Bleeding after sex during pregnancy may be a normal part of your hormonal changes. However, light bleeding can also signal a serious problem.
Heavier, bright red blood indicates that the placenta has covered the cervix, a condition called placenta previa. This generally happens in the second trimester and needs medical attention.
Spotting
During early pregnancy, hormonal changes can make your cervix drier and cause the blood vessels to rupture more easily. This can lead to light bleeding after sex, which looks pink, very light red or brown and may not cause pain. Any penetration, from a pap smear to sexual intercourse, can cause this type of mild bleeding. It’s also normal for the placenta to cover part of your cervix as it develops during pregnancy, which can cause heavier, bright red bleeding. It’s not a sign of miscarriage, but it should be reported to your practitioner for evaluation.
Regular sex is usually safe for most pregnant women, especially in the first trimester, when it can be a healthy way to bond with your partner and stay connected to your partner. However, if the bleeding is heavy or accompanied by cramping, back and pelvic pressure, abdominal pain, fever or contractions, it could be a sign of a more serious problem. Talk to your practitioner as soon as possible.
Light Flow
In some cases, especially in early pregnancy, you may get some light bleeding after sex. This is typically called spotting and usually occurs around the time your period would be due. This type of bleeding is pinkish, reddish or brownish in colour and can show up on toilet paper when you wipe or in your underwear or panty liner. It’s often not painful and does not last very long. This is a normal part of pregnancy and does not indicate a problem with the fetus.
This is caused by hormones and physical changes in the uterus and vagina. The levels of progesterone rise throughout pregnancy and can cause blood vessels to enlarge and become more fragile. Any penetration of the cervix – including by sex – can disturb or rupture some of these vessels and cause spotting. If you are unsure, check with your practitioner.
Heavy Flow
The progesterone hormones in pregnancy cause your cervix to expand and grow new blood vessels. Sometimes, these blood vessels get disturbed or irritated by sexual activity and may bleed. This is normal, and it doesn’t mean you have a miscarriage or other serious problem.
If your bleeding is heavy — enough to fill a pad end to end — it’s not normal and you should call your practitioner right away. It’s also important to keep track of how quickly your pad gets soaked, and save any tissue or clots you pass so that the doctor can examine them.
The most serious cause of bleeding after sex in pregnancy is called placenta previa, in which the placenta covers part or all of your cervix. It’s very rare for sex to cause this condition, but if it happens, the bleeding is likely catastrophic and life-threatening.
Pain
When you have sex during pregnancy, your cervix becomes a bit more sensitive and irritable thanks to the heightened levels of progesterone in your body. This makes blood vessels larger and friable (easily ruptured), which can lead to pain during intercourse if your penis or partner’s finger is in contact with your cervix. Using different sex positions, such as spooning or rear-entry, may help to alleviate pain.
You can also experience pain from sex if you have cervical polyps, which are benign growths on your cervix that happen due to high estrogen levels. They are usually painless, but if you are experiencing pressure on the cervix from sexual activity, they could cause bleeding.
Heavier bleeding during the first trimester after sex is not necessarily a sign of anything serious, but it is always best to call your practitioner so they can take a closer look at your symptoms and reassure you. This is because an ectopic pregnancy (when the fertilized egg implants outside the uterus, most often in the fallopian tube) is dangerous for both mother and baby.
Call Your Practitioner
Heavier bleeding and pain after sex can be signs of ectopic pregnancy (the fertilized egg implants outside the uterus, usually in a fallopian tube) or placental abruption. These can be more serious and need to be dealt with quickly and require medical attention (5).
Light spotting after sex is normal as your cervix thins and becomes more sensitive to bumping from sex or penetration. The spotting can also be a sign of early labor as the mucus plug gets looser and dislodges (6).
Implantation bleeding can occur very early in the pregnancy, as the embryo burrows into the lining of your uterus. The spotting may be pinkish, reddish or brownish and can be mistaken for your period. It’s easy to confuse with spotting after sex, but this is different and needs to be discussed with your practitioner. He/she will advise you on how to proceed. Heavier, bright red bleeding may be a sign of miscarriage in the first trimester and should be evaluated by your practitioner as soon as possible. (Sex doesn’t cause miscarriage, but it can make it worse (7).