Bleeding when you are pregnant
Bleeding during pregnancy is relatively common, but it can be a dangerous sign, and you should always contact your midwife or GP immediately if it happens to you.
In early pregnancy you might get some perfectly harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This often happens around the time that your first period after conception would have been due.
Causes of bleeding in early pregnancy
During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy. However, many women who bleed at this stage of pregnancy go on to have normal and successful pregnancies.
Miscarriage
If a pregnancy ends before the 24th week of pregnancy, it's called a miscarriage. Miscarriages are quite common in the first three months of pregnancy and around one in five confirmed pregnancies ends this way.
Many early miscarriages (before 14 weeks) happen because there is something wrong with the baby. There can be other causes of miscarriage, such as hormone or blood clotting problems.
Most miscarriages occur during the first 12 weeks (three months) of pregnancy and, sadly, most cannot be prevented. Read about symptoms of a miscarriage.
Ectopic pregnancy
Ectopic pregnancies (when a fertilised egg implants outside the womb – for example, in the fallopian tube) can cause bleeding, but are less common than miscarriages.
It's a dangerous condition, because the fertilised egg can't develop properly outside the womb. The egg has to be removed – this can be through an operation or with medicines. Find out about symptoms of an ectopic pregnancy.
Causes of bleeding in late pregnancy
- Cervical changes – can lead to bleeding, particularly after sex.
- Vaginal infections
- A "show" – when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is becoming 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 – 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 (or placenta praevia) – 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 usually a caesarean will be recommended. Read more information on placenta praevia.
- Vasa praevia – a rare condition where the baby's blood vessels run through the membranes covering the cervix. Normally, the blood vessels would be protected within the umbilical cord and the placenta. When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can lose a life-threatening amount of blood. It is very difficult to diagnose vasa praevia, but it may occasionally be identified before birth by an ultrasound scan. Vasa praevia should be suspected if there is bleeding and the baby's heart rate changes suddenly after the rupture of the membranes.
Finding out the cause of bleeding in pregnancy
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 the cause of bleeding cannot be found.
If your symptoms are not severe and your baby is not due for a while, you will 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.
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