Bleeding in pregnancy

Bleeding in pregnancy can be common and although it can be frightening for women, it doesn’t always mean that there is a problem.

  • If you are under 20 weeks pregnant and experiencing vaginal bleeding please contact your GP (in working hours) or call NHS 111 out of hours. Click here for more information.
  • There are many different causes of bleeding in later pregnancy and these need to be investigated by your maternity hospital to monitor your baby to rule out any problems.
Maternity Triage contact numbers:

Croydon Hospital - 0208 401 3853

Epsom & St. Helier Hospital - 0300 123 5473 (also applies to Surrey Hospitals)

Kingston Hospital - 0208 934 2802

St. George's Hospital - 0208 725 2777

 

When should you get help?

Call an ambulance if you have severe abdominal pain and you are losing a lot of blood (e.g. an ongoing flow of blood or blood clots)

You may also experience: 

  • Rapid heart rate
  • Quick, shallow breathing
  • Feeling increasingly weak and tired
  • Cool, clammy skin
  • Confusion or wooziness

You need urgent help.

Phone 999

Call your maternity unit immediately if you are bleeding (e.g. on wiping or small amounts on a pad) and have any of the following:

  • Abdominal pain
  • Reduced or no baby movements
  • If you have been told that your placenta is low
  • Rhesus negative blood group, or you don’t know your blood group.

Call maternity unit immediately

Self care at home if you have no red or amber signs and you have:

  • Normal baby movements
  • Spotting on wiping with no other symptoms
  • Small amount of spotting following sexual intercourse
  • Blood stained mucus is called a “show” and is a sign your body is preparing for the birth, (although not a sign it will happen imminently).

Please monitor your vaginal loss by wearing a maternity sanitary pad.

Self care

Do not hesitate to contact your maternity unit if you still have any concerns

Causes of bleeding in later pregnancy

Cervical changes

These can lead to bleeding, particularly after sex.

Vaginal infections

Your midwife or doctor can discuss tests and treatment with you.

A "show"

This is when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is getting ready for labour to start. It may happen a few days before contractions start or during labour itself.

Placental abruption

This is a serious condition in which the placenta starts to come away from the womb wall. Placental abruption usually causes constant stomach pain, and this may occur even if there is no bleeding.

Low-lying placenta (placenta praevia)

This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and can put you and your baby at risk.

You may be advised to go into hospital for emergency treatment, and a caesarean will usually be recommended.

Vasa praevia

This is a rare condition where the baby's blood vessels run through the membranes covering the cervix.

When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can potentially lose a life-threatening amount of blood.

Your local maternity unit is staffed 24 hours a day with obstetrician s and midwives to help care for you, your baby and your pregnancy related health concerns. For some AMBER concerns it may be possible to be seen in a midwifery led unit if it is more convenient for you. For health concerns that are not related to your pregnancy you are advised to see your GP, call NHS 111 out of hours, or attend A&E if it is an emergency.

To find the contact numbers for your local maternity unit, please click here.

  • Labour line (maternity advice line) - Many maternity units provide women with a central advice line often called “labour line”. You are advised to call this number if you think you might be in labour. The phone is answered by a midwife 24hours a day. They will ask you questions, assess you and give advice. When the time is right they will arrange for you to attend your preferred place of birth, or arrange a midwife to come to you if you are planning a homebirth.
  • Community Midwife- Your community midwife provides you with all routine maternity care from your first “booking in“ appointment in early pregnancy to discharging you to the care of the health visitors when your baby is 2 weeks old. She will give you information on keeping you and your baby healthy during pregnancy and refer you to specialists if required.

Whilst you may have individual contact details for your community midwife, if you are concerned about your pregnancy we advise you call the maternity unit on the numbers provided because staff are available 24 hours a day. Please do not leave urgent voicemails or text on a community midwife’s phone.

GPs assess, treat and manage a whole range of health problems. They also provide health education, give vaccinations and can arrange referral to a hospital specialist should you need it. Whilst pregnant, you will have regular appointments with a midwife but it is still important to continue with any ongoing care from your GP.

NHS 111 can ask you questions to assess your symptoms, give you advice or can put you in touch with a GP out of usual working hours.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life threatening emergencies, such as suspected heart attack or breathing difficulties. If you are not sure it’s an emergency, call 111 for advice.