Light spotting in early pregnancy is common and affects around 1 in 4 pregnancies. It is often caused by implantation bleeding, cervical changes, or irritation after sex. However, any bleeding during pregnancy should be reported to your midwife or maternity unit. Heavy bleeding, bleeding with pain, or bleeding after 12 weeks requires urgent assessment. Call 999 if bleeding is very heavy or you feel faint.
Bleeding or spotting during pregnancy is more common than many people realise. According to the RCOG, around 1 in 4 pregnant people experience some bleeding in the first trimester. While it can be alarming, it does not always mean something is wrong. Many people who bleed in early pregnancy go on to have healthy pregnancies.
However, any bleeding during pregnancy should always be reported to your midwife, GP, or maternity unit. They can assess whether further investigation is needed. The cause and significance of bleeding depends on the stage of pregnancy, the amount of bleeding, and whether it is accompanied by pain.
Bleeding in the first trimester has several possible causes:
Implantation bleeding. Around 6 to 12 days after conception, the fertilised egg implants into the lining of the uterus. This can cause light spotting or pink/brown discharge that lasts a day or two. It often occurs around the time you would expect your period, which can cause confusion.
Cervical changes. Pregnancy hormones increase blood flow to the cervix, making it more sensitive. Light bleeding can occur after sexual intercourse, a cervical screening test, or even a vigorous internal examination. This is usually harmless.
Subchorionic haematoma. A small collection of blood between the pregnancy sac and the uterine wall. These are often found on ultrasound and typically resolve on their own without affecting the pregnancy.
Ectopic pregnancy. When the fertilised egg implants outside the uterus, usually in a fallopian tube. Symptoms include one-sided abdominal pain, shoulder tip pain, and vaginal bleeding. An ectopic pregnancy is a medical emergency. If you experience these symptoms, call 999 or go to A&E immediately.
Miscarriage. Bleeding with cramping pain can be a sign of miscarriage. However, bleeding alone does not mean you are having a miscarriage. If you are concerned, contact your GP or Early Pregnancy Unit (EPU). They can arrange an ultrasound scan to check the pregnancy.
Bleeding after 12 weeks is less common and should always be assessed promptly. Possible causes include:
Cervical ectropion. Harmless changes to the cervix caused by pregnancy hormones. Can cause light bleeding, particularly after sex.
A show. A blood-tinged mucus discharge in the final weeks of pregnancy, indicating the cervix is beginning to prepare for labour. This is normal and expected near your due date.
Placenta praevia. When the placenta is positioned low in the uterus, partially or completely covering the cervix. This can cause painless bright red bleeding and is usually identified at the 20 week scan. It requires specialist monitoring.
Placental abruption. When the placenta starts to separate from the uterine wall before delivery. This causes pain and bleeding and is a medical emergency. Call 999 if you experience sudden, severe abdominal pain with bleeding.
Vasa praevia. A rare condition where fetal blood vessels cross or run near the internal opening of the cervix. If these vessels rupture, it can cause rapid fetal blood loss. This requires emergency delivery.
Call 999 or go to A&E if: Bleeding is very heavy (soaking through a pad in less than an hour). You have severe abdominal pain. You feel dizzy, faint, or unwell. You have shoulder tip pain (possible ectopic pregnancy).
Contact your maternity unit or GP urgently if: Any bleeding after 12 weeks. Bleeding with cramping in the first trimester. Bleeding that is bright red rather than brown. Bleeding that continues or increases.
Contact your midwife at your next appointment if: You had a single episode of very light brown spotting in early pregnancy that stopped on its own.
If you report bleeding, you may be referred to an Early Pregnancy Unit (EPU) in the first trimester or the maternity assessment unit later in pregnancy. They will typically check your blood pressure and pulse, examine your abdomen, perform an ultrasound scan to check the pregnancy, take blood tests including your blood group (in case you need anti-D if you are rhesus negative), and possibly perform a speculum examination to check the cervix.
If you are rhesus negative, you may be given an anti-D injection after a bleeding episode to prevent rhesus disease.
Experiencing bleeding during pregnancy can be extremely frightening, even when the cause turns out to be harmless. Anxiety, fear, and uncertainty are completely normal responses. If you are struggling emotionally after a bleeding episode, speak to your midwife about support options. Tommy''s also offers a free helpline staffed by trained midwives.
Light spotting in the first trimester is common and affects around 1 in 4 pregnancies. It is often caused by implantation, cervical changes, or irritation after sex. However, always report bleeding to your midwife.
Call 999 if bleeding is very heavy, you have severe abdominal pain, you feel dizzy or faint, or you have shoulder tip pain. Any bleeding after 12 weeks should be assessed urgently.
No. Many people who bleed in early pregnancy go on to have healthy pregnancies. However, bleeding with cramping pain should be assessed by your GP or Early Pregnancy Unit.
Light spotting that occurs 6 to 12 days after conception when the fertilised egg implants in the uterus. It is usually light pink or brown and lasts a day or two.
Go to A and E if bleeding is very heavy, you have severe pain, or you feel unwell. For less urgent bleeding, contact your GP, Early Pregnancy Unit, or maternity unit for advice.
Milestones, partner sharing, notes, photos, and a curated essentials guide. Free, no app to install.
Get Started Free© 2026 Nuhah. All rights reserved.