Abdominal pain and spotting during pregnancy

Light spotting can occur for several reasons, but pain changes the assessment. Contact your maternity unit, obstetric clinician, or urgent care service for advice, even if the bleeding seems slight.

Possible explanations depend on the stage of pregnancy and include changes around the cervix, infection, pregnancy loss, an ectopic pregnancy, or a problem involving the placenta. Digestive or urinary conditions can also cause abdominal pain while spotting has a separate source. Symptoms cannot reliably distinguish these possibilities at home.

A clinician will consider where the pain is, whether it is one-sided or cramping, the amount and colour of bleeding, clots or fluid loss, dizziness, shoulder-tip pain, fever, urinary symptoms, and fetal movement when relevant. Assessment may include an examination, ultrasound, or blood and urine tests.

Use a sanitary pad rather than an internal product so you can observe the bleeding, and note when the pain and spotting began. Rest somewhere safe, keep your phone nearby, and arrange transport if a clinician asks you to attend. Do not drive yourself if you feel faint or very unwell.

Avoid taking a new medicine unless a clinician or pharmacist confirms that it is suitable in pregnancy. If you know your blood group is rhesus negative, mention this when you call because the care team may need to consider additional treatment after bleeding.

Call emergency services or attend emergency care for severe or worsening abdominal pain, heavy bleeding, fainting, marked dizziness, shoulder-tip pain, breathing difficulty, confusion, or feeling cold and clammy. Sudden one-sided pain with bleeding or collapse is particularly urgent.

Prompt maternity assessment is also needed for fever, fluid leaking from the vagina, regular painful tightenings, pain when urinating, or reduced fetal movement once movements are usually felt. Do not wait for bleeding to become heavier before seeking help when any warning sign is present.

Ask where and how soon you should be assessed, what changes require emergency care, whether an ultrasound or blood test is appropriate, and which pain relief is safe. If you are sent home, request clear instructions about bleeding, pain, temperature, and fetal movement.