Pink spotting in early pregnancy: guidance

Early pregnancy changes can make the cervix bleed lightly, including after sex or a vaginal examination. Spotting can also occur with infection or a pregnancy complication. It is not possible to distinguish these causes from colour alone. Chlamydia can cause bleeding and discharge, while cervical dysplasia or cervical cancer can present with abnormal bleeding and need separate evaluation. These conditions are not diagnosed simply because spotting is present.

Write down the date, amount, colour, clots if any, and whether symptoms are improving. Note cramps, one-sided pain, shoulder pain, fever, faintness, urinary burning, or unusual discharge. A clinician may use pregnancy dating, examination, urine or blood tests, and ultrasound to decide what is needed.

Call your obstetric clinician, midwife, or early-pregnancy service. Use a liner rather than a tampon, avoid douching, and keep hydrated. Ask before taking any medicine for pain. If you have not yet confirmed the pregnancy, follow local testing advice and tell the clinician the result. Keep contact details available in case symptoms change overnight.

Seek emergency care for severe or one-sided pain, heavy bleeding, fainting, shoulder-tip pain, profound weakness, or fever. A positive pregnancy test with pain or bleeding needs prompt medical advice, even if the spotting is pale. Go sooner if symptoms are rapidly worsening or you cannot keep fluids down. Urgency is based on these associated features rather than the shade of the spotting.

Ask whether your dates change the recommended assessment, whether you need serial testing or an ultrasound, which pain medicines are suitable, and exactly where to go if bleeding becomes heavier.