Bleeding and spotting from the vagina during pregnancy are common
If you bleed or spot during pregnancy, it doesn’t always mean there’s a problem but in some cases they may be signs of a problem for you or your baby’s health
If you have heavy bleeding, call your health care provider right away
Tell your provider about any bleeding or spotting you have during pregnancy
Bleeding and spotting from the vagina during pregnancy are common. Up to 1 out of 4 (up to 25%) of all pregnant women have some bleeding or spotting during their pregnancy.
Bleeding and spotting in pregnancy don’t always mean there’s a problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.
Call your health care provider if you have any bleeding or spotting, even if it stops. It may not be caused by anything serious, but your provider needs to find out what’s causing it.
What’s the difference between bleeding and spotting?
Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Spotting is light bleeding. It happens when you have a few drops of blood on your underwear. Spotting is so light that the blood wouldn’t cover a panty liner. Bleeding is when the blood flow is heavier, enough that you need a panty liner or pad to keep the blood from soaking your underwear and clothes.
What should you do if you have bleeding or spotting during pregnancy?
Call your health care provider if you have any kind of bleeding during pregnancy and do these things:
- Keep track of how heavy your bleeding is, if it gets heavier or lighter, and how many pads you are using.
- Check the color of the blood. Your provider may want to know. It can be different colors, like brown, dark or bright red.
- Don’t use a tampon, douche or have sex when you’re bleeding.
Call your health care provider right away at any time during pregnancy or go to the emergency room if you have:
- Heavy bleeding
- Bleeding with pain or cramping
- Dizziness and bleeding
- Pain in your belly or pelvis
What causes bleeding or spotting early in pregnancy?
It’s normal to have some spotting or bleeding early in pregnancy. Bleeding or spotting in the first trimester may not be a problem. It can be caused by:
- Having sex
- An infection
- Implantation. When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow.
- Hormone changes. Hormones are chemicals made by the body.
- Changes in your cervix. The cervix is opening to the uterus that sits at the top of the vagina.
- Certain types of testing during pregnancy like an amniocentesis or Chorionic villus sampling (CVS). These are tests that are done to check for genetic abnormalities in your baby. Genetic abnormalities are changes in the genes that are passed down to a baby from mom or dad. These genetic changes can cause health problems for a baby.
- Problems related to smoking. If you smoke, it’s best to stop before pregnancy or as soon as you know you’re pregnant.
Sometimes bleeding or spotting in the first trimester is a sign of a serious problem, like:
- Miscarriage. Almost all women who miscarry have bleeding or spotting before the miscarriage.
- Ectopic pregnancy. This is when a fertilized egg implants itself outside of the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. It can cause serious, dangerous problems for the pregnant woman.
- Molar pregnancy. This is when a mass of tissue forms inside the womb, instead of a baby. Molar pregnancy is rare.
What causes bleeding or spotting later in pregnancy?
Bleeding or spotting later in pregnancy may be caused by:
- Labor
- Having sex
- An internal exam by your health care provider
- Problems with the cervix, like an infection, growths, inflammation or cervical insufficiency. This is when a woman’s cervix opens too early. Inflammation of the cervix is when it may be painful, swollen, red or irritated.
Bleeding or spotting later in pregnancy may be a sign of a serious problem, like:
- Preterm labor. This is labor that happens too early, before 37 weeks of pregnancy.
- Placenta previa. This is when the placenta lies very low in the uterus and covers all or part of the cervix.
- Placenta accreta. This is when the placenta grows into the wall of the uterus too deeply.
- Placental abruption. This is when the placenta separates from the wall of the uterus before birth.
- Uterine rupture. This is when the uterus tears during labor. This happens very rarely. It can happen if you have a scar in the uterus from a prior cesarean birth (also called c-section) or another kind of surgery on the uterus. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.
How are bleeding and spotting treated?
Your treatment depends on what caused your bleeding. You may need a medical exam and tests.
Most of the time, treatment for bleeding or spotting is rest. Your provider may also suggest treatments like:
- Take time off from work and stay off your feet for a little while
- You may need medicine to help protect your baby from Rh disease. Rh disease is when your blood and baby’s blood are incompatible (can’t be together). This disease can cause serious problems — even death — for your baby.
- Don’t have sex, douche or use tampons
- If you have heavy bleeding, you may need a hospital stay or surgery
Last reviewed: April 2020
Bleeding during pregnancy is relatively common and does not always mean there's a problem – but it can be a dangerous sign.
If you're well, it's really important you go to all your appointments and scans for the health of you and your baby.
If you're pregnant, hospitals and clinics are making sure it's safe for you to go to appointments.
If you get symptoms of COVID-19, or you're unwell with something other than COVID-19, speak to your midwife or maternity team. They will advise you what to do.
Find out more about pregnancy and COVID-19
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