby will most likely be fine.

Online Medical Reviewer: Donna Freeborn PhD CNM FNPHeather M Trevino BSN RNCIrina Burd MD PhD

Date Last Reviewed: 1/1/2022

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Vaginal bleeding in pregnancy

Bleeding during pregnancy is relatively common and does not always mean there’s a problem – but it can be a dangerous sign.

Urgent advice: Call your midwife or GP immediately if:

you have any bleeding from your vagina

Causes of bleeding in early pregnancy

Implantation bleeding

In early pregnancy, you might get some harmless light bleeding, called “spotting”. This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due.

Cervical changes

Pregnancy can cause changes to the cervix, and this may sometimes cause bleeding – after sex, for example.

Miscarriage or ectopic pregnancy

During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy.

If you bleed at this stage of pregnancy and the pregnancy ends, there is no reason for you not to go on to have a successful pregnancy.

Treating bleeding in early pregnancy

You may be offered a medicine called progesterone to stop bleeding in early pregnancy. This will only be recommended if you’ve had a scan to confirm you’re pregnant and you’ve had a miscarriage before.

Your doctor may recommend you take the medicine twice a day until you’re 16 weeks pregnant.

Miscarriage

If a pregnancy ends before the 24th week, it’s called a miscarriage. Around 1 in 5 pregnancies ends this way.

Ectopic pregnancy

An ectopic pregnancy is when a fertilised egg implants outside the womb – for example, in the fallopian tube.

It can cause bleeding and is dangerous because the fertilised egg cannot develop properly outside the womb. The egg has to be removed, which can be done through an operation or with medicines.

Symptoms of an ectopic pregnancy tend to develop between 6 to 8 weeks of pregnancy but can happen later.

Other signs of ectopic pregnancy can include:

tummy pain low down which may be on one side
vaginal bleeding or a brown, watery discharge
pain in the tip of your shoulder
discomfort when peeing or pooing

Call 111 if you have symptoms of an ectopic pregnancy.

Causes of bleeding in later pregnancy

Cervical changes

These can lead to bleeding, particularly after sex.

Vaginal infections

Your midwife or doctor can discuss tests and treatment with you.

A ‘show’

This is when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is getting ready for labour to start. It may happen a few days before contractions start or during labour itself.

Placental abruption

This is a serious condition in which the placenta starts to come away from the womb wall. Placental abruption usually causes stomach pain, and this may occur even if there is no bleeding.

Low-lying placenta (placenta praevia)

This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and put you and your baby at risk.

Vasa praevia

This is a rare condition where the baby’s blood vessels run through the membranes covering the cervix.

When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can lose a life-threatening amount of blood.

Finding out the cause of bleeding in pregnancy

To work out what is causing the bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels.

Your doctor will also ask you about other symptoms, such as cramp, pain and dizziness. Sometimes it might not be possible to find out what caused the bleeding.

If your symptoms are not severe and your baby is not due for a while, you’ll be monitored and, in some cases, kept in hospital for observation.

How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are.

Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems.

Video: What should I do if I start bleeding during early pregnancy?

In this video, a midwife tells you what to do if you start to bleed during early pregnancy.

Pictures Of Spotting During Pregnancy

Vaginal bleeding in pregnancy

Bleeding During Early Pregnancy

What causes early bleeding?

If you see spotting

If tests are needed

Warning signs

Questions you may be asked

Monitoring your pregnancy

Related Conditions

Vaginal bleeding in pregnancy

Urgent advice: Call your midwife or GP immediately if: