Causes of Spotting in Early Pregnancy

Spotting refers to light vaginal bleeding that occurs during pregnancy. As many as 30% of people 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.

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

• Recent sexual intercourse
• Recent pelvic exam
• Recent transvaginal ultrasound
• Cervical ectopy
• Implantation bleeding
• Cervical infection (cervicitis)
• Placenta issues, such as placenta previa
• Miscarriage or ectopic 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.

Spotting After Sex

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

In other cases, however, spotting after sex can be attributed to 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 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.

People with placenta previa often are prescribed bed rest and pelvic rest (no sex). With placenta previa, babies are delivered by C-section 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, protrude into the ectocervix, or outer part of the cervix. Cervical ectopy is a benign condition which doesn't require treatment. 

Use of oral contraceptives can contribute to the development of cervical ectopy. Typically, cervical ectopy gradually disappears with age. Thus, pregnant people with this condition are usually young.

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