Bleeding or pain in early pregnancy: what to do and when to call

You go to the toilet and see a spot of blood. Your heart races, your hands shake and a hundred thoughts arrive at once. If this is happening to you right now, take a breath. This article will help you know what to do next. If you have heavy bleeding, severe pain, or feel faint, stop reading and get urgent medical help first.

Some bleeding and cramping can happen in healthy pregnancies

Light spotting in early pregnancy is fairly common, and many women who have it go on to have healthy babies. Possible causes include the pregnancy settling into the womb lining, changes in the cervix that make it bleed more easily (for example after sex or an internal examination), or an infection. Mild, period-like twinges can also happen as your womb grows and stretches.

However, bleeding or pain can also be a sign of miscarriage or of an ectopic pregnancy, where the pregnancy grows outside the womb, usually in a fallopian tube. An ectopic pregnancy can be dangerous and needs urgent treatment. That is why the safest rule is simple: always tell a health professional about any bleeding in pregnancy.

Call your midwife, doctor or early pregnancy unit if you have

• any vaginal bleeding or spotting, even if it is light and stops
• cramping or tummy pain that does not settle
• brown or pink discharge that is new to you
• pain or burning when passing urine, or a fever

Your clinic may ask you to come in for an examination, blood tests or a scan. Write down when the bleeding started, roughly how much there is, its colour and whether you have pain, so you can explain clearly.

Get emergency help straight away if you have

• heavy bleeding, for example soaking a pad in an hour or passing large clots
• severe pain in your tummy, especially if it is on one side
• pain at the tip of your shoulder
• feeling dizzy, faint or very unwell, or collapsing
• pain when you open your bowels or pass urine together with any of the above
• a high temperature with bleeding or pain

In the UK call 999 or go to A&E. Elsewhere, go to the nearest hospital emergency department or call your local emergency number. Do not drive yourself if you feel faint; ask someone to take you.

While you wait

• Use pads rather than tampons so the bleeding can be checked.
• Rest if you can, and drink some water.
• Ask someone to be with you or stay on the phone with you.
• Do not take any medicine for pain unless a health professional has said it is safe in pregnancy.
• Keep a note of times and symptoms.

If the news is hard

Sometimes bleeding is the start of a miscarriage. If that is your story, please hear this clearly: early miscarriage is almost never caused by anything the mother did. It is not caused by working, lifting the shopping, having sex, a small argument or a cup of tea. You did not fail, and God has not turned away from you. Your grief is real, your baby was real, and you deserve gentle care. Ask your clinic about follow-up support, and let your partner, a friend or your church family come close.

If the bleeding settles and all is well, it is still fine to feel shaken. Fear leaves a mark. Tell your midwife if you continue to feel anxious; reassurance is part of good antenatal care.

A refuge in the waiting room

Hospital waiting rooms can be some of the loneliest places on earth. Even there, God is not far away.

“God is our refuge and strength, a very present help in trouble.” (Psalm 46:1)

Very present means close by, right now, in this moment. You do not need beautiful words. You can simply breathe and pray, Lord, be near. He hears that prayer as clearly as any long one.

Save your clinic's number and your local emergency number in your phone today, and share them with someone close to you, so that if you ever need them you will not have to search.

A prayer for a frightening moment

Lord, I am scared and I do not know what is happening in my body. Please be my refuge right now. Guide the doctors and nurses, hold my baby and hold me, and give me Your peace whatever the next hour brings. Amen.