Pain and bleeding in early pregnancy
Read our guide below about pain and bleeding in early pregnancy.
You can also download a PDF version of this patient information by following the link on the right.
Abdominal pain and vaginal bleeding in the early stages of pregnancy isn’t unusual and doesn’t always mean there’s a problem. However, pain and/or bleeding can sometimes be a warning sign of:
- miscarriage
- ectopic pregnancy (pregnancy located outside of the womb)
- a molar pregnancy (a rare condition with development of an abnormally fertilised egg in the womb).
When can bleeding happen?
At any time after you’ve missed a period. You’ll often notice it when going to the toilet as a smear of pink, brown or red blood loss on the toilet paper. The blood loss is different for everyone and can include ‘spotting’ or heavy bleeding with clots. The bleeding might happen every day or may be intermittent, sometimes for several weeks.
What are the causes ?
We don’t always know why pain and bleeding happens but in many cases, the pregnancy continues safely.
Some likely causes may happen at:
- the implantation site – when the placenta (the organ that provides oxygen and nutrients to your growing baby) tries to ‘burrow’ into the lining of the womb, it may cause some bleeding
- the cervix (neck of the womb) – during pregnancy the tissues become soft and rich in blood supply and this may cause bleeding.
- the vagina – thrush or any other infection may occasionally cause bleeding from the inflammation.
An ultrasound scan after 6 to 7 weeks of pregnancy can usually tell if the pregnancy is progressing normally. Sometimes the scan may show a small haematoma (blood clot) around the sac that contains your baby. If this is the case you may need a further scan. If you have any questions, please talk to the Early Pregnancy Unit (EPU) nurses when this is arranged.
It’s reassuring when the baby’s heartbeat can be seen during the scan as this means there is a high probability (over 85% chance) that your pregnancy will continue.
Do I need follow up care?
The consultant or nurse who sees you on the day will tell you if you need a follow up appointment. If you have further heavy bleeding, you can either attend the Emergency Department or, if it’s less than 4 weeks after your EPU visit, call the EPU during opening hours for advice.
Often there’s no reason for the bleeding, and the symptoms settle without further problems. You can contact the EPU or your GP if you’re worried.
What should I do?
There is no treatment to prevent or stop the bleeding, although if you’ve had a previous miscarriage, you may be offered Progesterone treatment. We don’t recommend bed but depending upon the type of work you have, you may wish to take some time off if you have heavy bleeding.
Do not use tampons. Use sanitary towels or panty liners. This will help you assess the amount of bleeding more easily and reduce the risk of infection.
Take regular paracetamol for any pain. Avoid taking ibuprofen in pregnancy.
We advise you not to swim or have sex until the bleeding has completely stopped.
When should I go to the Emergency Department?
You should go if:
- your bleeding is heavy and continuous, for example if you are soaking more than two pads an hour or passing large blood clots.
- you’re taking paracetamol regularly but the pain is getting worse
- you have severe pain in your abdomen
- you have pain in your shoulder that doesn’t improve by changing position
- you feel dizzy or faint.
Further information
Contact us
Early Pregnancy Unit, Stoke Mandeville Hospital
01296 316469 (Monday to Friday, 8am to 5pm except bank holidays)
Or call the Surgical Assessment Unit on 01296 316106/316365 at all other times.