Vaginal bleeding in early pregnancy (less than 16 weeks) is common. It is not always a sign of a problem and may settle on its own. We understand this is an anxious time and hope that the information on this page will help to reassure you.

Referral to the Early Pregnancy Assessment Unit (EPAU)

Most women who experience bleeding or pain do not need to stay in hospital but it is important that they see a specialist to rule out some of the more worrying causes. For this reason, you may be referred to the EPAU.

An appointment with the EPAU team will enable us to rule out miscarriage or ectopic pregnancy (where the pregnancy grows outside of the womb, usually in the fallopian tubes). You will be contacted by the EPAU team, usually within 24 hours, to arrange an appointment.

What happens at EPAU?

You will be seen by a member of the team (this may be a doctor or nurse) who will assess you and arrange for any necessary tests. This may be blood samples for testing and an ultrasound scan. Once the results of these tests are received you will be seen again by the doctor or nurse to discuss.

The staff at EPAU will help and advice you accordingly re your test results and guide you through what will happen next. It may not always be possible to find a cause for your symptoms at your first appointment so follow up appointments may be arranged.

When you attend EPAU

It is helpful if you can:

  • bring an early morning urine sample.
  • drink a pint or so of water before you come to the clinic so your bladder is relatively full (this helps with the ultrasound scan).
  • bring your pregnancy notes if you have them.

Contact information

If you feel unwell, experience further heavy vaginal bleeding or severe abdominal pain, please seek advice from the Helpline below or call NHS 111.

EPAU Helpline

Gloucestershire Royal Hospital

Tel: 0300 422 5549

Available 24 hours

NHS 111

Tel: 111

Further information

NHS Choices


Association of Early Pregnancy Units (AEPU)


Miscarriage Association


Ectopic Pregnancy Trust


Printable version of this page

Vaginal bleeding and pain in early pregnancy GHPI1203_01_24 Department: Emergency Medicine Review due: January 2027 PDF, 267.5 KB, 3 pages
Reference number GHPI1203_01_24
Department Emergency Medicine
Review due January 2027