Bleeding and cramps at 4 weeks pregnant

"That said, it’s understandable that you’re worried and it is always important to mention a bleed or cramping to your midwife or doctor, so that they can rule out any problems."

You should definitely contact your GP or your midwife if:

  • Any cramps are accompanied by tenderness low down in your belly
  • Any bleeding is heavy or contains pink or grey clots
  • The cramping pain is very sharp (particularly if it's on 1 side) or severe, and lasts for more than 24 hours
  • You have bright red bleeding and cramps at the same time
  • You also feel very dizzy, faint, feverish or nauseous

Why am I bleeding – and what should I do?

Most likely, you're bleeding as a result of your body adjusting to pregnancy: maybe your shifting hormonal balance is bringing on some breakthrough bleeding or, if you're about 6 to 12 days post-conception, you may be experiencing some 'implantation bleeding' as your fertilised egg beds itself in to the lining of your womb. It's also possible that you could have a vaginal infection.

With implantation bleeding and breakthrough bleeding, the bleeding is usually light and often brownish in colour. Both are worth mentioning to your midwife or GP.

If your bleeding is more like spotting and is happening over several days, you may have a vaginal infection – and should call your midwife or GP because, if it is an infection, it'll need treating.

If your bleeding is heavy or bright red, especially if it is accompanied by pain, you should contact your GP or midwife straightaway.

  • Read more about implantation bleeding
  • Read more about other causes of bleeding in early pregnancy

Why am I getting cramps – and what should I do?

Mild abdominal cramps in early pregnancy can be caused by implantation bleeding and also by your womb – and the ligaments around it – beginning to stretch to accommodate your baby. These are worth mentioning to your midwife or GP but are rarely anything to worry about.

But if you have severe or persistent pains, then you should call your midwife or GP and get yourself checked out – especially if the cramps are accompanied by spotting, bleeding, vaginal discharge, fever, faintness or vomiting.

Severe cramps can be sign of something more serious. But, as our expert GP Dr Philippa Kaye can testify, by no means always...

"In my 1st pregnancy," she says, "I was taken aback by how severe my cramps were in the early weeks, to the extent that I went to check it out with my doctor. That was the right thing to do – I’d always advise anyone to do the same. But in my case, and in lots of other cases, I was completely fine."

  • Read more about stomach cramps in pregnancy

What if it's a miscarriage?

Sadly, it's now known that miscarriage does happen in 1 in 4 pregnancies, and most miscarriages happen in the first 12 weeks of pregnancy. But bleeding and cramps do not, on their own, mean you are miscarrying or are going to.

More like this

As we've seen above, there are lots of other causes of bleeding and cramps that are either a normal part of pregnancy or that can be treated effectively without harm to your baby. In fact, it's thought that, although between 20% and 40% of pregnant women experience bleeding, 75% of these pregnancies will continue to term.

But when you experience bleeding and cramping together – particularly if one or both are heavy/severe – then your midwife or doctor may well suspect a miscarriage. They'll probably want to run some tests and do a transvaginal (internal) ultrasound before anyone can tell you for sure.

  • Read more about the signs and symptoms of miscarriage
  • Read more about what happens if early miscarriage is suspected

About our expert GP Rob Hicks

Rob is a GP with a special interest in family health. He has appeared as a medical expert on ITV’s This Morning and Good Morning Britain, Sky News, Channel 5 News, Channel 4 News, ITV News and BBC News, and is medical script adviser to the award-winning BBC1 drama series Doctors. He is also a highly skilled medical editor, contributing to the NHS website and WebMD. He lives in Greater London with his family.

About our expert GP Philippa Kaye

Dr Philippa Kaye works as a GP in both NHS and private practice. She attended Downing College, Cambridge, then took medical studies at Guy's, King's and St Thomas's medical schools in London, training in paediatrics, gynaecology, care of the elderly, acute medicine, psychiatry and general practice. Dr Philippa has also written a number of books, including ones on child health, diabetes in childhood and adolescence. She is a mum of 3.

Read more...

  • Bleeding in early pregnancy: should I worry?
  • Signs and symptoms of miscarriage
  • How the Miscarriage Association can help

Pics: Getty

Is it normal to bleed and have cramps during early pregnancy?

Bleeding and pain in early pregnancy is common. Heavy bleeding or blood clots could indicate a miscarriage or an ectopic pregnancy. Such symptoms can include bleeding, spotting, cramps and stomach pain.

Does bleeding at 4 weeks mean miscarriage?

The most common sign of miscarriage is vaginal bleeding. However, light vaginal bleeding is relatively common during the first trimester (first 3 months) of pregnancy and does not necessarily mean you're having a miscarriage. If you have vaginal bleeding, contact your GP or maternity team as soon as possible.

Are cramps normal during 4th week of pregnancy?

At 4 weeks pregnant, cramping might worry you, but it actually may be a sign that baby has properly implanted in the lining of your uterus.

How long does cramping and bleeding last in early pregnancy?

In most cases, implantation spotting only lasts from a few hours to a couple days, but some women report having implantation spotting for up to seven days. You may experience some light cramping and soreness during implantation. For this reason, women often mistake implantation spotting for their regular period.

Should I be worried about cramps at 4 weeks pregnant?

“Early on in your pregnancy, it's natural to feel some mild cramping in your lower abdomen at infrequent times as your body prepares for your growing baby,” Dr. Nalla said. As your belly grows, so does your uterus. This may cause you to feel some slight pulling, tugging or stretching similar to menstrual cramps.

Does cramping at 4 weeks mean miscarriage?

Normal pains: Cramping without bleeding is usually not a sign of miscarriage. Cramps or short-lived pains in your lower abdomen can happen early in normal pregnancy as your uterus adjusts to the implanted embryo,2 or even if you have a urinary tract infection.