Spotting throughout pregnancy: what to know

Bleeding can arise from a sensitive cervix, especially after sex or an examination, or from infection. It can also reflect a problem involving the placenta or pregnancy, with the possible causes changing as pregnancy progresses. The colour and amount provide useful clues but cannot determine the cause alone. Cervical dysplasia or cervical cancer may also present with abnormal bleeding, although pregnancy spotting does not mean either condition is present.

Call your maternity unit, obstetric clinician, or local urgent service whenever you notice bleeding. Describe when it began, whether it is increasing, its colour, clots, pain, contractions, fluid leakage, fever, and fetal movement when movements are established. Use a pad to monitor flow. Do not insert tampons. Your care team may recommend examination, testing, monitoring, or ultrasound based on pregnancy stage and symptoms.

Seek emergency help for heavy bleeding, severe abdominal pain, regular painful contractions, fluid leakage, fainting, severe dizziness, fever, or feeling seriously unwell. Later in pregnancy, reduced fetal movement needs immediate contact with maternity services. Sudden pain or bleeding after an injury also needs urgent assessment. If you are unsure how serious the bleeding is, call for advice rather than waiting for it to stop.

What should I do if the bleeding changes overnight? Do I need monitoring or an ultrasound? Which symptoms are specific to my stage of pregnancy?