Vaginal bleeding is common in the first 20 weeks of pregnancy. It is often nothing to worry about.

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Bleeding has many common causes, such as:

  • Bleeding that happens after conception as the fertilized egg attaches to the wall of the womb
  • Blood between the membrane that surrounds the fertilized egg and the wall of the womb
  • Miscarriage
  • A fertilized egg that attaches to the wall of the womb but doesn't grow into an embryo
  • Ectopic pregnancy—a fertilized egg that attaches and grows outside the womb
  • Molar pregnancy, also called gestational trophoblastic disease (GTD)—the growth of abnormal tissue, instead of an embryo, inside the womb
  • Threatened miscarriage
  • Cervical infection
  • Vulvovaginitis
  • Urinary tract infection
  • Trauma
  • Cervical cancer or polyps

Risk Factors

The factors that increase the risk of bleeding depend on what is causing it to happen.


The amount of blood and the way the blood looks will depend on the cause.


You will be asked about your symptoms and health history. A physical exam will be done. A pelvic exam may also be done.

Blood tests may be done to check hormone levels.

The belly and vagina may need to be viewed. This can be done with an ultrasound.


Treatment depends on the problem that is causing the bleeding. Bed rest, monitoring, and medicine may be needed. Some women may need surgery.


Some causes of bleeding cannot be prevented. Getting early and regular prenatal care can help find and treat some problems before they happen.

Avoiding smoking, drugs, and alcohol can also help lower the chances of bleeding.


The American Congress of Obstetricians and Gynecologists

American Pregnancy Association


The Society of Obstetricians and Gynaecologists of Canada

Women's Health Matters


Bleeding during pregnancy. American Pregnancy Association website. Available at: Updated August 2015. Accessed November 12, 2019.

Breeze C. Early pregnancy bleeding. Aust Fam Physician. 2016 May;45(5):283-286.

Early pregnancy bleeding. EBSCO DynaMed website. Available at: Updated May 17, 2019. Accessed November 12, 2019.

Pregnancy complications. Women's Health—US Department of Health and Human Services website. Available at: Updated April 19, 2019. Accessed November 12, 2019.

Sommers MS. Ectopic pregnancy. Diseases & Disorders: A Nursing Therapeutics Manual. 5th ed. F.A. Davis Company; 2015 (book chapter). EBSCO Nursing Reference Center Plus. Available at: Accessed November 12, 2019.

Last reviewed September 2019 by EBSCO Medical Review BoardElliot M. Levine, MD, FACOG  Last Updated: 1/22/2021