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Pain and bleeding in early pregnancy

Abdominal pain and vaginal bleeding in the early stages of pregnancy is not unusual and does not always mean there is a problem.  However, pain and/or bleeding can sometimes be a warning sign of miscarriage, ectopic pregnancy (pregnancy located outside of the womb), and, rarely, a molar pregnancy (a rare condition with development of an abnormally fertilised egg in the womb).

Bleeding can happen at any time after you have missed a period and is often noticed 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 be ‘spotting’ or heavy bleeding with clots.  The bleeding might happen every day or may be intermittent, sometimes `for several weeks.

What are the causes of pain and bleeding in early pregnancy?

We do not always know why pain and bleeding happens, but in many cases the pregnancy continues safely.

Some likely causes may be:

  • 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.

What should I do?

There is no treatment to prevent or stop the bleeding, although if you have had a previous miscarriage, you may be offered Progesterone treatment.  Bed rest is not recommended but, depending upon the type of work you have, you may wish to take some time off if you have heavy bleeding.

Please do not use tampons; but instead use sanitary towels or panty liners.  This way you will be able to 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.

If your bleeding is light to period like and your pain is not severe, contact your GP. They will refer you to the Early Pregnancy Unit (make this a link to the Early Pregnancy unit page) for assessment.

When should I go to the Emergency Department?

  • If your bleeding is heavy and continuous for example if you are soaking more than two pads an hour or passing large blood clots.
  • If you are taking paracetamol regularly but the pain is getting worse
  • If you have severe pain in your abdomen
  • If you have pain in your shoulder, that does not improve by changing position
  • If you are feeling dizzy or faint

Further information

Contact numbers

Stoke Mandeville Hospital
Early Pregnancy Unit: 01296 316469
8am to 5pm Monday–Friday (except bank holidays)

Or call the Surgical Assessment Unit on 01296 316106/316365 at all other times.

Find out more about the Early Pregnancy Unit