Vaginal bleeding during pregnancy: what to know

Light spotting can follow cervical irritation, including after sex or an examination. Infection, cervical dysplasia, and cervical cancer can also present with bleeding, although bleeding does not identify the cause by itself. Polyps or fibroids may contribute to bleeding from the uterus. In early pregnancy, bleeding can occur with changes that affect the pregnancy and may be accompanied by cramps. Later bleeding can have causes involving the placenta or the cervix, which require prompt clinical assessment. The stage of pregnancy, colour, amount, clots, pain, and fetal movement are useful details.

Contact your maternity team or obstetric clinician when you notice bleeding, even if it is light. Use a pad so you can observe the amount; avoid tampons. Note the time it began, its colour, whether it contains clots, and any pain, fluid loss, dizziness, fever, or change in fetal movement. Do not start medicines or assume the bleeding is from a known fibroid or polyp without advice. Your clinician may recommend an examination, blood tests, urine or infection testing, and ultrasound depending on your pregnancy stage and symptoms.

Seek emergency help for heavy bleeding, severe or one-sided abdominal pain, shoulder pain, faintness, collapse, fever, or feeling seriously unwell. Get immediate maternity advice for fluid loss, regular painful contractions, or reduced fetal movement. If you cannot reach your maternity team, use emergency services rather than waiting for the bleeding to stop.

What could explain the bleeding at this stage of pregnancy? Do I need an ultrasound or blood testing? Should I change activity or avoid sex? Which signs require emergency care?