Heavy bleeding with clots during pregnancy: what to know

Light spotting can have several causes in pregnancy, but heavy flow or clots need prompt assessment because bleeding can affect the pregnancy or your health. Possible explanations vary with the stage of pregnancy and may include changes around the cervix, pregnancy loss, problems with the placenta, or an ectopic pregnancy. An ectopic pregnancy can cause internal bleeding and may present with one-sided abdominal pain, shoulder-tip pain, weakness, or collapse. The amount of blood alone cannot tell you the cause or whether the pregnancy is continuing.

Contact your maternity service or emergency medical service immediately for advice. Use a pad rather than a tampon, note when the bleeding began and how quickly the pad becomes wet, and record clots, pain, dizziness, and your pregnancy stage. Do not drive yourself if you feel faint or have severe pain. Keep your phone nearby and follow the urgent service's instructions.

Call emergency services for severe or one-sided abdominal pain, shoulder-tip pain, fainting, confusion, marked weakness, breathlessness, a racing heartbeat, or bleeding that is rapidly increasing. Emergency assessment is also needed when heavy bleeding occurs with pregnancy, even if pain is absent or the flow later slows.

Ask what tests are needed to check your health and the pregnancy, whether the pregnancy location has been confirmed, and what symptoms require immediate return. Ask what to do about medicines and follow-up while the cause is being assessed.