Bleeding in early pregnancy
Bleeding during pregnancy is relatively common, with about 2 in 10 women and pregnant people experiencing some bleeding during the first 12 weeks of pregnancy. It can be a worrying sign, and you should always contact your midwife or GP if it happens to you.
In early pregnancy you might get some perfectly harmless light bleeding, called "spotting" or "implantation bleeding". This is when the developing embryo plants itself in the wall of your womb and often happens around the time that your first period after conception would have been due.
Bleeding can also be due to changes occurring to the cervix due to pregnancy hormones. Your cervix gets an increased blood supply and becomes softer so any slight trauma such as sexual intercourse can result in some bleeding.
Vaginal bleeding can also be caused by:
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- Infection
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- A "threatened miscarriage" (a warning sign for a miscarriage and is diagnosed where there is ongoing bleeding with or without pain but the pregnancy is continuing).
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- An ectopic pregnancy
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- A molar pregnancy
Bleeding that is mild and painless, with good pregnancy symptoms is usually reassuring
Bleeding and/or pain in early pregnancy
NICE - Guidance on ectopic pregnancy and miscarriage
NHS Choices
The Miscarriage Association
The Ectopic Pregnancy Association
It is important to remember that many women and pregnant people who experience bleeding early on do go on to have a successful pregnancy.
Any bleeding during pregnancy should be reported to your GP. Be prepared that you may be told to rest or 'wait and see' if the bleeding is light, a small amount or if you are in the early part of your pregnancy.
If the bleeding is heavy or contains clots and is accompanied with stomach cramps, backache and period type pains, contact your GP who may refer you to the Early Pregnancy Unit.
Women who are rhesus negative and experience any bleeding from twelve weeks gestation onwards will need to have an antiD injection.
If you are less than 12 weeks of pregnancy, and your bleeding is light/spotting you will not require anti-D.
If your bleeding is heavy you will be advised to have anti-D.
Please check with your GP or midwife.
Sickness/Nausea and Vomiting
Nausea and vomiting are symptoms of pregnancy and affects most women and pregnant people to some degree. If are suffering from nausea and vomiting in pregnancy there is nothing that you are doing or have done which has brought on these symptoms.
The cause is thought to be pregnancy hormones but it is unclear why some women and pregnant people get it worse than others.
It is important that other causes of vomiting are considered and looked into, particularly if you are unwell, have pain in your tummy or your vomiting only starts after 10 weeks of pregnancy. Other causes may include inflammation of the stomach (gastritis), a kidney infection, appendicitis or gastroenteritis.
Pregnancy Sickness is a fairly normal part of pregnancy, it affects up to 80% of pregnant women. Although it is generally considered pretty unpleasant it should not interfere with your ability to function normally and you can usually eat and drink normally.
(HG) is a severe complication of pregnancy and NOT a normal part of it
This is a much rarer condition and affects 1-3% of pregnant women. A woman who has HG will find normal functioning very difficult and struggle to maintain adequate food and fluid intake. Women can experience vomiting in excess of 30 times per day, dry retching and feel severely nauseous constantly. The condition is characterised by dehydration and weight loss of more than 5% of pre-pregnancy weight (weight loss can be up to or in excess of 20% of pre-pregnancy weight.
Other symptoms women with HG may experience include extremely heightened sense of smell, extreme fatigue, headaches, depression and isolation. HG can lead to more severe complications including oesophageal tears, muscle wasting and risk of DVT from bed rest, serious vitamin deficiency from excessive vomiting and complications from extreme dehydration. If you have symptoms of HG contact your GP who may prescribe medication or refer you to an Early Pregnancy Unit.
After being seen by an Obstetrician, a treatment plan will be made with you. This may include:
- Outpatient management
- Admission to hospital for a short day on our antenatal ward
- Day stay admission onto the Day Assessment Unit or Early Pregnancy Unit
When mild, pregnancy sickness, can be improved with a range of self-help techniques such as eating little and often, resting, avoiding triggers such as odours and caffeinated drinks and possibly with remedies such as ginger (as a 250mg capsule 4 times a day, not as a ginger biscuit!).
Pregnancy Sickness Support
RCOG: Pregnancy Sickness
The Management of NVP and HG
Constipation
You may become constipated very early on in your pregnancy due to the hormonal changes in your body.
Although uncomfortable, it is generally not harmful to women and birthing people or baby.
There are a few things you can do to help prevent constipation. These include:
- eating foods that are high in fibre, such as wholemeal breads and cereals, fruit and vegetables, and pulses, such as beans and lentils - see the 'Healthy Diet' section for further information
- exercising regularly to keep your muscles toned - see the 'Exercise in Pregnancy' section for further information
- drinking plenty of water
- choosing an iron supplement carefully. Some iron supplements may make you constipated. Discuss alternatives with your GP.
NHS - Conditions: Constipation
Treating constipation during pregnancy
Pelvic Girdle Pain
In pregnancy the hormone Relaxin is released to soften the joints in preparation for birth. For some women and pregnant people this causes ligaments to stretch and can cause pain in the pubic area, groin, legs, back and hips. If your daily activities are affected discuss with your midwife who may refer you to physiotherapy.
If you are pregnant and want to know what might be causing the pain in your pelvic girdle joints and what you can do about it, click here: Pelvic girdle pain information