Does Early Pregnancy Bleeding Mean a Miscarriage?

What Bleeding Can Mean at Different Stages of Pregnancy

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If you're newly pregnant and start to notice vaginal bleeding, give yourself a moment to take a deep breath. Although bleeding may be a cause for alarm, it isn't necessarily a sign of miscarriage—especially if it's light and sporadic. Bleeding may range in color from bright red to brown. It is most worrisome if it is heavy and/or accompanied by other symptoms of miscarriage, which include backache and abdominal cramping.

Here’s a look at why bleeding or spotting may happen during different points in pregnancy. Always be sure to call your doctor to discuss your individual concerns. Learn more about bleeding in early pregnancy from four to five weeks pregnant through the first trimester.

potential causes of early pregnancy bleeding

Verywell / Jessica Olah

Bleeding During the First Trimester

First-trimester bleeding is more common than many people assume. Research varies, with some experts citing early-pregnancy bleeding in 15% to 25% of patients, and others reporting this figure to be as high as 40%.

Though an impending miscarriage is possible, it's best not to jump to conclusions before discussing your symptoms with your doctor. For some pregnant people, first-trimester bleeding will not cause a problem, for others, it will result in pregnancy loss.

About 50% of women with first-trimester vaginal bleeding will miscarry, and 50% will not.

Possible Causes of Bleeding

Beyond miscarriage, possible causes of first-trimester bleeding or spotting include:

  • Cervical sensitivity: A pelvic exam or sexual intercourse may cause your cervix to become tender and inflamed, leading to light, brown-tinged spotting that should resolve within a day or so.
  • Implantation bleeding: Some women experience implantation bleeding as the lining of the uterus adjusts to the newly implanted egg.
  • Infection: A urinary tract, cervical, or pelvic infection can cause vaginal bleeding.
  • Molar pregnancy: Molar pregnancy is a rare form of gestational trophoblastic disease. In a molar pregnancy, a cluster of abnormal tissue develops in the uterus rather than an embryo, usually due to chromosomal problems during conception. Because molar pregnancies raise hCG levels, pregnancy tests still come back positive.
  • Subchorionic hemorrhage: When blood accumulates between your uterine wall and the amniotic sac, a subchorionic hemorrhage or hematoma can cause early pregnancy bleeding. Subchorionic hemorrhage occurs in about 1% of pregnancies.

Cervical polyps and heavy exercise may also be responsible for spotting during early pregnancy.

Signs of Miscarriage

The highest risk of miscarriage is during the first 12 weeks of pregnancy. Vaginal bleeding that is bright red and gets heavier over time (rather than lighter) is more likely to indicate a miscarriage. Other signs of a miscarriage may include:

  • Cramping: Lower abdominal cramping that's worse than your typical menstrual cycle
  • Discharge: Tissue, clots, or clumps in the blood
  • Dizziness: Feeling lightheaded or faint

Ectopic Pregnancy

Less common than miscarriages, ectopic pregnancies can also produce vaginal bleeding. In an ectopic pregnancy, the fertilized egg implants itself somewhere other than the uterus, often in one of the fallopian tubes. Symptoms of ectopic pregnancy can be similar to miscarriage (including bleeding and cramping), you may notice a sharp or stabbing pain in your abdomen.

Second and Third Trimester Bleeding

In some cases, vaginal bleeding in the second or third trimester is not serious. Nonetheless, a dangerous condition must always be ruled out through an evaluation by your doctor.

See your doctor right away if you experience bleeding in your second or third trimester. Heavy or bright red blood that is accompanied by other symptoms like abdominal pain or contractions must be addressed immediately.

Light bleeding or spotting can happen later in pregnancy due to many of the same reasons as first trimester bleeding, such as slight irritation of the cervix after sexual intercourse, a medical exam, or growths on the cervix. Make an appointment with your doctor right away to pinpoint the cause and rule out a serious condition, such as:

Placental Abruption

A placental abruption occurs if all or some of the placenta suddenly separates from the uterus after week 20 of gestation. It's an uncommon condition, occurring in about one out of every 100 pregnancies. It usually happens in the third trimester, and can trigger preterm delivery or stillbirth. You may feel contractions and abdominal pain along with the bleeding during a placental abruption.

Incompetent Cervix

This phenomenon happens in around one out of 100 pregnancies. An incompetent cervix is when the cervix starts to dilate too soon, which can result in miscarriage or pre-term birth. This complication is responsible for nearly 25% of miscarriages that occur in the second trimester.

Placenta Previa

This condition occurs when the placenta is low-lying and either somewhat or totally covers your cervix. Placenta previa can cause growth restrictions in the baby and fatal hemorrhaging (blood loss) in the mother, among other complications.

If you're diagnosed with placenta previa, you will likely have to go on bed rest, often in a hospital. While serious, placenta previa is also rare, occurring in approximately one out of every 200 pregnancies.

Placenta Accreta

When the placenta grows too deeply into the uterine wall it cannot be released after the baby is born. This condition is called placenta accreta. It can become life-threatening if not found before delivery due to the risk of hemorrhage and late-pregnancy bleeding.

Placenta accreta is usually found during routine prenatal ultrasound. If you have placenta accreta, your doctor will plan for extra precautions during the delivery and possibly a hysterectomy (surgical removal of the uterus) once the baby is born.

Preterm Labor

Labor prior to the 37th week of pregnancy is considered preterm labor, the signs of which can be mistaken for bleeding. Often, before labor starts, you'll pass the mucus plug, which can look bloody and watery (thus the common moniker, "bloody show"). The mucus plug may be passed several weeks before going into labor, or it could signal that preterm labor is about to occur.

Other symptoms of preterm labor may include cramping, abdominal pain or pressure, lower back pain or pressure, diarrhea, and contractions.

What to Do If You Notice Bleeding

If you experience bleeding or spotting any time during pregnancy, call your doctor and use a panty liner or pad to monitor it. Pay attention to the color: Is it pink, bright red, or brown? Note any activities you might have done in the past day or two that may be causing the bleeding, such as a pelvic exam, Pap smear, or sexual intercourse.

Never use a tampon during pregnancy or put anything in your vagina while you're bleeding. Avoid sexual intercourse until your doctor gives you the all-clear.

A Word From Verywell

Vaginal bleeding during pregnancy can have lots of different causes—some serious and some not. It's tough to know the difference on your own, so always call your doctor immediately if you experience bleeding during your pregnancy. Be sure to explain any other symptoms along with recent lifestyle cues to help decipher the cause.

7 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American College of Obstetricians and Gynecologists. Bleeding during pregnancy.

  2. Breeze C. Early pregnancy bleeding. Aust Fam Physician. 2016;45(5):283-6.

  3. March of Dimes. Placental abruption.

  4. Cleveland Clinic. Incompetent cervix.

  5. March of Dimes. Placenta previa.

  6. Cleveland Clinic. Placenta accreta.

  7. March of Dimes. Preterm labor and premature birth: Are you at risk?.

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage.