Below you can find guidance and information tailored to different symptoms including: what to expect, when to seek urgent care, and how to access support. Our aim is to provide reassurance, practical advice, and links to trusted resources to support you through this stage of pregnancy.

Bleeding and/or pain is common in early pregnancy and does not always mean that there is a problem.

We understand that experiencing bleeding and/or pain in early pregnancy can be distressing and emotional. While light bleeding and mild cramping are common in the first 12 weeks and often do not indicate a serious issue, they can sometimes be a sign of miscarriage or complications such as an ectopic pregnancy.

If you are experiencing these symptoms, a healthcare professional needs to assess you and may refer you to the Early Pregnancy Assessment Clinic (EPAC) if needed.

If You Are Less Than 7 Weeks Pregnant

  • Referrals to the Early Pregnancy Assessment Clinic (EPAC) are not routinely made before 7 weeks.
  • Light bleeding and mild cramping can be normal, and it is often too early for an ultrasound scan to provide clear answers.
  • You will be advised to monitor your symptoms and repeat a pregnancy test in one week.
  • If your pregnancy test is still positive and your symptoms have settled, continue with community midwife care.
  • If your pregnancy test is negative, this means a miscarriage has occurred. Please see the support links below for guidance.
  • If you need further advice, contact your GP or NHS 111.

If You Are 7–12 Weeks Pregnant

  • A referral to the Early Pregnancy Assessment Clinic (EPAC) may be made.
  • A doctor or specialist nurse will contact you within 72 hours for a telephone triage to assess your symptoms.
  • You may be given advice over the phone or be asked to attend a face-to-face consultation.

If You Are Over 12 Weeks Pregnant

  • If you are more than 12 weeks pregnant or experiencing severe pain, you will be assessed by the on-call gynaecology team in the hospital.

When to Seek Urgent Medical Attention

  • If you have severe abdominal pain, heavy bleeding, dizziness, or feel unwell, seek urgent medical attention immediately by calling 999 or attending your nearest A&E.

Next Steps

  • If you are experiencing early pregnancy complications, contact your GP or community midwife, who will assess you and refer you to EPAC if necessary.
  • Support and further information are available through the resources below.

Further information

Gynaecology : Bleeding and/or pain in early pregnancy

The Ectopic Pregnancy Trust: Ectopic Pregnancy Signs And Symptoms

The Royal College of Obstetricians and Gynaecologists: Bleeding and/or pain in early pregnancy

Cumbria Health:  Formerly known as CHoC,​​​​​​ providing out of hours GP primary health care services in and out of hours.

NHS 111:  Help when you need medical help or advice fast – but it's not a life-threatening emergency

The Early Pregnancy Assessment Clinic (EPAC) at NCIC provides specialist care for people experiencing complications in early pregnancy. Clinics are held on weekdays at both West Cumberland Hospital (WCH) and Cumberland Infirmary (CIC) and are staffed by doctors and specialist nurses.

Your referral and appointment

If you are referred to EPAC, we will contact you within 72 hours to arrange an appointment. Please wait for this time to pass before calling the clinic. If, for any reason, your referral is not accepted, we will notify your referring healthcare professional, who will inform you of the next steps.

Attending your appointment

  • You can bring one adult companion for support.
  • Unfortunately, children are not allowed in the clinic.
  • A nurse or healthcare assistant will be present as a chaperone for support.
  • As our hospitals support doctors and nurses in training, there may be students observing in the clinic. It is your right to decline the presence of students at your appointment.

What happens during your appointment

  • A doctor or specialist nurse will ask about your current pregnancy, previous pregnancies, symptoms, and medical history.
  • If appropriate, we may perform an ultrasound scan. This could be:
    • An abdominal scan (on your tummy).
    • A vaginal scan, which can provide clearer images in early pregnancy. If this is needed, we will ask you to empty your bladder first.

Some scans provide immediate answers, and we will discuss your results and any next steps during your appointment. However, early pregnancy scans are not always conclusive. You may need further scans or blood tests to monitor pregnancy hormone levels before we can be certain about what is happening.

We will explain everything clearly throughout your appointment, and if you need follow-up care, we will give you a clinic contact number for any questions or concerns.

We understand that this may be an anxious time for you. Our team is here to provide compassionate care and support throughout your visit.

Contact the service

Cumberland Infirmary

Women's Outpatient Department - Mon-Fri   08:00-18:00 - 01228 814264

West Cumberland Hospital

Women’s Outpatient Department – Mon –Fri 08.00 – 17.00 - 01946 523211

Ward 1 after 5pm 01946 523257

Further support

Royal College of Obstetricians and Gynaecologists: Bleeding and/or pain in early pregnancy

Nausea and vomiting are common in pregnancy, especially in the first 12 weeks. While often mild, for some people, these symptoms can be severe and impact daily life. If you are struggling, you are not alone, help and treatment options are available.

Why does pregnancy sickness happen?

Nausea and vomiting are thought to be caused by hormonal changes in early pregnancy. Symptoms usually improve by the second trimester (around 12–16 weeks), but some people experience them for longer.

When should I seek medical advice?

Most pregnancy sickness is manageable, but in some cases, it can lead to dehydration or weight loss. You should contact a healthcare professional if:

  • You are unable to keep fluids down for more than 24 hours.
  • You have dark urine, dizziness, or signs of dehydration.
  • You are losing weight because of sickness.
  • Your symptoms are making it difficult to cope with daily life.

Severe nausea and vomiting in pregnancy (hyperemesis gravidarum) may require medication or IV fluids to prevent dehydration. Treatments are available—speak to your GP or midwife for advice.

What can help?

There are different ways to manage pregnancy sickness, including:

  • Eating small, frequent meals and avoiding triggers that worsen nausea.
  • Drinking fluids in small sips to stay hydrated.
  • Resting when needed, as tiredness can make symptoms worse.
  • Considering medication, if recommended by a doctor.

For more advice and support, see the links below.

NHS Website: Vomiting and morning sickness

Pregnancy Sickness Support Charity Pregnancy Sickness Support

Royal Collage of Obstetrics & Gynaecology: Pregnancy sickness (nausea and vomiting of pregnancy and hyperemesis gravidarum)

pregnancy loss ribbonThe loss of a baby at all stages of pregnancy can be extremely upsetting and we realise that this can be a difficult time for you and your family.

Below are links to local and national organisations that provide guidance, emotional support, and practical help for those affected by pregnancy loss.

If you have been affected - we are so sorry for your loss.

National Support

Local Support

Further Support and Counselling

If you would like to speak to someone, support is available. You may be able to access counselling or emotional support through your GP, local mental health services, midwife, nurse, or local bereavement services. If you are struggling, please know that help is available, and you are not alone.