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Spotting During Pregnancy

Spotting is the name given to light vaginal bleeding. Lighter than a period, spotting may be brown or red in colour. Spotting is the name given to very light vaginal bleeding, not enough to warrant the use of a sanitary towel, anything heavier than that is classed as bleeding. Spotting during pregnancy is quite common, and as many as 20-30 percent of women will experience some spotting during the first trimester. While it is usually nothing to worry about, spotting can be a sign that something is wrong so you should contact your healthcare provider immediately if you are spotting.


Women who conceived with the help of fertility treatment are more likely to experience spotting. If two embryos were placed into your uterus, when one stops developing (this is known as a vanishing twin) it can trigger a small bleed. Contact your healthcare provider if you think this has happened to you.


The most common causes of spotting

Although it is a common occurrence, it can be quite daunting to see blood when you go to the bathroom. Regardless of your stage of pregnancy, you probably have enough to worry about already, and may feel anxious for your pregnancy. More often than not though, spotting is nothing to worry about. During the first few weeks of pregnancy, there are two main causes of spotting, these are:

  • breakthrough bleeding – this happens when you would normally have a period and is caused by hormones. This bleeding is usually lighter than a menstrual period, although occurs at the same time. It is possible to experience breakthrough bleeding more than once. In a small number of cases, repeat breakthrough bleeding leads women to believe they are not pregnant, when in fact they are
  • implantation bleeding – this occurs when a fertilised egg embeds in the lining of your uterus, and causes a bleed. For some women, implantation bleeding is a small amount of brown blood, but for others it may mimic a period. Implantation bleeding occurs during the first few weeks following conception, and can be one of the first symptoms of early pregnancy


Other possible causes

Though breakthrough and implantation bleeding are the most common, there are other causes for spotting during early pregnancy, including:

  • fibroids – these are growths on the lining of your uterus that may cause bleeding
  • irritation to the cervix – pregnancy hormones can make the surface of the cervix more sensitive than usual, and this can cause bleeding when irritated
  • sex – sex can irritate the cervix and cause bleeding. Although this is probably nothing to worry about, you should abstain from sex until you have been checked over by your healthcare provider
  • cervical polyp – a small benign tumour on the cervix
  • vaginal infection
  • sexually transmitted infection
  • cervical infection
  • an inherited disorder that makes it difficult for your blood to clot
  • molar pregnancy – this is a rare condition which affects one in 700 pregnancies. In a molar pregnancy, abnormal tissue grows instead of an embryo. There are a number of types of molar pregnancy and treatment will depend upon your individual diagnosis, but normally the tissue will be removed as soon as possible
  • a painful blow to your belly
  • ectopic pregnancy
  • early miscarriage


Ectopic pregnancy

Though rare, bleeding during pregnancy can be a symptom of ectopic pregnancy. An ectopic pregnancy is when a fertilised egg embeds outside of the womb, usually in a fallopian tube. Unfortunately, this egg will not develop into a baby.


The symptoms of ectopic pregnancy include:

  • abnormal vaginal bleeding
  • abdominal pain, usually felt on one side


Symptoms usually occur between four to eight weeks after the last menstrual period. Some women do not experience any symptoms and the ectopic pregnancy is picked up during routine ultrasound scans. An ectopic pregnancy can cause the fallopian tube to rupture which can be life threatening, because of this it is important to remove an ectopic pregnancy as soon as possible.


You have an increased risk of ectopic pregnancy if you have had:

  • an infection in your fallopian tubes
  • a previous ectopic pregnancy
  • previous pelvic surgery


Early miscarriage

If a pregnancy ends before the 24th week of pregnancy it is called a miscarriage. As many as one in five confirmed pregnancies end in miscarriage. Bleeding in early pregnancy can be a sign of early miscarriage. It is believed that early miscarriage usually occurs when a baby is not developing properly. Rather than light spotting, the vaginal bleeding will grow heavier overtime and be accompanied by abdominal pain or cramps. You may also notice clots or tissue being passed. Sadly, most miscarriages occur within the first 12 weeks and cannot be prevented.


What should I do if I notice bleeding?

You should contact your healthcare provider immediately, even if the bleeding has since stopped. They will want to check you over and make sure it is nothing to worry about. Your healthcare provider will ask you a few questions, so make sure you take note of:

  • the colour of the blood – was it brown, pink or red?
  • the flow – was it heavy or light spotting?
  • whether it contained clots or tissue
  • whether you needed sanitary towels to soak up the flow, and if so, how many?
  • any other symptoms – did you experience fever, chills, dizziness or pain?


Your healthcare provider may be able to determine that everything is ok simply by asking a few questions, or may wish to carry out a more thorough investigation. You may be offered a vaginal exam or, depending how far into the pregnancy you are, an ultrasound scan to check that the pregnancy is developing normally.


Blood and urine samples may be taken to check your HcG levels. This pregnancy hormone increases rapidly during the first trimester, and a low level of HcG could indicate a problem.


Your healthcare provider will probably advise you:

  • to wear a pad – if you are still bleeding, you should monitor your blood loss. Most women find the spotting lessens over time, if your bleeding increases you should contact your healthcare provider for advice
  • to avoid tampons and douches during pregnancy
  • to avoid sex until the bleeding stops – in extreme cases, you may even be advised to avoid sex until later in the pregnancy but this will depend on your individual diagnosis
  • to rest – your healthcare provider may tell you to take it easy and avoid heavy lifting for the duration of the pregnancy
  • not to worry – remember, most likely, spotting is nothing to worry about but it won’t do any harm to get checked out. In fact, it may help to relieve your worry. Try not to feel stressed or anxious about it, and get checked out as soon as possible


When to go to the emergency room

You should head straight to the emergency room if the spotting is accompanied by any of the following symptoms:

  • severe abdominal pain or cramping
  • severe vaginal bleeding
  • passing tissue or clots
  • dizziness and/or fainting
  • a high fever and/or chills


Spotting during the second and third trimesters

Spotting or bleeding in the second and third trimesters should be considered more serious, especially when no bleeding has occurred prior to this point. If you experience spotting after the first trimester, you should contact your health provider immediately. Possible causes of spotting and bleeding later in the pregnancy include:

  • placenta previa – the placenta begins to cover, or partially cover, the cervix. This condition requires close monitoring. Heavy vaginal bleeding is more likely to be symptomatic of this condition, although occasionally it can cause spotting
  • placental abruption – this typically occurs after a blow to the belly, such as a car accident or fall, and results in the placenta separating from the uterus. This condition is usually accompanied by vaginal bleeding, although spotting may be present as an early symptom
  • incompetent cervix – this condition is rare but can cause the cervix to soften and dilate early, compromising the pregnancy. You will need close monitoring throughout the pregnancy if you are diagnosed with this condition
  • mucus plug – as you approach the end of your pregnancy, spotting could be a sign that you have lost your mucus plug. The mucus plug keeps the uterus sterile during pregnancy but often becomes dislodged as the cervix begins to soften and dilate. The mucus plug may be noted as a brown or red tinged discharge
  • preterm labour – if you think you have lost your mucus plug but are not yet full term, you should contact your healthcare provider immediately. Although rare, it is possible to experience preterm labour. Other symptoms of preterm labour include stomach cramps, lower backache and regular contractions. Your healthcare provider will assess your condition and decide whether to deliver the babies early or try to hold off labour until close to your due date






Share your Thoughts
  • melissa

    Hi I’m soon gonna be going for a ultrasound in April but when I went doctors I done a test and it was negitive I had my bloods done and still waiting for the results but I don’t know why the dr has said I should go for a ultrasound when it says I wasn’t pregnant on the test I did at doctors I started of with a brown and a little bit red period type thing then the next day it was a full on bright red bleed with clots then I thought I was comming of then I had brown fluid come out like a period when I wiped and on my knickers then went to a pinky coulour please help could I be pregnant and do I need to go hospital straght away ?

    • yasemin

      I think your pregnant go to hospital for and ultrasound just in case ..

  • yasemin

    hi there I was 2 days late for my period , had red pink spotting and then brown and know am bleeding but not heavy so am I pregnant or miscarried did a test the first day that I suppose to start my period because I
    was late the period didn’t come , but it was negative so I am confused .