Blood spotting during pregnancy: what you need to know

The colour may be pink, red or brown, and the amount may range from a trace on tissue to bleeding that needs a pad. The amount, timing and accompanying symptoms help a clinician decide how quickly you need assessment.

Small amounts of blood can come from the cervix, which has a richer blood supply during pregnancy and may bleed after sex or an examination. Early spotting can also occur around implantation. Infection, pregnancy loss and an ectopic pregnancy are other possibilities, so appearance alone cannot identify the cause.

Later in pregnancy, bleeding can be related to changes in the cervix, labour or the placenta. A maternity professional may ask about pregnancy stage, pain, contractions, fluid leakage, fetal movement and your blood group before recommending an examination, ultrasound or blood tests.

Contact your obstetrician, midwife or maternity assessment service and describe the bleeding. Use a pad rather than a tampon so you can monitor the amount, and note when it began, its colour, whether clots or tissue appeared, and any pain. Avoid sex until you have received advice if intercourse appears to trigger bleeding.

Do not stop prescribed medicines without guidance. If you know that your blood group is Rh-negative, mention this when you call because the care team may consider whether anti-D medicine is needed.

Go to emergency care for heavy or rapidly increasing bleeding, severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked dizziness, breathing difficulty or feeling very unwell. These symptoms can signal significant blood loss or a pregnancy complication that needs immediate assessment.

Later in pregnancy, urgent assessment is also needed for bleeding with contractions, fluid leaking from the vagina or reduced fetal movement. If you cannot reach your maternity service and symptoms are worsening, use local emergency services.

Ask what the likely source of bleeding is, whether you need an ultrasound or blood tests, which activities to avoid, and exactly which changes should bring you back. You can also ask how to contact the maternity unit if another episode occurs outside clinic hours.