Spotting During Early Pregnancy

Vaginal bleeding during pregnancy describes any blood flow from the vagina. The term "spotting" describes light vaginal bleeding. Around 20% 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% to 25% of women have some amount of bleeding in early pregnancy (the first trimester). 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.

Causes of Early Pregnancy Spotting

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:

• Cervical polyp: There are more blood vessels near the cervix during pregnancy. If a begin polyp is hit in a doctor's exam or during intercourse, it may bleed. Cervical polyps are 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.
• Cervical or vaginal irritation: Your cervix and/or vagina may be more easily irritated since there's more blood flow during pregnancy. Spotting can occur after sex or after an exam such as a pelvic exam, a Pap smear, or a vaginal ultrasound. This bleeding is not dangerous, and it is not necessary to avoid intercourse (or pelvic exams or ultrasounds) in early pregnancy.
• Implantation bleeding: This is light bleeding that occurs 6–12 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. 
• Too much exercise: Lifting heavy weights or working out too hard may also cause spotting.

When to See Your Doctor

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. But you can always call your doctor any time you are concerned.

First Trimester

If your first-trimester spotting stops within a day, only happens on occasion, isn't accompanied by other symptoms, and is 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 you may need to go in for a check-up to make sure everything's okay.

Heavier bleeding could be a sign of something more serious, such as:

• Ectopic pregnancy: This 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.
• Infection: An infection in your cervix (cervicitis), pelvic area, or urinary tract can be caused by chlamydia, gonorrhea, trichomonas, or genital herpes, or non-sexually transmitted infections such as bacterial vaginosis. They are sometimes accompanied by a fever. Cervicitis may also occur from irritation by a diaphragm​ or an allergy to the latex in condoms.
• Miscarriage: About 80% of miscarriages (early pregnancy loss) occur in the first 12 weeks of pregnancy. Symptoms may include heavier bleeding, abdominal or back pain, cramping, along with noticeable tissue passing. Once a miscarriage begins, there's nothing that can stop it. Miscarriages occur in over 8–20% of pregnancies.
• Molar pregnancy or gestational trophoblastic disease: This rare condition, resulting from chromosomal abnormalities, describes when abnormal tissue grows in the uterus instead of an embryo. Though it's not an emergency situation, see your doctor right away. The only symptom is bleeding.

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 a fetal heartbeat. Often you will be given 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, they 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.

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.

The bleeding could indicate one of the following:

• Placental abruption: This is when the placenta detaches from the uterine wall before or during labor.
• Preterm labor: Labor has begun prior to week 37 of gestation.
• Placenta previa: The placenta is low-lying in the uterus and either partially or totally covers the cervix.