Bleeding in Early Pregnancy

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Overview

You may have experienced some bleeding and / or pain in the early part of your pregnancy which has resulted in you attending the early pregnancy clinic. This leaflet is to give you some information about the bleeding you may have experienced and what happens next.

How common is bleeding in early pregnancy?

Bleeding during pregnancy is relatively common with around one in four women experiencing some bleeding. Around one in five women go on to have a miscarriage. If you have bleeding at any stage during your pregnancy, that causes you concern then you are advised to contact your GP and or midwife for an early assessment.

She or he may refer you to the hospital for an ultrasound scan to establish if the pregnancy is developing as it should. Normal activities of daily living do not cause miscarriage / pregnancy loss and in most cases, bleeding is not a sign of a serious problem. However, it is important (and reassuring) to get assessed by a health professional.

During this time we advise you to use a pantyliner or a sanitary towel instead of a tampon.

When is the most common time to see vaginal bleeding in early pregnancy?

Bleeding or spotting can be relatively common during the early stages of pregnancy. There could be various reasons.

In early pregnancy you might get some light bleeding when the fetus plants itself into the wall of your womb. This is also known as implantation bleeding, and often happens around the time that your first period after conception would have been due.

There are other less frequent causes of vaginal bleeding which can include bleeding from the neck of the womb (the cervix). Bleeding or spotting may be continuous or intermittent for hours or days or maybe even weeks. This does not mean that you are miscarrying or that you will miscarry. Studies have shown that some women who have had bleeding in pregnancy may still go on and have a successful pregnancy.

What investigations do I need if I have bleeding?

If you have bleeding in early pregnancy you may be referred to the Early Pregnancy Unit (EPU) for assessment. This will include a pregnancy test, a scan and possibly blood tests. In the very early stages of pregnancy the scan may need to be done vaginally. This is a safe and (usually) painless examination. Occasionally we may also need to do a vaginal examination.

Do I need any further investigations?

Hopefully the results of all these tests will be reassuring and your pregnancy will continue without any further problems. We often cannot give you a reason why the bleeding happened and we do not normally suggest any further tests.

If the scan does pick up a heartbeat and the baby appears to be the right size according to your dates, this can be very reassuring, even if you are still bleeding.

Research has shown that if you see a heartbeat at 6 weeks of pregnancy, the chances of the pregnancy continuing are 78 per cent.

A heartbeat at 8 weeks increases the chance of a continuing pregnancy to 98 per cent and at 10 weeks that goes up to 99.4 per cent.

So things could still go wrong and sadly sometimes do, but as long as there is a heartbeat, the risk of miscarriage decreases as the weeks go by. We hope you will find this information helpful and reassuring. The important thing to remember is that whatever you do (having a scan, resting or carrying on with normal activities of daily living), if the bleeding is because the pregnancy is failing, nothing can be done to stop this.

Contact numbers

If you have bleeding and / or pain you can get medical help or advice from:

• Your GP or midwife who may advise you to go to hospital.
• Your nearest EPU which can be found at earlypregnancy.org
• Referral into the Early pregnancy unit is based on assessment by a health professional.

NHS CHOICES 111 when you need medical help fast but it’s not a 999 emergency. The service is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones.

BSUH NHS TRUST(2011) GP001 Early Pregnancy Unit Clinical Guidelines.
Patient UK Information leaflets Women’s Health Category
Royal College of Obstetricians and Gynaecologists
National institute for Heath and Clinical Excellence: Clinical Guidelines: Nice
Pathways