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It’s fairly common for women to bleed during their pregnancies, after sex or anytime, and those red or brown spots are rarely a sign that something is wrong. While it can be unsettling at best to see blood after sex, it’s doesn’t mean that intercourse hurt the baby or that you have to put a halt to sexual activity. Vaginal bleeding occurs in 15 percent to 25 percent of pregnancies, usually in the first trimester, but blood flow can appear on and off throughout your term.

As scary as it looks, even copious bleeding in expectant moms can be normal. One study found that half of women with bleeding profuse enough to send them to the emergency room went on to have healthy pregnancies. But because this symptom is so distressing, it’s always a good idea to check with your practitioner to find out what’s causing your post-sex blood flow, and to get the green light to continue with intercourse.

What Does It Mean If You Bleed After Sex When You’re Pregnant?

Chances are, bleeding after sex means your pregnancy is going along fairly normally. Light to medium vaginal bleeding can be a sign of implantation, especially during the first trimester, or it could be the result of natural changes to your cervix. More rarely, heavy bleeding can be a sign of miscarriage or an ectopic pregnancy. The bleeding itself is rarely anything to worry about, but you should check with your practitioner to identify the cause.

What Causes Bleeding After Sex During Pregnancy?

There are several things that might be behind bleeding after sex when you’re pregnant, including:

• Implantation. About a week after conception, the fertilized egg attaches to the lining of the uterus. This process, called implantation, can cause a little spotting or light flow.
• Changes to your cervix. During pregnancy, the cervix goes through a process called “remodeling” in preparation for birth. Remodeling causes it to change shape, open up, shed cells and become quite tender. You probably won’t feel it, but your body could be extra vulnerable to your partner’s thrusting, which can lead to bleeds.
• Ectopic pregnancy. Although it’s unlikely, bleeding after sex could be a sign of an ectopic pregnancy, where the fertilized egg attaches somewhere other than the uterus.
• Placenta previa. This condition generally happens in the the second or third trimester and is when the placenta covers part or all of the cervix. If sex is followed by bright red bleeding, it could point to placenta previa as the cause.
• Placental abruption. This occurs when there’s an early separation of the placenta from the uterus, which can cause heavy bleeding, with or without clots. If the separation is slight, there’s usually little danger to you or your baby. But if it’s more severe, you may need to be hospitalized — which is why it’s so important to see your doctor.
• Early labor. If you’re having regular contractions that intensify and become more frequent even when you change positions, back pressure, bleeding, and pelvic pressure well before your due date, these could be signs of preterm labor. If you suspect labor is starting prematurely, contact your practitioner immediately.
• Miscarriage. Sex does not cause miscarriage, but heavy bleeding — when you fill a pad every hour, or have lighter bleeding that lasts for days — sometimes indicates that a pregnancy is at risk of ending before 20 weeks. If you suspect you are having a miscarriage, call your practitioner immediately. Many women who start to miscarry can go on to have a healthy pregnancy with guidance from their doctor.  

What to Do About Bleeding After Sex

If you notice spotting or very light flow, don’t insert a tampon. Instead, wear a pad. If the bleeding is copious or doesn’t stop flowing, or is accompanied by moderate to severe cramping, fever, back and pelvic pressure, or contractions, call your practitioner right away to find out what’s causing it. 

Can You Prevent Bleeding After Sex?

While you may be able to prevent some bleeding after sex by avoiding intercourse, that won’t affect the underlying cause. More importantly, unless your doctor tells you that intercourse or orgasm is unsafe, keep it up. Regular sex is one the healthiest ways an expecting couple can reduce stress, stay connected and keep the romance alive while they’re waiting for baby to arrive.

When to Call the Doctor

Red or brown spotting or light flow mixed with mucus is normal, especially early on in your pregnancy. But bleeding after sex can be alarming, so don’t hesitate to check in with your practitioner any time you notice it, if only for reassurance that sexual activity isn’t harming your baby (it’s not).

If the bleeding is heavy, lasts for more than a few days, or is accompanied by cramping, pelvic pressure, back pressure, contractions or fever, check in with your practitioner as soon as possible. Some women experience copious bleeding throughout their pregnancies, after sex and at other times too, but it’s a good idea to rule out early labor or other medical issues. Studies confirm the benefits of sex during pregnancy, so try not to let a little spotting prevent you and your partner from being intimate.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.