Dark red spotting in early pregnancy

Dark red blood may represent blood that has taken time to leave the vagina. Early-pregnancy spotting can happen when the cervix is more sensitive, including after sex or an examination. Infection can also cause bleeding. Bleeding with one-sided or severe pelvic pain, shoulder-tip pain, dizziness or faintness needs urgent assessment because an ectopic pregnancy must be considered. Increasing bleeding or tissue passing can occur with pregnancy loss. The colour and amount alone cannot confirm whether a pregnancy is continuing.

Contact your maternity team, obstetric clinician or an urgent medical service for advice, even if the spotting is light. Note when it started, whether it is becoming heavier, any pain, clots or tissue, and your last known menstrual timing. Use a pad so you can observe the amount, and avoid tampons while bleeding. Do not take medicines for pain or bleeding without checking that they are suitable in pregnancy. You may be offered an examination, pregnancy hormone testing or an ultrasound depending on timing and symptoms.

Go to urgent care immediately for severe or one-sided abdominal pain, shoulder-tip pain, faintness, collapse, heavy bleeding, fever or feeling very unwell. Seek same-day advice if bleeding is increasing, pain is persistent, or you pass clots or tissue. Keep emergency contact details available and do not drive yourself if dizzy or faint.

Ask what assessment is suitable at this stage of pregnancy. Do you need blood tests or an ultrasound, and when should results be repeated? Which pain relief is safe for you? What symptoms should take you directly to emergency care?