Spotting in early pregnancy at 4 weeks

Spotting means a small amount of blood from the vagina. It may look pink, brown, or red and can occur around the time a period was expected. Changes to the cervix in early pregnancy, irritation after sex, or an infection can contribute. Bleeding can also occur with a pregnancy that needs urgent assessment, including ectopic pregnancy or early pregnancy loss. The colour alone cannot establish the cause.

Tell the clinician whether the bleeding is increasing, whether you have cramps or one-sided pain, and whether pregnancy was confirmed with a test. A clinician may use an examination, blood tests, or an ultrasound depending on timing and symptoms.

Use a pad rather than a tampon so you can observe the amount and colour. Note when it began, whether clots or tissue appear, and any pain, dizziness, fever, or shoulder-tip discomfort. Avoid sex until you have received advice if it seems to trigger bleeding. Arrange contact with your maternity service, gynaecology clinic, or urgent care service, especially if the bleeding continues.

Seek emergency care for heavy bleeding, severe or one-sided abdominal pain, fainting, marked weakness, shoulder-tip pain, or dizziness. These symptoms can signal internal bleeding or another urgent pregnancy problem. Fever, worsening pain, or unpleasant-smelling discharge also needs prompt assessment. Do not wait for the bleeding to stop before seeking help when these warning signs are present.

Ask whether you need repeat pregnancy hormone testing or an ultrasound, what amount of bleeding should trigger urgent review, and whether your blood group affects the care you need. You can also ask when to return if spotting recurs.