Spotting During Early Pregnancy

Even though you may know that spotting can occur in viable pregnancies and may not mean anything is wrong, it's normal to worry about miscarriage. Light vaginal bleeding in early pregnancy can occur for a variety of reasons, and here is some helpful information to help you understand pregnancy spotting and why it happens.

The term "spotting" is defined as very light vaginal bleeding during pregnancy or between periods. Spotting is usually light and brown, although heavy spotting can be red. A woman who is spotting might need only a panty liner rather than menstrual supplies to control the flow.

Spotting can be a symptom of impending miscarriage but can also happen in a normal pregnancy. Sexual intercourse in pregnancy may cause spotting, as might a vaginal exam or other irritation to the cervix, but this bleeding would stop.

It's thought that up to 30 percent of women experience spotting at some point during pregnancy. Any woman experiencing spotting should call her doctor if she is concerned.


pregnant woman holding her abdomen worried about bleeding

There are many causes of spotting in early pregnancy. Certainly, miscarriage is one cause, but there are many possible reasons for spotting in a normal, healthy pregnancy.

Possible causes of spotting in early pregnancy include:

  • Irritation of the cervix following sexual intercourse, a recent pelvic exam, or a recent transvaginal ultrasound. The cervix becomes very vascular during pregnancy and can sometimes bleed with minimal contact. This bleeding is not dangerous, other than making you fear that something could be wrong, and it is not necessary to avoid intercourse (or pelvic exams or ultrasounds) in early pregnancy.
  • Implantation bleeding - When the placenta implants in the uterine wall, spotting may occur. In fact, thinking about how this occurs makes it surprising that implantation bleeding does not occur more often. (Implantation bleeding is discussed further below.)
  • Cervical ectopy - Cervical ectopy refers to the invasion of cells that are normally present in the uterus or cervical canal to the surface of the cervix. Since these cells are more delicate than the cells ordinarily present on the surface of the cervix, they have a tendency to bleed with very little irritation. It is more common in women who have experienced vaginal childbirth in the past (stretching of the cervix) and those who have used birth control pills for an extended period of time.
  • Infection of the cervix (cervicitis) - Cervicits refers to inflammation of the cervix and is most commonly caused by infections. These infections can be caused by sexually transmitted infections such as chlamydia, gonorrhea, trichomonas, or genital herpes, or non-sexually transmitted infections such as bacterial vaginosis. Cervicitis may also be caused by irritation from a diaphragm​ or an allergy to the latex in condoms.
  • Miscarriage - Roughly half of spotting in early pregnancy is caused by a miscarriage
  • Ectopic pregnancy - A pregnancy which occurs in the fallopian tubes may result in spotting and is a medical emergency.

Spotting later in pregnancy (second and third trimesters)

  • Often the cause is not known and does not cause problems
  • Placenta previa - Placenta previa refers to the placement of the placenta over the opening to the cervix.
  • Placental abruption - Separation of the placenta from the uterine wall before delivery often results in very heavy bleeding, but at times the bleeding is contained above the placenta and only spotting occurs.
  • Labor - When the cervix begins to dilate in early labor. it is common to have a "bloody show."

What It Looks Like

Generally, the term spotting is used for very light bleeding at any point in pregnancy, which is usually of a small quantity and lasts for a short duration of time. The blood may be red, pink, or light brown in appearance.

Spotting may result in redness on your underwear or require you to wear a panty liner. Bleeding that is heavy enough to require a menstrual pad is usually referred to as vaginal bleeding rather than spotting.

Does Spotting Mean Miscarriage?

Many people fear that spotting in early pregnancy is a sign of miscarriage, but as we have noted, there are many possible causes for spotting.

Roughly half of women who experience spotting in early pregnancy do have a miscarriage. This also means that half of women who spot in early pregnancy do not have a miscarriage. Spotting later in pregnancy, during the second and third trimesters is often less serious, but there are also times when it is very serious.

Between 10 and 30 percent of women who deliver full term healthy babies report that they had spotting at some point during pregnancy. Anyone who experiences spotting during their second or third trimester should contact their doctor right away.

Is It Implantation Bleeding?

Implantation bleeding may occur very early in the pregnancy, around the time that you would otherwise expect your menstrual period, but the quantity would usually be minimal and bleeding would not last a long time.

Implantation bleeding occurs when the egg implants in the uterus, around 10 days after ovulation. Most often women notice only a tinge of red on their panties or on toilet paper, though sometimes it may be heavier.

Women who ordinarily have light periods may mistake implantation bleeding for a period and not realize that they are pregnant.

What to Do If You're Spotting and Worried

If your bleeding in early pregnancy is very minimal and you otherwise are not having any symptoms, you may wish to wait until your next appointment to talk to your doctor.

If you are feeling at all concerned, give your doctor's office a call. Pregnancy can be a stressful time, and actually being able to talk to your doctor about your symptoms can be very reassuring.

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Article Sources

  • U.S. National Library of Medicine. Medline Plus. Bleeding in Early Pregnancy. Updated 11/19/14.