Bleeding during pregnancy is very common, and although understandably worrying, there are many causes for bleeding. Around 20 to 40% of women have bleeding during the first twelve weeks of pregnancy (first trimester). Bleeding any time during pregnancy needs looking at to check you and the baby are safe, so you should be assessed by your midwife or doctor urgently, or attend the Early Pregnancy Assessment Unit (EPAU) at your local hospital. Miscarriage and ectopic pregnancy are two common causes of bleeding in the first trimester. There are other causes that are less worrying, but first, the medical team would want to exclude these.
Bleeding later in pregnancy is likely due to other reasons. These include placenta praevia, placental abruption and pregnancy-related changes in the cervix. As with bleeding earlier in pregnancy, you should be assessed by your midwife or doctor urgently, or attend the Maternity Unit at your local hospital. At the end of your pregnancy, you may get your ‘show’, which is a small amount of mucus mixed with blood that occurs just before the first stage of labour. The show is caused by the shedding of the plug at the cervix in preparation for labour to start.
If you are pregnant and have had vaginal bleeding, you should seek urgent medical advice. Bleeding can be nothing to worry about, but your doctor will need to exclude any concerning causes. You can either speak with your doctor or attend your local emergency department or the EPAU or Maternity Unit where you will be reviewed by the most appropriate team. The EPAU is for those in their first trimester, the Maternity Unit for the second and third trimester. The absence of baby movements is also reason for urgent medical attention.
Assessment for bleeding in pregnancy is usually done by a specialist doctor called an obstetrician, or a midwife. It's best to take your antenatal notes with you, if you have them. Your doctor or midwife will ask you questions about your pregnancy and medical history, and if you are comfortable, will examine you. If you are later in your pregnancy, an intimate examination such as a vaginal examination and check of your cervix may be required. Commonly blood tests and imaging such as an ultrasound will be needed, and they may listen to the baby's heartbeat.