Bleeding in the second half of pregnancy accompanied by abdominal pain needs urgent attention – it may indicate placental abruption with separation of the placenta from the uterine wall. It may occur if there is bleeding between the placenta and the wall of the uterus and the placenta lifts away from the uterus. If there is a large volume of blood lost the oxygen supply to the baby may be reduced and the mother may experience severe shock. Sometimes abruption is indicated by severe constant pain without bleeding – both should be investigated urgently. The abruption and its severity will be diagnosed by scan. Mild abruption may require only bedrest and surveillance, but if it is severe delivery by caesarean section may be needed. There is a very great risk to the baby with a large abruption because the placental function may be severely affected.