Bleeding and pain in early pregnancy
For women who have not had a scan in our unit please contact your GP.
We do not take self-referrals.
Any amount of vaginal bleeding or abdominal pain in early pregnancy can cause concern that something is wrong with your pregnancy. However, up to one in three women have these symptoms during the first twelve weeks of their pregnancy and it does not necessarily indicate a problem such as a miscarriage. If you have a scan showing a pregnancy in the womb with a heartbeat there is a 95% chance that your pregnancy will continue provided the bleeding settles down.
What causes bleeding in early pregnancy?
In most cases we do not find a reason for the bleeding and the pregnancy continues with no effect on the baby.
However these are some reasons why vaginal bleeding may occur:
Implantation site bleeding
As part of the normal development the pregnancy attaches itself to the lining of your uterus (womb). This can cause some of the blood vessels from your womb to bleed. This does not harm you or your baby and there is nothing that you need to do differently.
Haematoma or small area of bruising
This is also referred to as extrachorionic haemorrhage (ECH). This is seen on an ultrasound scan as a small area of bleeding near the pregnancy. If your scan shows one it will either be reabsorbed by your body or come away naturally as mild (usually dark or brown) vaginal bleeding for a few weeks until it stops altogether. It does not harm you or your pregnancy.
You do not need a repeat scan in early pregnancy to check on it. You do not need to do anything differently although avoiding heavy lifting may settle your symptoms sooner.
Cervical erosion/ectropion
During pregnancy an area on the neck of your womb (cervix) can develop which is soft and rich in blood supply. This is a normal process but may cause bleeding. This area may be found during an internal examination.
It is not harmful to you or your baby and you do not need to do anything differently although you may find that sexual intercourse and vigorous exercise may cause bleeding.
Vaginal infections
Thrush and other vaginal infections can cause bleeding from inflammation (swelling) within your vagina. This may be found during an internal examination and swabs may be taken. If an infection is found you may be prescribed antibiotics to take. Some infections are sexually transmitted and your partner may be advised to get checked and treated as well.
What causes abdominal pain in early pregnancy?
Pain is very common in early pregnancy. The commonest reasons are outlined below.
‘Growing pains’
You may experience aching and cramping pains as the womb increases in size in early pregnancy. This is common and may be eased with paracetamol which is safe for most women at any stage of pregnancy.
Muscle and joint pain
Muscle and pelvic joint pains are common especially towards the end of the first three months of pregnancy. This is because the joints of your pelvis are under the influence of pregnancy hormones. Simple pain relief and keeping active should help relieve this.
Constipation
Constipation and wind are common in early pregnancy. Your bowels work slower and you may find you open your bowels less frequently. It is important to drink plenty of fluids and eat a healthy diet with fresh fruit and vegetables every day. Peppermint water or tea may help relieve discomfort. Occasionally you may need a short course of laxatives from your GP.
Urine infection
Up to one in three women experience a urine infection during pregnancy. You may have a urine sample tested to check for this. To reduce the risk of getting a urine infection it is important to drink plenty of fluid and to completely empty your bladder when you go to the toilet. It may also be useful to pass urine after having sex. If your test shows that you have a urine infection you will be prescribed a short course of antibiotics.
Threatened miscarriage
If you have had vaginal bleeding with lower abdominal pain you may experience pain because the womb in trying to expel the blood. This pain should settle as the bleeding slows. Simple pain relief should help. If your bleeding increases significantly (like a heavy period) or you pass large clots or you are concerned you should contact the early pregnancy unit.
What to do if you get further abdominal pain or vaginal bleeding?
Most women who have had a scan confirming an early pregnancy with a heart beat do not need a further scan in the early pregnancy unit. It is understandable to be concerned if you get more symptoms, however, in most women there is nothing to worry about.
If you get mild or moderate bleeding wear a pad and monitor the loss over the course of two days. In most cases the bleeding settles. If it increases in its amount during this time or persists as fresh bright red bleeding after two days then contact the early pregnancy unit for advice.
If you have heavy bleeding or bleeding with clots (bigger than a twenty pence piece) please contact the early pregnancy unit for advice.
If you get mild or moderate abdominal pain take pain relief (paracetamol 1 gram) and have a bath. Usually this helps relieve pain. If this does not help then either contact your GP or the early pregnancy unit if you are already under their care. We do not accept self-referrals.
