Is Spotting Normal During Pregnancy?
Spotting is a common concern that many pregnant women face. Approximately 20% of women report they experience spotting during their first 12 weeks of pregnancy. Bleeding that occurs early on in pregnancy is usually lighter in flow than a menstrual period. Also, the color often varies from pink to red to brown.
Although it is easy to be concerned, don’t panic. The majority of women who experiencing spotting during pregnancy go on to have a healthy pregnancy and baby.
Spotting During Pregnancy Versus Bleeding
Vaginal bleeding during pregnancy is any discharge of blood from the vagina. It can happen anytime from conception (when the egg is fertilized) to the end of pregnancy.
Light bleeding, or spotting, during pregnancy is common, especially during the first trimester. Usually, this is no cause for alarm. It is considered spotting when you notice a few drops of blood occasionally in your underwear, or if you wipe yourself with tissue and see a little blood on the paper. There should not be enough blood to cover a panty liner.
Bleeding is a heavier flow of blood. With bleeding, you will need a liner or pad to keep the blood from soaking your clothes. Whether you are bleeding or spotting, it is best to contact your healthcare provider and describe what you are experiencing.
What Causes Spotting During Pregnancy?
Implantation bleeding is a common cause of spotting early on in pregnancy. Implantation bleeding happens when the fertilized egg attaches to the uterine lining. This can trigger a few days of light bleeding or spotting. This spotting occurs before a woman even knows she is pregnant and is often mistaken as a pending period. Bleeding that occurs after the day a woman expects her period is typically too late to be considered implantation bleeding, and is more likely related to early pregnancy in general.
Another common cause of spotting is a cervical polyp (a harmless growth on the cervix), which is more likely to bleed during pregnancy due to higher estrogen levels. This may occur because there is an increased number of blood vessels in the tissue around the cervix during pregnancy. As a result, contact with this area (through sexual intercourse or a gynecological exam, for example) can cause bleeding.
Even without the presence of a cervical polyp, there are a few things that may cause some spotting in the couple days after:
- Sexual intercourse
- Gynecological exam, such as a vaginal ultrasound
- Heavy lifting/excessive exercise
When to Worry About Spotting During Pregnancy?
Spotting or bleeding during pregnancy is not expected and may be abnormal, but it is not always a cause for concern. However, it is important to contact your healthcare provider to discuss the symptoms you are experiencing. The good news is that 50% of women with bleeding during pregnancy go on to have a healthy pregnancy and a healthy baby.
Any spotting or bleeding in the second or third trimesters should be reported to your healthcare provider immediately. In the first trimester, spotting is somewhat more common, but should also be reported to your doctor or midwife.
Call your obstetrician especially if you notice heavy bleeding similar to a menstrual period to make sure the bleeding is not a result of pregnancy complications, such as an ectopic pregnancy. Abnormal bleeding in late pregnancy may be more serious because it can signal a complication with you or your baby. Call your doctor as soon as possible if you experience any bleeding in your second or third trimester. Your healthcare provider will most likely check for cervical polyps, and make sure your cervix is closed.
To help manage your spotting during pregnancy and to increase the probability of continuing with a healthy pregnancy, your healthcare provider may encourage you to do the following:
- Bed rest or more naps
- More time off your feet
- Staying well hydrated
- Limit your physical activity
- Elevate your feet when possible
- Avoid lifting items over 10 pounds
Remember, the good news is the majority of women who experience spotting during pregnancy go on to have a healthy pregnancy. However, do not let this fact keep you from contacting your healthcare provider. It is important to discuss spotting and bleeding with your doctor.
Compiled using information from the following sources:
1. Mayo Clinic Guide to a Healthy Pregnancy, New York, NY: HarperCollins Publishers Inc.
2. Obstetrics and Gynecology: The Essentials of Clinical Care. New York, NY: Thieme New York
3. Danforth’s Obstetrics and Gynecology, Ninth Ed. Scott, James et al., Ch. 17
4. Williams Obstetrics, Twenty-Second Ed. Cunningham, F. Gary et al., Ch. 51