1. Spotting: Light bleeding that is pink, red, or brown. It is often less than a normal period and may not be accompanied by pain.
2. Heavier bleeding: Bleeding similar to or heavier than a period, often accompanied by cramping or pain.

1. Implantation Bleeding: Occurs when the fertilized egg attaches to the lining of the uterus, usually around 6-12 days after conception. It is usually light and lasts for a few hours or days. This type of bleeding is harmless and is often mistaken for a very light period.
2. Cervical Changes: The cervix becomes more sensitive during pregnancy due to increased blood flow, so light spotting can occur after sex or a vaginal exam. This is very rare and is usually harmless and stops on its own.
3. Miscarriage: Unfortunately, bleeding can also be a sign of miscarriage, which occurs when a pregnancy ends spontaneously before the age of viability which varies from country to country. For instance, 24 weeks in the UK and 28 weeks in Nigeria. A foetus is considered viable if it has reached a stage of development where it is able to live outside of its mother’s womb. Signs of miscarriage may include spotting, heavy bleeding, clotting, and cramping. However, not all bleeding means a miscarriage, and many women with early pregnancy bleeding go on to have healthy pregnancies.
4. Ectopic Pregnancy: This occurs when a fertilized egg implants outside the uterus, usually in a fallopian tube. An ectopic pregnancy is life-threatening and requires urgent medical care. Symptoms include sharp abdominal pain, shoulder pain, dizziness, and spotting/light bleeding.
5. Molar Pregnancy: A rare condition where abnormal placental tissue grows inside the uterus instead of a baby. This can cause severe nausea, vomiting, and bleeding. A molar pregnancy must be treated by a gynaecologist to prevent complications.
6. Infection: Infections of the cervix or vagina (often caused by sexually transmitted infections or poor hygiene) can cause bleeding and should be treated to prevent complications in pregnancy.

If you experience any bleeding during early pregnancy, it’s important to seek medical attention, especially if it is heavy, accompanied by pain, or if you feel dizzy or faint. In many areas of Sub-Saharan Africa, access to healthcare may be limited, but you should try to visit a local clinic, health center, or community health worker as soon as possible. 

• Light spotting or bleeding that goes away within a day or two without pain may be normal, but it’s still a good idea to consult a healthcare provider.
• Heavy bleeding like a menstrual period, especially if it is accompanied by cramping or abdominal pain, requires medical attention.
• Severe pain in the lower abdomen, shoulder pain, dizziness, or fainting could indicate a ruptured ectopic pregnancy or other serious conditions and needs emergency care.
• Cultural and Social Context in Sub-Saharan Africa: In some regions of Sub-Saharan Africa, discussing reproductive health or pregnancy-related issues may be considered private or taboo, which could prevent women from seeking early care. It is important to understand that pregnancy complications like bleeding can happen to anyone and are not a cause for shame. Seeking help from a healthcare provider is crucial to protect your health and your baby’s health.
• Many traditional beliefs or remedies may exist in rural areas. If you are experiencing bleeding, prioritize visiting a clinic or hospital where you can receive proper diagnosis and treatment.

• Miscarriage: Without proper care, a miscarriage meaning an eventual loss of the pregnancy could occur. It is important to receive emotional and medical support after a miscarriage, as this is a difficult experience for many women.
• Ectopic Pregnancy especially for the ruptured one: If not treated can lead to internal bleeding, and even death.
• Infection: If the bleeding is caused by an infection, leaving it untreated could lead to more severe health problems for you and your baby, including miscarriage, preterm birth and its attendant complications, stillbirth or early neonatal death.

To determine the cause of bleeding, a healthcare provider may perform:

• Physical exams to check the cervix.
• Ultrasound to assess the pregnancy and see if the baby is developing normally.
• Blood tests and swabs from the vagina to detect infections.
• Once the cause of bleeding is identified, the doctor may recommend:
• Rest and observation if the bleeding is mild and there are no signs of a serious problem.
• Medications to treat infections or other conditions that may be causing bleeding.
• Surgery if the cause is an ectopic pregnancy or molar pregnancy, or if there is heavy bleeding that cannot be controlled by other means.

While bleeding can sometimes happen unexpectedly, there are steps you can take to increase your chances of a healthy pregnancy:

• Prenatal care: Start prenatal checkups as soon as you find out you are pregnant. Early and regular care can help identify and prevent complications.
• Good nutrition: Eating a healthy diet with plenty of iron-rich foods like leafy greens and beans helps maintain your health and prevent anaemia, which can worsen bleeding.
• Avoid strenuous activities: Rest when needed and avoid heavy lifting or strenuous work that could cause stress on your body.
• Safe sexual practices: Talk to your healthcare provider about whether it is safe to continue sexual activity during pregnancy, especially if you have had previous miscarriages or other complications.