Version July 2025
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What can cause bleeding in late pregnancy? —
Vaginal bleeding during early pregnancy is common. Bleeding later in pregnancy, after 20 weeks, is less common.
Different things can cause bleeding in late pregnancy. They include:
●A problem with the placenta – The placenta is the organ that forms between you and your baby during pregnancy (figure 1). It brings the baby nutrients and oxygen from your body and carries away waste. Problems that can happen include:
•Placental abruption – This is when the placenta separates from the uterus before birth.
•Placenta previa – This is when the placenta covers the opening of the cervix.
●A tear in the uterus – This is called "uterine rupture." It is when the uterus tears where it was cut during past surgery. For example, this can happen if there is a scar from a previous cesarean birth (c-section).
●A problem in the vagina or cervix – This could be a cut, scrape, growth, wart, or infection.
●Cervical insufficiency – This is when the cervix starts to open too early in pregnancy, without other signs of labor. (Normally, the cervix should stay closed until labor starts.)
●Labor – Sometimes, bleeding means that labor is starting or will start soon. If this happens before 37 weeks of pregnancy, it is called "preterm" labor.
●A problem with the blood vessels in the umbilical cord – This is called "vasa previa." It is a rare but serious problem where these blood vessels go across the opening of the cervix.
Sometimes, the reason for bleeding is not obvious.
Should I see a doctor or nurse? —
Yes. If you are pregnant and have vaginal bleeding, call your doctor, nurse, or midwife right away. They will ask you questions and tell you if you should go to the hospital or doctor's office.
If you are bleeding and cannot reach your doctor, nurse, or midwife, go to the emergency department. If the bleeding is very heavy and soaking through your clothing, call for an ambulance (in the US and Canada, call 9-1-1).
Will I need tests? —
Yes. First, your doctor, nurse, or midwife will do an exam and ask questions. This includes things like when you started bleeding, how heavy it is, and whether you also have pain or any other symptoms. This can give clues about the cause of your bleeding.
The doctor, nurse, or midwife will also check the baby's heartbeat. They might also do an ultrasound. This lets them check your uterus, cervix, and placenta, as well as your baby's heartbeat. They might order blood tests, too.
How is bleeding in late pregnancy treated? —
It depends on the cause, how much you are bleeding, and how far along you are in your pregnancy. For example:
●If there is a problem with the placenta, you might need to stay in the hospital. There, the staff can monitor you and your baby closely.
●If your health or your baby's health is in danger, you might need to have a cesarean birth as soon as possible.
●If you have a cut, scrape, growth, wart, or infection, you might need treatment for this.
●If you have cervical insufficiency, your doctor might place a stitch to help keep the cervix closed. This is called a "cervical cerclage."
●If you are in preterm labor, you might get medicines to try to stop or slow down your labor. Depending on how many weeks pregnant you are, you might get other medicines, too.
●If you have "Rh-negative" blood, you will need a shot of "anti-D immune globulin" (sample brand name: RhoGAM). This prevents problems that can happen if your baby has "Rh-positive" blood.
●If you lost a lot of blood, you might need to get fluids by IV. In severe cases, you might need a blood transfusion.
Your doctor, nurse, or midwife will recommend treatment based on your situation, your health, and your baby's health.
Can bleeding in late pregnancy be prevented? —
Not always. But there are ways to lower your risk of some of the problems that can cause bleeding. For example, you can:
●Avoid smoking and drugs.
●Avoid activities and sports in which you could easily fall, fall hard, or be hit in the belly.
●Always wear your seat belt when driving or riding in a car.
●Follow your doctor's instructions about physical activity, including work, exercise, and sex.
Patient education: Placental abruption (The Basics)
Patient education: Placenta previa (The Basics)
Patient education: Cervical insufficiency (The Basics)
Patient education: Preterm labor (The Basics)
Patient education: Pregnancy in Rh-negative people (The Basics)
Patient education: Preventing injuries during pregnancy (The Basics)
Patient education: Activity during pregnancy (The Basics)
