Causes of Spotting in Early Pregnancy

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Spotting refers to light vaginal bleeding that occurs during pregnancy. As many as 30% of pregnant women may experience spotting at one time or another during pregnancy.

Spotting, or light brown vaginal bleeding, can occur in both viable and nonviable pregnancies. It's easy to panic and fear the worst when you discover that you are spotting, especially in the first trimester, but try to stay calm. Miscarriage is only one possible cause of spotting.

Common Causes of Spotting During Early Pregnancy

The following factors can also cause light bleeding or spotting in pregnancy:

If you are spotting, keep an eye on the flow to see if it gets heavier. If the spotting goes away, it is more likely to be nothing to worry about, but if it gets heavier and begins to resemble a menstrual flow, you should call your physician. Bleeding in the second and third trimesters, especially red bleeding, should always be reported to a physician.

Let's take a closer look at some of the specific causes of early spotting during pregnancy.

Spotting After Sex (Postcoital Bleeding)

Bleeding after sex most often occurs in women who are between 20 and 40 years old and have had more than one child (multiparous). In two-thirds of women, bleeding after sex is benign and no cause can be found.

In other women, however, spotting after sex can be attributed to things like cervicitis, or infection and inflammation of the cervix, which is part of the birth canal and the tissues that links the vagina to the uterus. A common cause of cervicitis among women is chlamydia, a sexually transmitted infection, which requires treatment with antibiotics.

Placenta Previa

Placenta previa is a problem that occurs only during pregnancy. With placenta previa, the placenta covers the opening of the cervix. The degree to which the placenta can cover the cervix can be marginal, partial. or complete.

Women with placenta previa often are prescribed bed rest and pelvic rest (no sex). Furthermore, women with placenta previa receive C-sections because a vaginal delivery may cause too much bleeding.

Cervical Ectopy

Sometimes people inappropriately refer to cervical ectopy as cervical erosion. Cervical ectopy is when the cells of the endocervix, or inner part of the cervix, protrudes into the ectocervix, or outer part of the cervix. Cervical ectopy is a benign condition, which doesn't require treatment (like cauterization). 

Use of oral contraceptives can contribute to the development of cervical ectopy. Typically, cervical ectopy gradually disappears when a woman is in her 20s and 30s. Thus, pregnant women with this condition are usually young.

Cervical ectopy can be mistaken for cervicitis or cervical infection. Furthermore, cervical ectopy may increase a woman's susceptibility to sexually transmitted infections, such as gonorrhea and HIV.

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  1. Hoffman B, Schorge J, Schaffer J et al. Williams Gynecology, Second Edition. McGraw Hill Professional; 2012.

Additional Reading
  • American Pregnancy Association, "Bleeding During Pregnancy." Aug 2007.
  • Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham F, Calver LE. Chapter 8. Abnormal Uterine Bleeding.
  • Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham F, Calver LE. eds. Williams Gynecology, 2e. New York, NY: McGraw-Hill; 2012.