Heavy bleeding after sex during pregnancy

Pregnancy increases blood flow to the cervix, so contact during sex can sometimes cause light spotting. Heavy bleeding is different: it can come from a vaginal or cervical injury, infection such as Chlamydia, or a problem involving the placenta or pregnancy. Cervical dysplasia or, less commonly, cervical or vaginal cancer can also cause bleeding, although the symptom alone cannot identify its cause.

The stage of pregnancy, the colour and amount of blood, pain, fluid leakage, contractions, fetal movements, and your blood group all help the maternity team decide what assessment is needed. Do not try to diagnose the source from the bleeding alone.

Stop sex and place a pad to monitor the amount; do not use a tampon or put anything in the vagina. Contact your maternity unit or obstetric team immediately for advice, even if the bleeding starts to settle. Rest while arranging care, and do not drive if you feel faint or unwell. Tell the clinician how far along the pregnancy is, when the bleeding began, whether there is pain or fluid, and whether fetal movement has changed. Further examination or tests may be needed.

Call emergency services for heavy or rapidly increasing bleeding, severe abdominal pain, faintness, weakness, breathlessness, a racing heartbeat, shoulder pain, fluid leakage, regular contractions, or reduced fetal movement. Do not wait for an appointment when these symptoms occur. Emergency assessment is also needed after a significant injury or if you feel unsafe. Avoid further vaginal penetration until your maternity team gives specific advice.

Ask: Could the bleeding be from the cervix, vagina, placenta, or another source? Should I have an examination or ultrasound? Do I need to know my blood group or receive treatment? Should I avoid sex, exercise, or travel for now? Which changes in pain, fluid, contractions, or fetal movement require immediate help?