Bleeding and/or pain in early pregnancy - up to 12 weeks gestation
We understand experiencing bleeding and/or pain in early pregnancy can be an extremely stressful and emotional time. Please be aware it is not unusual, to have light bleeding and/or mild cramping in the first 12 weeks of pregnancy and more often than not, the pregnancy is ongoing. However, it can be an indication of miscarriage or other complications such as an ectopic pregnancy.
After being triaged by a healthcare professional, you may be referred to the Early Pregnancy Assessment Clinic (EPAC). The EPAC provides assessment of women experiencing early pregnancy complications and is based in Women’s Outpatients at the Cumberland Infirmary and West Cumberland Hospital.
What to expect?
If you are less than 7 weeks pregnant referrals to the EPAC are not routinely made. This is because, as mentioned, light bleeding and mild cramping is common in early pregnancy, and it is often too early to perform an ultrasound scan. You will be asked to monitor the bleeding and repeat a pregnancy test in a week. If it remains positive and your symptoms settle you should continue with your community midwife care. If your pregnancy test is negative this means the pregnancy has miscarried, please see the list of useful websites over the page. If you require any further advice, please contact your GP or NHS 111.
If you are 7-12 weeks pregnant, a referral will be made to the EPAC. A Doctor or specialist nurse will contact you within 72 hours of referral and undertake a telephone triage to assess your symptoms. You may be given advice over the phone or you may be asked to attend for a face-to-face consultation.
If you are above 12 weeks pregnant or have severe pain you will be assessed by the on-call gynaecology team in the hospital.
Preparing for an appointment
If you are asked to attend a clinic appointment please ensure you arrive with a relatively full bladder. You may bring an adult with you, but no children. You will be seen by a Doctor or specialist nurse for a consultation and an ultrasound scan may be performed, this can be an internal scan.
What to do whilst awaiting contact?
- Use sanitary towels, not tampons
- Take Paracetamol if required
- Abstain from intercourse
You should return to the emergency department if:
- Your bleeding becomes too heavy (i.e. saturating through sanitary towels every half hour for more than 2 hours)
- Your pain becomes unmanageable, despite pain relief
- You begin to feel unwell, faint or dizzy
Please do not contact the Women’s Outpatients department before 72 hours of referral has passed.
Useful telephone numbers & websites
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
Out of Hours – NHS 111
Tommy’s - www.tommys.org/pregnancy-information
Royal College of Obstetricians and Gynaecology:
Miscarriage Association - https://www.miscarriageassociation.org.uk/
Association of Early Pregnancy Units (AEPU) - http://www.aepu.org.uk
Pregnancy Sickness Support -https://www.pregnancysicknesssupport.org.uk/
The Ectopic Pregnancy Trust - https://www.ectopic.org.uk
Confidentiality
‘The Trust’s vision is to keep your information safe in our hands.’ We promise to use your information fairly and legally, and in-line with local and national policies. You have a right to understand how your information is used and you can request a copy of the information we hold about you at any time.
For further information on confidentiality contact the Information Governance Team:
Information.Governance@ncic.nhs.uk | 01228 603961
Feedback
We appreciate and encourage feedback, which helps us to improve our services. If you have any comments, compliments or concerns to make about your care, please contact the Patient, Advice & Liaison Service:
pals@ncic.nhs.uk | 01228 814008 or 01946 523818
If you would like to raise a complaint regarding your care, please contact the Complaints Department:
complaints@ncic.nhs.uk | 01228 936302