Spotting During Pregnancy

Some causes are benign, but others can be serious

pregnant woman in the bathroom
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Vaginal bleeding during pregnancy describes any blood flow from the vagina. The term "spotting" describes light vaginal bleeding. Around 20 percent of women say they experienced spotting during the first trimester of pregnancy and most of these women go on to have healthy babies, as do around half of all women who have any kind of bleeding during their pregnancies.

According to the American College of Obstetrics and Gynecology, about 15 percent to 25 percent of women have some amount of bleeding in their first trimesters. Bleeding is less common—and more concerning—if it occurs in the second or third trimester. 

What Spotting Looks Like

Generally, the discharge you'll see if you experience spotting is brown, red, or pink in color and has a slightly gummy or stringy texture (because the discharge consists of a few drops of dried blood that's mixed with cervical mucus). In terms of the quantity, expect a very small amount—it's usually just a few drops that you see when you wipe after using the bathroom or in your underwear, but not enough to soak through a panty liner.

Bleeding is heavier than spotting, requiring a pad to protect your clothing because the blood is soaking through. Color-wise, it tends to be red, though this may vary.

Common Causes in Early Pregnancy

If you're experiencing spotting in early pregnancy, it's not necessarily a cause for alarm. Light spotting has a few different potential causes, including:

  • Implantation bleeding: This is light bleeding that occurs six to twelve days after the fertilized egg attaches to your uterine lining. This happens so early on that some women don't even realize that they're pregnant yet and mistake it for the beginning of a regular menstrual period. This type of spotting may last anywhere from a few hours to a few days. 
  • Cervical polyp: If you have this type of benign growth on your cervix, it may cause spotting. There are more blood vessels near the cervix during pregnancy, and if this growth is accidentally hit during a doctor's exam or during intercourse, it may bleed.
  • Cervical or vaginal irritation: Your cervix and/or vagina may be more easily irritated since there's more blood flow during pregnancy, so spotting can occur after sex or after an exam such as a pelvic exam, a Pap smear, or a vaginal ultrasound.
  • Too much exercise: Lifting heavy weights or working out too hard may also cause spotting.

When to See Your Doctor

Here's when you should see your doctor about your spotting.

First Trimester

If your first-trimester spotting stops within a day, only happens on occasion, you don't have any other symptoms, and it's light, then it's probably nothing to worry about. Remember, the majority of women who have spotting in early pregnancy have normal pregnancies and deliveries. However, any bleeding during pregnancy is considered irregular, so it's important to call your doctor and tell him or her about it over the phone to be sure there's not a more sinister cause. You may need to go in for a checkup to make sure everything's okay.

If the spotting turns into heavier bleeding that resembles a menstrual flow or you notice additional symptoms like cramping, fever, or a backache, call your doctor immediately since this could be a sign of something more serious, such as:

  • Ectopic pregnancy: This kind of pregnancy occurs when a fertilized egg implants outside your uterus, such as in your fallopian tubes, and can't grow. Because it can cause your fallopian tube to rupture, resulting in severe blood loss, it's important to see your doctor as soon as possible. You may also notice pain in your abdomen, shoulder, or pelvis.
  • Molar pregnancy or gestational trophoblastic disease: When abnormal tissue grows in your uterus instead of an embryo, this is called a molar pregnancy. This rare condition usually results from chromosomal abnormalities. Though it's not an emergency situation and there aren't any symptoms other than bleeding, it's still important to see your doctor right away to make sure you aren't dealing with something that needs immediate attention.
  • Infection: You may have an infection in your pelvic area or in your urinary tract. This may also be accompanied by a fever.
  • Miscarriage: An estimated 80 percent of miscarriages (early pregnancy loss) occur during the first 12 weeks of pregnancy, and these are typically associated with heavier bleeding and sometimes abdominal or back pain or cramping. There may be noticeable tissue that passes with the blood as well. Once a miscarriage begins, there's nothing that can stop it. There's also nothing you did to cause it. Miscarriages are fairly common, occurring in an estimated 8 percent to 20 percent of pregnancies, but the actual number is higher since many miscarriages happen before a woman even knows she's pregnant.

    Second and Third Trimesters

    Second- or third-trimester spotting or bleeding is concerning and is more likely to be due to a pregnancy complication. Late bleeding can sometimes put your fetus and you in serious danger, so always call your doctor right away if you notice any spotting or bleeding after the first trimester. The bleeding could indicate one of the following:

    • Placental abruption: This is when the placenta detaches from the uterine wall before or during labor.
    • Placenta previa: The placenta is low-lying in the uterus and either partially or totally covers the cervix.
    • Preterm labor: When you go into labor before week 37 of gestation, this is earlier than it should be.

    Diagnosis

    In the event that your doctor has you come in to see what the source of your spotting is, you'll likely have a vaginal exam. You may also have an ultrasound to listen for your baby's heartbeat, as well as a human chorionic gonadotropin (hCG) blood test to check for the hCG hormone in your blood. These tests can help your doctor determine what might be causing your spotting.

    If your doctor hasn't found any cause for your spotting, he or she may advise you to take it easy by staying off your feet, resting more, not lifting anything heavy, and putting your feet up. Be sure to follow your doctor's instructions and to call right away if you notice any other symptoms like back or abdominal pain, fever, or increased bleeding.

    View Article Sources
    • American College of Obstetricians and Gynecologists.Bleeding During Pregnancy. Frequently Asked Questions: Pregnancy, FAQ038. Published July 2016. https://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy
    • American Pregnancy Association. Spotting During Pregnancy. Updated November 1, 2017. http://americanpregnancy.org/pregnancy-concerns/spotting-during-pregnancy/
    • American Pregnancy Association. Bleeding During Pregnancy. Updated August 2015. http://americanpregnancy.org/pregnancy-complications/bleeding-during-pregnancy/
    • Tulandi T. Patient Education: Miscarriage (Beyond the Basics). UpToDate. Updated July 31, 2018. https://www.uptodate.com/contents/miscarriage-beyond-the-basics#H2