Bleeding and Passing a Clot During Pregnancy

Bleeding and passing a clot during pregnancy can have several meanings. It may come from a sensitive cervix, a small collection of blood near the pregnancy, pregnancy loss or, less commonly, a serious complication such as ectopic pregnancy or a placental problem. A clot alone cannot confirm the cause, and the amount or colour of blood does not reliably show whether the pregnancy is continuing normally.

If this is happening now, contact your maternal health nurse, midwife, GP or maternity service today for individual advice, even if the bleeding has stopped. Seek emergency help immediately for heavy bleeding, severe or one-sided pain, shoulder-tip pain, faintness, breathing difficulty, fever, or reduced baby movements later in pregnancy. While bleeding can be frightening, it does not always mean that a pregnancy is ending.

What might bleeding and a clot mean?

The likely cause depends on how many weeks pregnant you are, how much you are bleeding, whether you have pain and whether the blood came from the vagina. An examination, ultrasound and sometimes blood tests may be needed to find the cause.

Changes in the cervix

During pregnancy, the cervix has an increased blood supply and can bleed more easily. Light spotting may occur after sex, a cervical screening test or a vaginal examination. Infection, inflammation or a cervical polyp can also cause bleeding. This is often light, but collected blood may occasionally form a small clot.

Bleeding near the pregnancy

A subchorionic haematoma is a collection of blood between the pregnancy membranes and the wall of the uterus. It can cause spotting, heavier bleeding or clots, although it is sometimes found on ultrasound without any symptoms. Its significance varies according to its location and size, so your maternity team will advise whether follow-up is needed.

Early pregnancy loss

Bleeding with cramps, clots or tissue can be a sign of miscarriage, particularly in the first half of pregnancy. However, bleeding and cramping can also occur in an ongoing pregnancy. Symptoms alone cannot give a definite answer. Ultrasound and, in some circumstances, repeat pregnancy-hormone blood tests help clarify what is happening.

Ectopic pregnancy

An ectopic pregnancy develops outside the uterus, most often in a fallopian tube. It may cause vaginal bleeding with lower abdominal or pelvic pain, which can be on one side. Shoulder-tip pain, dizziness, weakness, fainting or collapse can indicate internal bleeding and require emergency care. An ectopic pregnancy cannot continue safely and needs prompt medical treatment.

Molar pregnancy

Rarely, abnormal pregnancy tissue can grow inside the uterus and cause bleeding. Other possible features include severe nausea or a uterus measuring differently from expected. Diagnosis is made using ultrasound and blood tests, followed by specialist care.

Placental causes later in pregnancy

Bleeding in the second half of pregnancy may come from the placenta. Placenta praevia, where the placenta lies low in the uterus, can cause painless bright-red bleeding. Placental abruption, where the placenta begins to separate from the uterine wall, may cause bleeding, constant abdominal or back pain, contractions, or a firm and tender uterus. Sometimes much of the blood remains inside the uterus, so visible bleeding may be limited despite a serious problem.

Later-pregnancy bleeding can also happen when the cervix begins to change before labour. A sticky, blood-streaked mucus discharge may be a “show,” but fresh bleeding, clots or bleeding before 37 weeks still require prompt maternity assessment. Visit our pregnancy hub for further guidance throughout pregnancy.

Is it definitely a blood clot?

A blood clot is usually dark red, maroon or jelly-like. Pregnancy tissue may look greyish, pale, sac-like or different from an ordinary clot, but appearance is not a reliable way to identify it. Mucus can also be mixed with blood.

Do not try to pull tissue from the vagina or cervix. If you pass something that may be tissue, your healthcare professional may ask you to bring it in a clean container or take a photograph, but only do this if you feel comfortable and follow local advice. Never delay urgent care to collect it.

What to do if you are bleeding

• Contact your care team: Tell your maternal health nurse, midwife, GP or maternity assessment service how many weeks pregnant you are and whether you have pain or other symptoms.
• Use a maternity or sanitary pad: This helps you observe the amount and colour. Avoid tampons or menstrual cups while you are bleeding.
• Note the pattern: Record when bleeding began, how often you change pads, the approximate size of clots and whether there is pain, dizziness, fever or fluid leakage.
• Follow advice about sex and activity: Strict bed rest has not been shown to stop a miscarriage. Your clinician may recommend avoiding sex or strenuous activity depending on the cause.
• Check your blood group plan: If you are rhesus D negative, ask whether anti-D immunoglobulin is recommended. Guidance depends on gestation, the bleeding and local protocols.
• Monitor movements later in pregnancy: If your baby is moving less than usual or the pattern changes, contact your maternity service immediately rather than waiting to see if movement returns.

If you feel able, ask someone you trust to stay with you or help with transport and childcare. Pregnancy bleeding can be emotionally difficult, whatever the outcome. You deserve clear information and compassionate support.

What assessment may involve

Your healthcare professional will ask about the bleeding, pain, last menstrual period, previous pregnancies and medical history. They may check your pulse, blood pressure, temperature and abdomen. Depending on the stage of pregnancy, assessment may include:

• An ultrasound through the abdomen or vagina
• Blood tests, including pregnancy hormone levels, blood count and blood group
• A speculum examination to look at the cervix and source of bleeding
• Monitoring of the baby's heartbeat and uterine activity later in pregnancy
• Tests for infection when symptoms suggest it

Very early in pregnancy, one scan may not provide a definite answer. A repeat scan or blood test may be arranged. This waiting period can be stressful; ask your team who to contact if symptoms change. You can also browse our pregnancy information while following the personalised advice of your clinician.

Can bleeding be prevented?

Often, pregnancy bleeding cannot be predicted or prevented. Everyday movement, gentle exercise, working, sex or lifting an older child do not usually cause miscarriage in an otherwise uncomplicated pregnancy. Do not blame yourself. If your healthcare professional identifies a specific cause or risk, they will explain whether treatment, medication or changes to activity are appropriate.

When to seek help

Contact emergency services or go to an emergency department now if you have any of the following:

• Heavy bleeding that is rapidly soaking pads, blood pouring out, or repeated large clots
• Severe, worsening or one-sided abdominal or pelvic pain
• Shoulder-tip pain, fainting, marked dizziness, confusion, weakness, pale or clammy skin
• Difficulty breathing, chest pain or a racing heartbeat with feeling unwell
• Severe abdominal tenderness, a rigid abdomen or constant pain later in pregnancy

Contact your midwife, maternity assessment service, maternal health nurse or GP urgently today for any bleeding during pregnancy, especially if it includes a clot. Seek prompt assessment for fever, chills, unpleasant-smelling discharge, fluid leaking from the vagina, regular contractions, bleeding after an abdominal injury, or pain when urinating.

After your baby has begun moving regularly, call your maternity service immediately if movements are reduced, weaker or have changed. Do not wait until the next day and do not rely on a home Doppler for reassurance. If you are unsure how serious the bleeding is, it is safer to seek advice. For rapidly worsening symptoms or if you cannot reach your maternity team, contact emergency services.