Why is there bleeding during pregnancy

Table of Contents Show

Cervical changes
Miscarriage or ectopic pregnancy
Vaginal infections
Placental abruption
Low-lying placenta (placenta praevia)
Vasa praevia
What are the causes of bleeding during pregnancy?
What should I do if I bleed during pregnancy?
How will my doctor or midwife diagnose the cause of my bleeding?
When should I seek medical attention?
Does bleeding mean I am having a miscarriage or might lose my baby?

Bleeding during pregnancy is relatively common and does not always mean there's a problem – but it can be a dangerous sign.

you have any bleeding from your vagina

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In early pregnancy, you might get some harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due.

Cervical changes

Pregnancy can cause changes to the cervix, and this may sometimes cause bleeding – after sex, for example.

Miscarriage or ectopic pregnancy

During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy.

However, if you bleed at this stage of pregnancy it's likely you will go on to have normal and successful pregnancies.

If a pregnancy ends before the 24th week, it's called a miscarriage. Around 1 in 5 pregnancies ends this way.

Many early miscarriages (before 14 weeks) happen because there is something wrong with the baby. There can also be other causes of miscarriage, such as hormone or blood clotting problems.

Most miscarriages occur during the first 12 weeks (3 months) of pregnancy and, sadly, most cannot be prevented. Other symptoms of miscarriage include:

cramping and pain in your lower abdomen
a discharge or fluid from your vagina
a discharge of tissue from your vagina
no longer experiencing the symptoms of pregnancy, such as feeling sick

If you have bleeding or any of the symptoms above, contact your midwife or GP straightaway.

An ectopic pregnancy is when a fertilised egg implants outside the womb – for example, in the fallopian tube.

It can cause bleeding and is dangerous because the fertilised egg cannot develop properly outside the womb. The egg has to be removed, which can be done through an operation or with medicines.

Symptoms of an ectopic pregnancy tend to develop in the 6th week of pregnancy but can happen later.

Other signs of ectopic pregnancy can include:

tummy pain low down which may be on one side
vaginal bleeding or a brown, watery discharge
pain in the tip of your shoulder
discomfort when peeing or pooing

Call 111 if you have symptoms of an ectopic pregnancy.

These can lead to bleeding, particularly after sex.

Vaginal infections

Your midwife or doctor can discuss tests and treatment with you.

A 'show'

This is when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is getting ready for labour to start. It may happen a few days before contractions start or during labour itself.

Find out about the signs of labour and what happens in labour.

Placental abruption

This is a serious condition in which the placenta starts to come away from the womb wall. Placental abruption usually causes stomach pain, and this may occur even if there is no bleeding.

Low-lying placenta (placenta praevia)

This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and put you and your baby at risk.

You may be advised to go into hospital for emergency treatment, and a caesarean section will usually be recommended. The Royal College of Obstetricians and Gynaecologists has more information on placenta praevia.

Vasa praevia

This is a rare condition where the baby's blood vessels run through the membranes covering the cervix.

When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can lose a life-threatening amount of blood.

To work out what is causing the bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels.

Your doctor will also ask you about other symptoms, such as cramp, pain and dizziness. Sometimes it might not be possible to find out what caused the bleeding.

If your symptoms are not severe and your baby is not due for a while, you'll be monitored and, in some cases, kept in hospital for observation.

How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are.

Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems.

Find the answers to common health problems in pregnancy

In this video, a midwife tells you what to do if you start to bleed during early pregnancy.

Page last reviewed: 10 March 2021
Next review due: 10 March 2024

Bleeding during pregnancy, especially in the early stages, is quite common. About 1 in 4 women will experience vaginal spotting or bleeding during the first trimester. Many of these women will go on to have healthy pregnancies.

However, vaginal bleeding may be the first sign of a problem, so it’s important to contact your doctor or midwife if you experience vaginal bleeding at any stage of your pregnancy for advice on what to do next.

What are the causes of bleeding during pregnancy?

The causes of bleeding during pregnancy are generally divided into two categories — bleeding before 20 weeks and bleeding after 20 weeks gestation.

Before 20 weeks gestation, causes of bleeding may include:

Implantation bleeding — in very early pregnancy (4 to 5 weeks gestation) some women may experience bleeding when the pregnancy implants itself in the lining of the uterus (womb).
Miscarriage — bleeding may be the first sign of a miscarriage. About 1 in 15 women who experience bleeding in early pregnancy end up having a miscarriage.
Ectopic pregnancy — a rare but serious cause of bleeding when a fertilised egg starts growing outside the uterus (womb). An ectopic pregnancy can rupture (burst) and cause heavy bleeding, and may be life-threatening.

Bleeding in later pregnancy (after 20 weeks) is usually caused by problems with the placenta such as:

Placenta previa — also known as a 'low lying placenta', when the placenta implants close to the cervix (neck of the uterus). If the cervix starts to open or the uterus contracts, this can cause bleeding.
Placental abruption — when the placenta starts to separate from the uterus during pregnancy but before birth, causing bleeding from the place where the placenta has peeled away. Bleeding caused by placental abruption is usually associated with sudden, severe abdominal pain.

Less common causes of bleeding, which may happen at any stage of pregnancy, may include:

genital tract infections
injuries to the genital tract
growths or tumours of the reproductive system
bleeding from vulvovaginal varicosities (varicose veins in the vulva or vagina)

What should I do if I bleed during pregnancy?

If you bleed during pregnancy, contact your doctor or midwife. Your antenatal care provider can give you advice about what to do next.

It can be helpful to note down details about what you have been experiencing. This may include:

the amount and colour of any discharge
whether you have passed any clots
whether you have had any abdominal pain

If you are having heavy bleeding, it’s a good idea to keep your pads or stained clothes to show your doctor or midwife.

How will my doctor or midwife diagnose the cause of my bleeding?

Your doctor or midwife will ask you questions about the bleeding, any other symptoms you have been having and about your pregnancy and general health. Your doctor or midwife may also perform a vaginal examination to check the bleeding and look for any visible cause.

You may be referred for a blood test to check your human chorionic gonadotropin (hCG) level. hCG is a hormone made by the placenta that can be found in your blood and urine. Your hCG level can give your doctor important information about how your pregnancy is progressing.

You may also be referred for an ultrasound scan, which may be used to:

It may take some time to work out what is causing your bleeding. You may need to have several blood tests or ultrasound scans over a few days or weeks. This can be a stressful time, so consider seeking support from your partner or someone else you trust.

In some situations, your bleeding may resolve on its own without your doctor or midwife finding a cause.

When should I seek medical attention?

If you have bleeding at any stage of pregnancy, contact your doctor or midwife for advice and support.

You should contact your doctor urgently, or visit the nearest emergency department, if:

your bleeding becomes very heavy
you have strong pains
you feel dizzy or faint
you feel short of breath

Does bleeding mean I am having a miscarriage or might lose my baby?

Bleeding in early pregnancy is very common and does not necessarily mean you are having a miscarriage. Many women who experience bleeding in early pregnancy go on to have healthy babies.

In some cases, bleeding can be the first sign of a miscarriage. If you are experiencing bleeding in early pregnancy, contact your doctor or midwife for advice.