Overview
About 25% of pregnant women can experience vaginal bleeding during the first trimester for different reasons. (1)
Spotting (light bleeding) could be a sign of implantation bleeding, which is harmless and not a cause for concern. However, heavy bleeding could be due to more serious pregnancy complications, including ectopic pregnancy, molar pregnancy, or a miscarriage. (1)
What’s the difference between pregnancy spotting and bleeding, how can you tell what’s normal and what isn’t, when should you see your doctor, and what are the treatment options? Continue reading to find out.
Pregnancy Spotting Vs. Bleeding: How To Tell The Difference
Pregnancy spotting is light bleeding during pregnancy. You might notice drops of blood on your panties or panty liner that stop after a few days. Often, this happens without abdominal cramps or pain. (2)
Pregnancy bleeding is heavy bleeding that could be a cause for concern, especially if you pass clots and experience abdominal pain and cramps.
If the blood flow is steady and bright red, go to the ER (emergency room) or call 911 immediately.
Pregnancy Spotting: Should I Worry About It? (Outlook & Prognosis)
In most cases, pregnancy spotting isn’t something you should worry about, especially if it happens during the first few weeks of pregnancy. (2)
Spotting during this time is often linked to implantation bleeding or cervical changes as your body prepares for your baby.
Bleeding Or Spotting In The First Trimester
What Does Spotting Look Like During Early Pregnancy?
Spotting in early pregnancy can be a few drops of dark brown blood on your panty liner. You might also find rusty red or pinkish blood, but these are rarely a cause for concern as long as they’re just a few drops. (3)
What Does Pregnancy Bleeding Look Like?
Pregnancy bleeding can cause concern if you find bright red vaginal discharge, with or without clots. (2)
Heavy bleeding, especially with abdominal pain, could signify miscarriage.
How Much Spotting or Bleeding Is Normal In Early Pregnancy?
Spotting might be normal if you only experience a few drops of blood within just a day or two. Some women don’t even notice the spotting but might see some blood when wiping. (2)
Is Period-Like Bleeding Normal During Pregnancy?
No. Studies show that early pregnancy bleeding is rarely the same as period bleeding. It’s usually lighter and has a shorter duration than your normal period. (2)
Still, it can be heavy enough for some women to mistake it for their period, leading to discrepancies in calculating gestational age because they count it as their LMP (last menstrual period). (2)
How Common Is Spotting During Early Pregnancy?
Light spotting is common during early pregnancy and can occur in 25% of pregnant women. (1)(2)
Heavy bleeding is more commonly experienced in pregnancies that result in a miscarriage. (2)
What Can Cause Spotting Or Bleeding During Early Pregnancy?
- Implantation bleeding
- Cervical changes
- Miscarriage or early pregnancy loss
- Threatened abortion
- Ectopic pregnancy
- Molar pregnancy
- Vaginal infections and other unknown causes
Let’s discuss these in detail below.
Implantation Bleeding: What Kind Of Spotting Indicates Pregnancy?
If you’re just spotting or experiencing light bleeding, this could be implantation bleeding. It’s among the most common causes of spotting in early pregnancy. (2)(3)
Many women experience implantation bleeding. You might easily mistake it for your period, but pregnancy spotting has a lighter volume than your regular period. (2)(3)
Often, the color might be brown instead of red. That’s from the blood and cells at the lining of the uterus displaced as the embryo implants. (3)
Why Do You Spot At 6 Weeks Pregnant?
Some blood vessels or membranes in the lining of your uterus become displaced when the embryo implants. (2)
How Long Do You Spot While Pregnant?
About 50% of those who experience spotting might only have it for a day, 30% have it for 2-3 days, and only 20% experience it for more than three days. (2)
Is Spotting Normal At 7 Weeks Pregnant?
Yes. Most episodes of implantation bleeding occur at around 6-7 weeks gestation. (2)
Cervical Changes
During pregnancy, your body increases blood flow to the wall of your uterus and cervix. But due to these changes, your cervix might be more sensitive. (4)
This can lead to some light bleeding after sexual intercourse or a pelvic exam. (4)
Sex during pregnancy isn’t likely to harm your baby or cause a miscarriage, but it’s best to hold off intercourse and consult your doctor if you experience bleeding. (4)
What’s A Miscarriage or Early Pregnancy Loss?
Spontaneous abortion (miscarriage) is pregnancy loss before 20 weeks gestation, while early pregnancy loss is a miscarriage that happens at less than 13 weeks gestation. (1)
Both can lead to spotting and bleeding.
What Are Three Symptoms & Signs Of Miscarriage?
- Heavy vaginal bleeding
- Abdominal cramping
- Sudden decrease in pregnancy symptoms, such as not feeling any fetal movement (in the second or third trimester)
What Color Is Miscarriage Blood?
- Bright red and may be accompanied by large clots
Threatened Abortion
This happens when the embryo has cardiac activity, and the cervix is closed, but some bleeding happens. Without immediate intervention, this can lead to a miscarriage. (1)
What’s An Ectopic Pregnancy?
Ectopic pregnancy happens when the fertilized egg implants outside the uterus, usually in the fallopian tube. (1)
The pregnancy isn’t viable and can be life-threatening to the pregnant woman if not detected early. The fallopian tube can burst, leading to internal hemorrhage (heavy bleeding).
Ectopic pregnancy happens in 1-2% of pregnancies in the US and accounts for 6% of maternal deaths. (1)
Molar Pregnancy
This happens when cells that are supposed to form a baby become a tumor. It’s a rare pregnancy complication but doesn’t usually lead to cancer. The best treatment is removing the molar pregnancy tumor cells. (5)
This kind of pregnancy can result in bleeding and doesn’t lead to the formation of healthy babies. (5)
Vaginal Infections & Other Unknown Causes
As much as 50% of abnormal vaginal bleeding, with or without pregnancy, might be caused by polyps. (6)
Endometrial polyps are abnormal growths that contain blood vessels, glands, and stroma (nerves, connective tissues, etc.) in the uterus lining (called the endometrium). (1)
Vaginal infections such as chlamydia, an STD (sexually transmitted disease), can also lead to bleeding and increase your risk of an ectopic pregnancy. (7)
Second & Third Trimesters: What Can Cause Spotting Or Bleeding Later In Pregnancy?
- Placental problems
- Preterm labor
- Start of labor
Let’s discuss each one below.
What Placenta Problems Can Cause Bleeding During Pregnancy?
These conditions can be life-threatening for both you and your unborn baby. Once diagnosed, your health care provider or OB-GYN (a doctor trained in obstetrics and gynecology) might recommend an emergency C-section.
Placental Abruption
This happens when the placenta (the structure that provides blood and nutrients to your baby) detaches from the wall of the uterus. It can lead to heavy bleeding and pregnancy loss. (4)(8)
Low-Lying Placenta (Placenta Previa)
Placenta previa happens when the placenta partially or fully covers your cervix. (4)(8)
Vasa Previa
This occurs when blood vessels connecting the placenta to your baby pass close to your cervix and are unprotected by the umbilical cord. They have a higher risk of rupturing. (8)
Is Bleeding A Sign Of Preterm Labor?
Preterm labor happens when you begin labor before 38 weeks gestation. This is characterized by vaginal bleeding, abdominal cramps, back pain, and labor contractions as early as 37 weeks. (4)
Time For Labor
Healthy pregnancies often culminate in labor and birth at around 38 weeks gestation. You can feel your water break or have bloody vaginal discharge as your body prepares for birth.
Things To Do If You Experience Abnormal Bleeding During Pregnancy
Warning Signs & When To See Your Doctor
Anytime you experience abnormal or heavy bleeding during pregnancy, call your doctor or rush to the emergency room.
Some miscarriages, spontaneous abortions, or pregnancy complications can still be prevented with early intervention.
Any heavy bleeding is a warning sign, but you might also experience the following:
- Fatigue or weakness
- Low heart rate
- Vomiting (more severe than morning sickness)
- Dizziness
- Fever
Things To Consider: What Your Doctor Needs To Know
Take note of the following:
- Type of bleeding (light or heavy)
- Blood color
- Clots or other discharge
- When did the bleeding stop or start?
- Estimated amount of discharged blood
- What happened before the vaginal discharge (internal exam, sexual intercourse, etc.)
- Other symptoms (fever, dizziness, fatigue, vomiting, etc.)
- Bleeding disorders
- Your blood type
What To Do if You Discharge More Than Blood
Call your doctor immediately or go to the ER. You might also consider taking the discharge for your doctor to check if this might be a sign of early miscarriage or other pregnancy complications.
Tests & Diagnosis
Your doctor might order an ultrasound to check the condition of your uterus, cervix, and embryo or fetus. (1)
Blood tests to check for hCG (human chorionic gonadotropin) levels will also help determine or identify a healthy or aborted pregnancy.
Preparing For Your Check-up
Questions To Ask
- Is my spotting normal?
- Is my pregnancy at risk?
- Am I bleeding too much, or is this just normal?
- Is it better to abstain from sexual intercourse until my baby is born?
Questions To Answer
Don’t feel embarrassed to answer questions that might seem private or personal because your answers can help your doctor diagnose your condition.
For example, your doctor might ask:
- When did you last have sex?
- Did you experience pain, bleeding, or spotting after sexual intercourse?
- Does your vaginal discharge fill your tampon, panty liner, or pads?
- What color is the discharge? Does it smell bad?
Risk Factors
A 2010 study concludes that women have a higher risk for pregnancy spotting or bleeding if: (2)(9)
- Older than 35 years
- Passive smoking exposure
- Prior preterm birth
- Multiple prior miscarriages or elective terminations
Treatment For Pregnancy Spotting & Bleeding
Home Remedies Or First Aid To Stop Pregnancy Bleeding
Don’t try home remedies to stop pregnancy bleeding unless your OB-GYN recommends them. If the bleeding is increasing quickly or you’re experiencing high levels of pain, call 911 and wait for the emergency responders to arrive.
Don’t try to clean up the mess or lift heavy things while waiting. It’s best to conserve your energy.
Avoid using a tampon. Instead, a pad or panty liner can help contain your bleeding.
Hospital Treatment
Options can include the following, depending on the situation: (9)
- Blood transfusion for massive blood loss
- Bed rest if delivery isn’t required
- Emergency C-section if needed
- Uterine massage
- Oxytocin or misoprostol treatment
- Surgical repair of ruptured fallopian tubes, uterus, or other affected organs
Finding Support After Pregnancy Loss
A miscarriage or pregnancy losscan be devastating. Find help from your family, wellness or support group, or your licensed OB-GYN, a member of the ACOG (American College of Obstetricians and Gynecologists).
FAQs
Can Stress Cause Spotting In Pregnancy?
Stress can make your hormones fluctuate, possibly leading to occasional spotting. (10)(11)
Studies show that oxidative stress (excessive levels of harmful free radicals in your body) can also lead to spotting and vaginal bleeding in the first trimester. (12)
Can Lack Of Sleep Cause Spotting?
Lack of sleep can also be stressful for your body, possibly leading to sporadic spotting. (13)
Can You Get A Positive Pregnancy Test When Spotting?
Yes. If spotting is caused by implantation bleeding, you will get a positive pregnancy test after a few days.
REFERENCES
(1) https://www.aafp.org/pubs/afp/issues/2019/0201/p166.html
(2) https://www.researchgate.net/publication/44663682_Patterns_and_Predictors_of_Vaginal_Bleeding_in_the_First_Trimester_of_Pregnancy
(3) https://www.memorialcare.org/blog/what-color-implantation-bleeding
(4) https://njperinatal.com/2017/03/normal-bleed-pregnancy/
(5) https://www.researchgate.net/publication/227697192_Molar_pregnancy
(6) https://journals.sagepub.com/doi/pdf/10.1177/2050312119848247
(7) https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm
(8) https://www.rcog.org.uk/for-the-public/browse-all-patient-information-leaflets/placenta-praevia-placenta-accreta-and-vasa-praevia/
(9) https://www.msdmanuals.com/home/women-s-health-issues/complications-of-labor-and-delivery/introduction-to-complications-of-labor-and-delivery
(10) https://mytexashealthcareobgyn.com/well-woman-care/can-abnormal-bleeding-be-caused-by-stress-3-ways-stress-affects-your-period/
(11) https://www.healthdirect.gov.au/vaginal-bleeding
(12) https://www.researchgate.net/publication/260150707_Role_of_Oxidative_Stress_on_Vaginal_Bleeding_during_The_First_Trimester_of_Pregnant_Women
(13) https://midcityobgyn.com/posts/womens-health/7-conditions-that-can-cause-sporadic-spotting-between-periods/
