Bleeding after sex during pregnancy is common, but not always a cause for concern. It’s most often a sign of implantation—when the fertilized egg attaches to your uterus. But heavier, bright red bleeding can be a sign of placenta previa (when the placenta covers part or all of your cervix) and needs medical attention right away.
Spotting
While spotting while pregnant can be alarming, it’s usually nothing to worry about if the spotting is light and doesn’t last long. However, it’s always good to check in with your practitioner for reassurance. If you’re concerned, you can wear a pad to help keep track of how much bleeding you’re getting, and call your practitioner if you start to fill a pad in less than an hour or have any other symptoms like back or pelvic pain or contractions.
It’s normal to have spotting while pregnant, and it can occur even before you miss your period. This spotting is called implantation bleeding and happens when the fertilized egg attaches to the uterine lining.
Bleeding may also happen in the first trimester due to hormonal changes that cause the cervix to change. The cervix is also more sensitive during pregnancy, and it can bruise or get irritated during sex, especially with deep penetration.
Heavy bleeding that fills a pad every hour or more and lasts for days is not normal and can indicate a miscarriage. Miscarriages are most common after 20 weeks, but they can occur earlier as well. Other risk factors for a miscarriage include placenta previa, which is when the placenta lies low in the uterus and covers all or part of your cervix, or placenta accreta, which is when the placenta grows into the wall of the uterus too deeply.
Light Bleeding
When you see pink, red, or brown blood on the sheets after sex and you’re not on your period, it can be alarming. But it may not be a big deal — especially if the bleeding is light, short-lived, and happens before or around the time your period would normally begin.
Spotting in early pregnancy is usually caused by implantation, which occurs when the fertilized egg plants itself in the wall of your uterus. The bleeding is lighter than a normal period and might last for several hours or up to a day. It’s also possible to get this kind of bleeding in the late stages of a pregnancy when the cervix is preparing for labor.
If you have a history of bleeding disorders, it’s worth discussing with your doctor before getting pregnant. Women with these conditions are more likely to have complications during and after a pregnancy, including heavy bleeding at the beginning (called early miscarriage).
Another cause of light spotting in pregnancy is cervical inflammation or cervicitis. This is usually harmless, but it can happen if you have a sexually transmitted disease like chlamydia or gonorrhea that you need to treat. Bleeding might also occur if you have cervical polyps, which are small, noncancerous growths on the opening of your cervix. In some cases, these might be irritated by sexual activity or a pelvic exam and bleed a little.
Heavy Bleeding
If you see blood on your sheets after sex and you’re not on your period, that’s considered bleeding. It’s usually a sign of an infection, but in some cases it could indicate damage to your cervix or other organs. Bleeding isn’t normal, especially if it lasts for more than two weeks.
Light spotting during pregnancy is common, especially in the first trimester. This can happen when the fertilized egg attaches to the lining of your uterus or when hormonal changes cause your uterus to shed a bit more than usual. Generally, it’s nothing to worry about if you have an appointment scheduled with your OB-GYN.
A yeast infection, STIs such as chlamydia and gonorrhea or cervical cancer may also cause light bleeding after sex. If you suspect one of these issues, talk to your doctor as soon as possible and schedule a pelvic exam or an ultrasound in their office.
Bleeding during pregnancy can also be a symptom of cervical cancer, though this is rare. In this case, you’ll need to have a pap test and possibly a colposcopy to check for abnormal cells in the lining of your cervix. If they find an issue, they’ll probably recommend bed rest or other treatments such as hormones to speed up your recovery and prevent miscarriage or ectopic pregnancy.
Other Symptoms
Seeing blood after sex during pregnancy can understandably make you worry, especially if the bleeding is heavy. However, most of the time it is not a sign of something serious and you and your baby are fine.
The main reason for any sex-related bleeding is due to hormonal changes. Higher levels of progesterone make blood vessels enlarge and more fragile. This means that any penetration (with a penis, finger, or toy) could cause a vessel on the cervix to rupture, causing light or spotting bleeding.
Bleeding after sex could also occur because of the fertilized egg attaching to the uterine lining. This is called implantation bleeding and happens in about a week after conception. It usually causes light spotting and is nothing to worry about.
Bleeding after sex in pregnancy is also sometimes caused by cervical polyps or a cervical ectopic pregnancy (an embryo that grows outside the uterus). This is more common with intrauterine sex and may happen after any type of penetration, including vaginal sex. Cervical ectopic pregnancies can be very dangerous and require medical attention. Bleeding during pregnancy is not always a sign of a problem but it’s important to talk to your doctor or midwife about it. This way they can check to see if it is normal and how far along you are.