Bleeding between periods during pregnancy

Pregnancy bleeding can come from the cervix or vagina, or it may be related to the pregnancy itself. Its colour or amount alone cannot identify the cause.

Light spotting may occur when a blood-rich cervix is irritated, including after sex or an examination. Bleeding can also accompany pregnancy loss or an ectopic pregnancy, in which a pregnancy develops outside the womb. Later in pregnancy, bleeding may relate to the placenta and needs maternity assessment.

A clinician interprets the bleeding alongside the stage of pregnancy, pain, examination findings and, when appropriate, ultrasound or blood tests. Bleeding does not by itself establish whether a pregnancy is continuing normally.

Contact your obstetrician, maternity unit or urgent healthcare service for advice. If pregnancy is possible but unconfirmed, take a home pregnancy test without delaying care for concerning symptoms. Use a pad rather than a tampon or menstrual cup so you can observe the flow, and note the colour, clots, pain and whether bleeding is increasing.

Tell the clinician your last menstrual period, pregnancy test result, previous ectopic pregnancy or miscarriage, and your blood group if known. Do not stop prescribed medicine unless the treating clinician advises it.

Go to emergency care now for heavy or rapidly increasing bleeding, severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked dizziness, weakness, breathing difficulty, or feeling acutely unwell. These signs can accompany significant blood loss or an ectopic pregnancy and should not wait for a routine appointment.

Seek prompt maternity advice for any bleeding later in pregnancy, bleeding with cramps or fluid loss, or a reduction in your baby's usual movements when you are at a stage where movements are established.

Ask where the bleeding is most likely coming from, whether you need an examination, ultrasound or blood tests, and which changes should make you return urgently. You can also ask whether your blood group affects follow-up after pregnancy bleeding.