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What causes bleeding during pregnancy?

Bleeding in pregnancy is relatively common - around 1 in 10 women experience some bleeding.

However if you have bleeding at any stage during your pregnancy, you should call your midwife or GP immediately. It is not always caused by something serious, but it is very important to make sure. Lie down and rest until you can see the doctor, and don 't take any medication while you are waiting.

You might get a little light bleeding called spotting, when the foetus plants itself into your womb wall. This is called implantation bleeding and often happens around the time that your first period after conception would have been due.

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In early pregnancy (up to around 3 months), bleeding is sometimes a sign of miscarriage or an ectopic pregnancy, when the foetus starts to grow inside your fallopian tubes instead of the womb.

In later pregnancy, bleeding can have many different causes. This is not a full list, but some of the more common causes include:

Cervical ectropion - this is where there are harmless changes in the cervix (neck of the womb). This is the commonest cause of bleeding during the latter stages of pregnancy.

A show - this is where a plug of mucus from the cervix falls away just before labour. It can look like a lump of blood, and if it happens before you are due to give birth, it might be a sign of early labour.

Placental abruption - this is a serious condition where the placenta starts to come away from the inside of the womb wall. If it happens close to your babys due date, your baby may be delivered early.

Placenta praevia - this is where the placenta lies low in the womb, partially or completely blocking the babys path to the cervix. The placenta usually moves gradually upwards during pregnancy, but if it is still low when the baby is due to be born, you might need to have a caesarean

Vaginal bleeding in the later stages of pregnancy can also be a sign of a miscarriage. However, a miscarriage is very uncommon after the third month of pregnancy.

To work out what is causing bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan, or blood tests to check your hormone levels. Your doctor will also ask you about other symptoms, such as cramp, pain, and dizziness, and what foods, medication and exercise you have been taking recently.

If your symptoms are not severe and your baby is not due for a while, you will be monitored and, in some cases, kept in hospital for observation. You might have to stay in overnight, or until the birth, depending on the cause of the bleeding and how far you are into your pregnancy. This will enable staff to keep an eye on you and your baby so that they can act quickly if there are any further problems.