Bleeding after sex is scary for most moms-to-be. But it’s important to know that most bleeding in early pregnancy is normal.
Some light spotting after sex is caused by the fertilized egg attaching to the uterus wall, which leads to implantation bleeding. It is not a sign of anything wrong or serious.
Causes
During pregnancy, your body goes through significant hormonal changes, especially in the cervix. That can make the area more sensitive. The light bleeding after sex is often just a normal response to that, especially in the first trimester.
Sometimes, the spotting is a sign of implantation, which occurs when a fertilised egg attaches to the lining of your uterus. You might also have implantation bleeding in the first trimester, which can happen either before or after your missed period.
Bleeding after sex can also occur from the impact of sexual intercourse, especially if your partner has a harder cervix or a larger penis. It can also be from the use of lubricants. Bleeding may also be caused by vaginal infections such as yeast infections, which are very common in pregnant women.
A rare but serious cause of bleeding after sex is placenta previa or placental abruption. These conditions lead to severe or prolonged bleeding and require hospitalisation and treatment with medicines. Your doctor might also recommend pelvic rest and bed rest, or a blood transfusion. In some cases, the doctor might need to perform a procedure called dilation and curettage (D and C), in which he or she opens the cervix to remove any miscarried tissue. This is usually done in the second trimester but may be needed earlier.
Symptoms
Bleeding during pregnancy can be scary, especially if you’re worried about a miscarriage. However, light bleeding occurs in up to 25 percent of pregnancies in the first trimester. This can be implantation bleeding, when the fertilized egg attaches to the uterine lining. It can also result from having sex, as the cervix softens during pregnancy and might be bruised by penetration. It’s important to let your doctor know about any vaginal bleeding you have, no matter the cause.
It’s also possible that your bleeding is caused by a sexually transmitted infection, such as chlamydia or gonorrhoea. Your GP can give you a swab to test for this and provide treatment, if needed.
If you’re having trouble with sex because of the spotting, try switching up your sex position. Spooning or rear-entry can help avoid any irritation to the cervix.
Heavy or prolonged bleeding can signal a problem with the pregnancy, such as ectopic pregnancy or placental abruption. This is a serious condition that requires medical attention. Your practitioner will recommend pelvic rest, and may prescribe medications, such as antibiotics or a blood transfusion. If this isn’t an option, a cesarean delivery may be necessary. Fortunately, many women at risk for a miscarriage can go on to have healthy pregnancies with proper guidance from their practitioners.
Treatment
Bleeding after sex during pregnancy can be very alarming, but there are several treatment options. Your doctor will likely want to see you right away if the bleeding is heavy, says Dr. Rainford. Depending on the cause of your bleeding, the doctor may recommend pelvic rest (avoidance of anything in your vagina until further notice) or antibiotics if infection is the issue. If the bleeding is caused by placenta previa or placenta abruption, the doctor may also prescribe medication to help with the condition or a C-section if the situation is severe.
If you have a bleeding disorder, your doctor will prescribe blood-thinning medications to treat the problem and prevent complications in future pregnancies. Women with bleeding disorders also need to get treatment with Rho(D) immune globulin before getting pregnant.
Light spotting is normal, especially in early pregnancy. However, if the bleeding is heavier than your period or accompanied by back and pelvic pain, contact your practitioner immediately. If the bleeding is accompanied by other concerning symptoms, such as a low fever or if your water breaks, you should seek emergency care as these are more serious issues. Having penetrative sex, even without a diagnosis from your practitioner, could lead to miscarriage or complications with the pregnancy. Be sure to wear a pad and save any clots for the doctor to examine.
Prevention
While sex and pregnancy are natural, it’s always good to check in with your doctor if you experience heavy bleeding after sex. This could indicate a serious condition such as placenta previa or early labor, which can be dangerous to the mother and baby.
Your doctor will take a full history and do a pelvic exam. They may also order an ultrasound to look at your cervix and check the viability of your pregnancy. They will also want to know whether the bleeding is light spotting or heavy. They will need to know the duration of the bleeding and whether it accompanied by pain, cramping or a fever.
If the spotting is very heavy, it may be an indicator of an ectopic pregnancy. This is where the fertilised egg implants outside the womb – for example in the fallopian tube – and is very dangerous. If you suspect you have this condition, call 111. They will advise you on the next steps.
The best prevention of bleeding after sex during pregnancy is to abstain from penetrative sex until you’re at least 12 weeks pregnant. This will reduce your risk of complications such as damage to the uterus wall or placenta. If you have a low-lying placenta or incompetent cervix, your doctor may advise you not to have penetrative sex at all (7).
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