Unexpected bleeding while pregnant

Although people may call it breakthrough bleeding, once pregnancy is established clinicians assess it as bleeding in pregnancy. The colour or small amount of blood cannot by itself show the cause or whether the pregnancy is progressing normally.

Bleeding may arise from the cervix, which has increased blood flow and can bleed after sex or an examination. Infection is another possibility. Chlamydia can present with bleeding, yet bleeding does not indicate that chlamydia is the explanation. Problems affecting the pregnancy itself must also be considered, including pregnancy loss or a pregnancy developing outside the uterus.

Later in pregnancy, bleeding can be related to the placenta or the start of labour. The stage of pregnancy, blood amount, pain, contractions, fluid loss, fetal movement when usually felt, and your blood group can influence the assessment and next steps.

Call your maternity unit, obstetric clinician, or emergency service according to the symptoms and the instructions given for your pregnancy. Describe the amount and colour of blood, whether there are clots or tissue, where pain is felt, and whether you have dizziness, fever, contractions, fluid leakage, or altered fetal movement.

Use a pad so the flow is easier to observe, and avoid inserting tampons. Keep your pregnancy and medication details available. Do not take or stop hormones, pain medicines, or other treatments specifically because of the bleeding without clinical advice. Assessment may involve an examination, ultrasound, and blood or urine testing, depending on the circumstances.

Seek emergency care now for heavy bleeding, severe or one-sided abdominal pain, shoulder-tip pain, fainting, collapse, pronounced dizziness, breathing difficulty, or feeling very unwell. Urgent maternity assessment is also needed for bleeding with strong contractions, fluid leakage, fever, or reduced fetal movement when movement is normally felt. Do not drive yourself if you feel faint or unstable.

Ask what possible source of bleeding was identified, whether follow-up testing or another scan is needed, and which activities or medicines should be modified. Confirm exactly whom to contact if bleeding returns, how changes in pain or flow alter the urgency, and whether your blood group affects treatment.