Early pregnancy home management advice

Following your attendance at the Urgent and Emergency Care Centre, you have been assessed as suitable for home management of pain and/or bleeding in early pregnancy. Your assessment means that you are safe to go home and you should contact the Early Pregnancy Assessment Unit (EPAU) for advice or support if required on 01709 427072.

What are the common causes of bleeding and pain in early pregnancy?

Some common causes of bleeding and pain in early pregnancy are:

• Bleeding from the implantation site - as the pregnancy attaches itself into the endometrium (lining of the womb) it may cause some blood vessels of the uterus (womb) to bleed. This is also called a ‘threatened miscarriage’.
• Miscarriage - is a loss of pregnancy, which can cause vaginal bleeding and may include lower abdominal (tummy) pain or cramping.
• Ectopic pregnancy - a pregnancy outside of the uterus (womb), usually in a fallopian tube that carries the egg to the womb from the ovaries. Symptoms include vaginal bleeding, abdominal pain, rectal (back passage) pain and diarrhoea.
• A haematoma - this is a small area of bleeding, like a bruise, next to the pregnancy sac. A haematoma may be reabsorbed by the body or come away naturally as vaginal blood loss.
• Trauma to the cervix (neck of the womb) - during pregnancy, tissues become rich in blood supply and soften. Because of this, any slight trauma to the cervix can cause bleeding. (This may occur after sexual intercourse).
• Infection in the vagina - common infections like thrush or other infections may cause bleeding from the vagina in small amounts described as ‘spotting’.
• Constipation - this is a common cause of pain in early pregnancy. The bowel becomes lazy because of the effect of the pregnancy hormones, and you may find that you go to the toilet to open your bowels (have a poo) less frequently. This causes a build-up of poo in the bowel, which leads to abdominal pain.
• Urine infection - this is common in pregnancy and can cause pain and bleeding.

What should I do next?

It is normal to feel anxious during this time, but there are many reasons why pain and/or bleeding can occur in early pregnancy. If you feel that you need to rest, you can, but try to keep as active as you feel able to. There is not always a specific treatment to stop your bleeding and unfortunately, miscarriage cannot be prevented.

Taking pain relief such as Paracetamol for any back or abdominal pain you might have, is perfectly safe. It is important to wear sanitary pads only and not tampons if you are experiencing vaginal bleeding.

If you have had vaginal bleeding, please take a repeat pregnancy test 1 week after the bleeding stops. If the pregnancy test is negative, or if the test is positive and you are still experiencing symptoms please contact EPAU, who will be able to offer you further advice and support.

What should I do if my symptoms change or I need further advice?

If your pain gets worse and is not managed with pain relief such as paracetamol, or your bleeding increases, please contact EPAU (Monday to Friday, 8am - 4pm) or the Gynaecology Inpatient Ward if outside of these times.

If you develop any of the following:

• very heavy bleeding
• severe abdominal pain
• shoulder tip pain
• fainting or a fever

seek help immediately by phoning 999 or come back to the Urgent and Emergency Care Centre (A&E).

Contact details

EPAU can be contacted on 01709 427072 (Monday to Friday, 8am - 4pm)
Gynaecology can be contacted outside of these hours on 01709 424349 (any time)

Further information and support

Miscarriage Association and Tommy’s can provide further information and support.

Produced by EPAU, January 2022. Revision due January 2024. Version: 1.0 ©The Rotherham NHS Foundation Trust 2022. All rights reserved.