Cramping and spotting in the first trimester

Spotting can come from a sensitive cervix, including after sex, while mild cramps may reflect stretching and uterine change. Neither symptom by itself can show whether a pregnancy is healthy. Infection may cause bleeding alongside discharge, pain when passing urine, pelvic pain, or fever. A pregnancy developing outside the uterus may cause pain that is stronger on one side. Bleeding and cramps can also occur with pregnancy loss, so a clinician may need to assess you rather than rely on the symptom pattern alone.

Tell your obstetric or primary-care team about the bleeding, even if it is light. Note when it began, its colour and amount, any clots, pain severity and location, and associated symptoms. Rest as needed and follow the advice given by your care team; do not self-medicate without checking that a medicine is suitable in pregnancy. Depending on your history, assessment may involve examination, blood tests, or ultrasound.

Use emergency services for heavy bleeding, severe or one-sided pain, shoulder-tip pain, fainting, severe dizziness, fever, or a sudden deterioration. If symptoms are increasing but not yet severe, contact your maternity service promptly for direction. Take someone with you if you feel weak or light-headed.

What could explain this bleeding at my stage of pregnancy? Do I need an ultrasound or blood tests? How should I monitor the symptoms, and when should I return urgently?