Bleeding in Pregnancy

Bleeding in Pregnancy under 20 weeks

Although bleeding in early pregnancy can be very frightening for women, it is fairly common and doesn’t always mean that there is a problem. However during the first 12 weeks, vaginal bleeding can be a sign of miscarriage and sometimes ectopic pregnancy. 

You are more likely to have episodes of bleeding during pregnancy if you are a smoker. There are many health benefits to stopping smoking and you can get support to quit from your midwife.

Causes of bleeding in early pregnancy

Implantation bleeding

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 a few days before your period would have been due. 

Cervical changes

Pregnancy can cause normal changes to the surface of the cervix. These can lead to bleeding or “spotting”, particularly after sex. Sex is not harmful during pregnancy, but in some instances, your doctor may advise you to avoid it.


If a pregnancy ends before the 24th week, it's called a miscarriage. Around 1 in 4 pregnancies ends this way.

Most miscarriages occur during the first 12 weeks (3 months) of pregnancy. In about 80% of miscarriages this is due to genetic problems (the genetic code that is used to build all of the baby and placenta’s cells). Genetic problems are usually a chance event for that particular pregnancy and do not generally happen in future pregnancies.

Ectopic pregnancy

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. Some ectopic pregnancies will stop and resolve by themselves, but many will require either surgery to remove the egg or medical treatment to stop the pregnancy continuing to grow.

Ectopic pregnancies do not develop normally and unfortunately there is no way to move an ectopic pregnancy into the womb.

 Symptoms of an ectopic pregnancy tend to develop in the 6th week of pregnancy but can happen later.

Call 999 if you have any of the following:

  • Bleeding heavily (soaking through a sanitary pad in less than an hour). Signs that you may have lost a lot blood include a rapid heart rate; quick, shallow breathing; feeling increasingly weak and tired; cool, clammy skin; confusion or wooziness 

  • Abdominal pain with dizziness, fainting or loss of consciousness

  • Experiencing pain in the tip of your shoulder

Contact your GP surgery today or NHS 111 out of hours if you are bleeding and have any of the following: 

  • Cramping and pain in your lower tummy which may be on one side

  • A brown watery discharge from your vagina

  • Semi solid material discharged from your vagina

  • Pain in the tip of your shoulder

  • If you are between 12 and 20 weeks pregnant and have Rh NEG blood group


  • Minimal/ slight blood loss on wiping after using the toilet

  • Small amount of blood after sex 

Self care

Please keep an eye on your blood loss by wearing a maternity sanitary pad.

Contact your GP surgery if you are still worried

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