Bleeding in early pregnancy can be frightening. It does not always mean miscarriage, but it should be checked. Contact your GP or midwife straight away for any vaginal bleeding, including light spotting. You do not need to wait to see whether it continues.
When bleeding needs emergency care
In Australia, call triple zero (000) for an ambulance if you have heavy bleeding, severe abdominal pain, fainting, collapse or feel very unwell. Do not drive yourself if you feel faint or unwell.
Go to an emergency department immediately for increasing bleeding, shoulder-tip pain, one-sided or worsening abdominal pain, dizziness, fever, chills or unusual-smelling vaginal discharge. Rapidly soaking pads or passing large clots also needs emergency assessment. Do not wait to reach a particular pad count if you are worried or unwell.
An ectopic pregnancy can cause internal bleeding with little blood coming from the vagina. Emergency symptoms matter even if you have not yet confirmed the pregnancy or an earlier scan was inconclusive.
If bleeding is light and you feel well, call your GP or midwife now. They may arrange assessment through an early pregnancy service. If you cannot reach your usual clinician, Healthdirect on 1800 022 222 can help you find appropriate care. This advice line is not a substitute for 000 in an emergency.
What can cause bleeding?
Possible causes include changes in the cervix, an infection, a polyp, miscarriage or an ectopic pregnancy. Occasionally, abnormal pregnancy tissue develops in a molar pregnancy. Sometimes no definite cause is found.
Bleeding may be described online as implantation bleeding, but that label should not be used to decide that your symptoms are safe. The amount or colour of blood alone cannot tell you whether the pregnancy is developing normally.
Read more about ectopic pregnancy and possible signs of miscarriage.
What tests might I need?
Your clinician will ask about the bleeding, any pain, your last period and your pregnancy history. They may suggest an examination to check where the bleeding is coming from.
An ultrasound looks at the pregnancy’s location and development. In early pregnancy, a scan through the vagina often gives the clearest view. Blood tests may check your blood group and pregnancy hormone hCG; repeat hCG tests can help show the pattern over time.
One appointment may not give a definite answer. Dates can be uncertain and an early scan may need repeating. If a pregnancy test is positive but the pregnancy cannot be seen, clinicians call this a pregnancy of unknown location. Further tests are needed because an ectopic pregnancy has not yet been excluded.
While you are waiting for answers
- Use sanitary pads so you can describe the amount of bleeding. Note any pain or other new symptoms.
- Keep your arranged blood tests and scans, even if the bleeding settles. Ask who will give you the results and when.
- Ask your clinician about pain relief and any activity or sex restrictions that apply to your situation.
- If symptoms worsen, seek care again immediately rather than waiting for the next test.
Waiting can be hard. You can ask someone you trust to come with you, or ask the service to write the plan down. Being upset does not mean you are coping badly.
Sources and further reading
- The Royal Women’s Hospital: Bleeding in early pregnancy
- The Royal Women’s Hospital: Pain and bleeding in early pregnancy
- Queensland Clinical Guidelines: Early pregnancy loss
- Healthdirect: Ectopic pregnancy and advice line
- Pregnancy, Birth and Baby: Miscarriage and other causes of bleeding
- Queensland Health: Pain and bleeding in early pregnancy
This is general information for Australian readers, not a diagnosis or individual treatment plan.