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Date issued: December 2022

Review date: December 2024

Ref: A-520/NB/ED/Bleeding in Early Pregnancy

PDF:  Early Pregnancy Bleed final December 2022.pdf [pdf] 111KB

What causes early pregnancy bleeding?

We understand this is a very stressful event, regardless of whether this is your first pregnancy or not.

During the first 12 weeks of pregnancy between 20-30% of women (more than 1 in 5) experience vaginal bleeding or spotting.

The vast majority of pregnancies continue normally, but if you experience bleeding, you should always consult either your GP or midwife (if you have one yet).

The most common cause is an “implantation bleed”, where the embryo implants itself into the wall of your womb.  More concerning causes include miscarriage and an ectopic pregnancy.

What is a miscarriage?

Pregnancies which end before 24 weeks are referred to as miscarriages.  Often, we do not know exactly why this happens.

Symptoms include:

• Vaginal bleeding

• Spotting, bloodstains, or discharge

• Occasionally, abdominal cramps, period pains or backaches.

It is important to note that most pregnant women experience some kind of discomfort, backache or abdominal pain during the initial stages of pregnancy, and these can be normal pregnancy symptoms.

What is an ectopic pregnancy?

This is a pregnancy where the embryo does not implant in the womb.  It is life-threatening condition for the Mum, and the egg must be removed either with medicines or an operation.

Why is it happening to me?

It is most unlikely to be anything you have done, it is not your fault. There are a number of reasons for vaginal bleeding that may not be related to miscarriage, including:

• Infection, such as STDs and Pelvic Inflammatory Disease (PID)

• Hormonal changes

• Endometriosis

• Cervical inflammation caused by sexual intercourse

• Polyps, cysts, or uterine fibroids.

What happens now?

In the Emergency Department you will have a urine pregnancy test performed and may have a blood test.

If the blood loss is severe, you will be admitted to hospital. Otherwise you will be referred to the Early Pregnancy Unit and you will be seen within a few days. An ultrasound scan will be performed at this stage.

We do not normally offer a scan from the Emergency Department as it will not help us to reassure you: this can only be done by a scan in a few days’ time.  We know it is difficult to not know what will happen, but a scan today will not change things.  It is important to know that it is likely that you will have an internal (vaginal) scan.

Hopefully, your symptoms will settle down of their own accord and your pregnancy will continue.  However, it is possible that your symptoms may worsen, and you will suffer a miscarriage.  Nothing can be done to prevent this, but we understand this does not make it any less distressing.

What is the treatment at this stage?

There is no specific treatment, but we would advise taking it easy and avoiding strenuous exercise including housework and carrying children.  We also advise you abstain from sexual intercourse and tampon use whilst the bleeding persists.  You may notice more bleeding after you have been lying down (e.g., first thing in the morning).

Can I prevent it happening?

It is difficult to prevent a threatened miscarriage.  Maintaining regular prenatal appointments and following a healthy lifestyle will help ensure that you stay healthy throughout your pregnancy.  To help you through this process you can contact the Miscarriage Association: www.miscarriageassociation.org.uk

Date to attend

Early Pregnancy Unit (EPU) Appointment Your appointment in the EPU is: DATE:                                     TIME: EPU is on Level 5 of Derriford Hospital, it is best to enter through the maternity entrance.  It is well sign-posted from there.  Remember to bring your maternity notes with you (if you have been given them).