Bleeding in Early Pregnancy: When to Worry and When It’s Normal

Bleeding in early pregnancy is a common experience, yet it can feel extremely worrying. Around 20–25% of women notice some bleeding during the first trimester. For some, it turns out to be harmless, while for others it may be the first sign of a complication. Understanding when spotting is normal and when it requires urgent attention can help you feel more informed and prepared.

What Causes Bleeding in Early Pregnancy?

Not all bleeding is a cause for alarm. Some of the more common, non-threatening reasons include:

• Implantation bleeding: This occurs when the fertilised egg attaches to the womb lining, typically around 10–14 days after conception. It is usually light, short-lived spotting.
• Hormonal changes: Fluctuations in progesterone and oestrogen can sometimes trigger light bleeding.
• Cervical changes: Increased blood supply to the cervix makes it more sensitive, so bleeding may happen after sex, exercise, or a vaginal examination.
• Subchorionic haematoma: A small pocket of blood between the placenta and womb lining may cause spotting but often resolves on its own.

In these cases, the pregnancy usually continues without problems.

When Bleeding Could be a Warning Sign

Heavier bleeding or bleeding accompanied by other symptoms can sometimes indicate complications. These include:

• Miscarriage: Unfortunately, miscarriage is most common in the first trimester, affecting about 1 in 5 pregnancies. Symptoms may include bleeding, cramping, and the passage of tissue.
• Ectopic pregnancy: This occurs when a fertilised egg implants outside the womb, most often in a fallopian tube. Signs include sharp pelvic pain, shoulder-tip pain, dizziness, and heavy bleeding. This is a medical emergency.
• Molar pregnancy: A rare condition where abnormal cells grow in the womb instead of a developing pregnancy. It usually causes abnormal bleeding and requires specialist treatment.

If you’re experiencing bleeding with pain, dizziness, or heavy flow, an early pregnancy scan can confirm what’s happening and ensure you get the right care quickly.

What to Look out for

When noticing bleeding in early pregnancy, it’s helpful to keep track of:

• Colour: Brown spotting is often older blood and less concerning, while bright red bleeding may suggest fresh loss.
• Flow: Light spotting is more reassuring than soaking through pads or passing large clots.
• Associated symptoms: Cramping, fever, or faintness should always prompt urgent medical advice.
• Timing: Bleeding before 6 weeks can sometimes be too early to assess clearly without both scans and blood tests.

What to do If You Experience Bleeding

• Stay calm but don’t ignore it. Light spotting is often harmless, but it’s always worth checking.
• Contact your doctor or gynaecologist. They may arrange a scan and blood tests to check pregnancy hormone levels.
• Seek emergency help if bleeding is heavy, you feel faint, or pain is severe.
• Avoid self-blame. Many women blame themselves, but bleeding in early pregnancy is usually beyond your control.

Role of Scans and Tests

An ultrasound scan is the most effective way to check the cause of bleeding. A trans-vaginal scan from around 6 weeks can confirm:

• Whether the pregnancy is located inside the womb
• If a heartbeat is present
• Whether there are complications such as ectopic pregnancy or miscarriage

Blood tests for hCG (human chorionic gonadotropin) and progesterone may also be used to track how the pregnancy is progressing.

Emotional Impact

Bleeding in early pregnancy can be very stressful, even when the outcome is positive. It’s normal to feel anxious and uncertain. Seeking reassurance through a scan or consultation can help ease these worries and give you clarity during what can be an overwhelming time.

Final Thoughts

Bleeding during early pregnancy is common and not always a cause for alarm, but it should never be ignored. While some women experience harmless spotting, others may face complications such as miscarriage or ectopic pregnancy. The key is to recognise when to seek help and to get checked promptly.

If you’re worried about bleeding or early pregnancy symptoms

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