Stomach pain and bleeding in early pregnancy

If you're pregnant, you're likely paying extra close attention to your body. If you feel a cramp, you may worry that it is a sign of a miscarriage, especially if it is early in your pregnancy.

While the first trimester is the most common time for miscarriages, there are other reasons for cramps. Whether cramping signals a miscarriage depends on when it occurs, severity, and whether you're experiencing other symptoms with it.

Cramping in Early Pregnancy

Having cramps in your lower abdominal area or lower back in early pregnancy (the first trimester) most likely signals one of three things:

• Ectopic pregnancy: Faintness and/or severe abdominal cramping may be a symptom of ectopic pregnancy. This occurs when the egg implants outside of the uterus, usually in a fallopian tube. While rare, ectopic pregnancies are not viable and can put your life in danger. If you suspect this issue, go to the emergency room right away.
• Miscarriage: When cramping is accompanied by spotting or vaginal bleeding, it can be a sign of miscarriage. Call your doctor for advice; they may suggest testing to determine whether you are having a miscarriage. A miscarriage can occur within the first 20 weeks of gestation, but the risk is higher in the first trimester.
• Normal pains: Cramping without bleeding is usually not a sign of miscarriage. Cramps or short-lived pains in your lower abdomen can happen early in normal pregnancy as your uterus adjusts to the implanted embryo, or even if you have a urinary tract infection. These pains are likely mild and brief. If you feel anything severe and/or prolonged, always call your doctor to be safe.

Symptoms of Miscarriage

Look out for these signs and symptoms of miscarriage in the first trimester.

• Bleeding that is brown or bright red
• Clots of tissue passing from the vagina
• Mild to severe back pain that's worse than normal menstrual cramps
• A sudden decrease in the signs of pregnancy, such as breast tenderness or morning sickness
• Very painful contractions every five to 20 minutes
• Weight loss
• White-pink mucus-like vaginal discharge

Contact your doctor if you notice any of these symptoms. Miscarriage is the most common cause of early bleeding in pregnancy.

However, it's important to note that early bleeding could actually be a threatened miscarriage. This is diagnosed when there's uterine bleeding but the cervix is closed and an ultrasound shows that the baby's heart is beating.

Fortunately, threatened miscarriages don't always result in pregnancy loss, even when there's a lot of blood on more than one occasion. If you experience spotting or bleeding that's concerning, your doctor may perform an ultrasound to check on the baby's status.

Cramping in Late Pregnancy

Cramping in the second or third trimester could be harmless or concerning—it depends on the situation.

• Preterm labor: Cramps occurring at regular intervals (try timing them) may indicate preterm labor. More than six cramps or contractions in 1 hour, a change in vaginal discharge such as bright red vaginal bleeding, a sudden gush of clear fluid, a low, dull backache, or intense pelvic pressure are all possible signs. For any of these symptoms, call your doctor immediately.
• Round ligament pain: You may experience shooting pains in the lower abdomen or around your hips due to a phenomenon called round ligament pain, which occurs as your body accommodates your growing uterus. These types of pains are normal and will pass, but you should discuss them with your doctor.

Signs of Preterm Labor

A Word From Verywell

A little bit of anxiety is totally normal in early pregnancy. After all, your life is about to change with the addition of this tiny bundle of joy. Your instinct is to protect your little one and make sure that he or she is as healthy and as safe as possible.

Talk to your doctor whenever you are concerned about any level of cramping during pregnancy. It can be a stressful time, and talking to your doctor about your symptoms can be very reassuring.

Bleeding, spotting, pain and cramping in early pregnancy? What it can mean and what to do

Bleeding, spotting, pain and cramping during early pregnancy are common and may not affect your pregnancy. However, it is important to rule out a non-viable pregnancy, an ectopic pregnancy, a miscarriage or any other condition that may affect you or your baby. These conditions occur in about 15% of pregnant patients.

The Urgent Access Early Pregnancy Scanning Service at Newcastle Ultrasound prioritises your appointment so that you can be seen by our expert team straight away. Our service goes beyond a scan. You leave with a report and treatment advice, as well as a referral for further testing or treatment, if necessary, on the same day as your scan. Bleeding, spotting, pain and cramping in early pregnancy can be distressing. We are here to help and hopefully reassure you that all is well.

Bleeding, spotting or cramping in the first trimester is common

Approximately 1 in 3 women experience minor pain, cramping, spotting or bleeding in their first trimester. In many cases these symptoms are not directly related to the pregnancy and only 1 in 6 will go on to have a miscarriage. Pain, cramping or bleeding in the second and third trimesters is more serious, however, and can be a sign that something is not right with you or your baby. If you are experiencing any cramping or bleeding outside of your first trimester seek medical advice immediately.

Cramping or bleeding in the first trimester can be due to:

• Flatulence or gas (as the uterus gets larger and places pressure on your bowel)
• Constipation
• Urinary tract infections
• Sexual intercourse
• Implantation bleeding
• Ectopic pregnancy
• Cervical changes due to pregnancy hormones
• Infection
• Miscarriage
• Molar pregnancy

Seek medical advice if you are experiencing any bleeding or spotting along with cramping during your first trimester

If you are experiencing cramping and bleeding together this could be a sign of an ectopic pregnancy or a miscarriage. You should seek medical advice immediately.

1. Make an appointment with your GP to discuss your symptoms as soon as you are able to
2. If you require further assessment by Newcastle Ultrasound, your GP may provide a referral to access our Urgent Access Early Pregnancy Scanning Service. You can download a referral form for your GP here. If you call us prior to 11:00am you will be seen on the same day
3. Do not use a tampon or have sex while you are experiencing any pain or bleeding

Call 000 or have someone drive you to your nearest emergency department if you are experiencing any of the following symptoms:

• Severe pain or cramping in the lower abdomen or shoulder pain
• Intense bleeding (much heavier than a period) with or without pain. Milder bleeding can wait
• Dizziness or fainting
• Fever of more than 38 °C and/or chills

Find the underlying reason for any spotting, bleeding or cramping you may have in early pregnancy. Contact your GP and request a referral to Newcastle Ultrasound

Call our patient liaison coordinator on (02) 4957 3899 to ask any further questions about our Urgent Access Early Pregnancy Scanning Service.

Is it normal to have abdominal pain and bleeding in early pregnancy?

How much bleeding and pain is normal in early pregnancy?

Does abdominal pain and bleeding mean miscarriage?

When should I worry about cramping and bleeding in early pregnancy?