Spotting During Pregnancy: What’s Normal?

Spotting During Pregnancy: What Is and Isn’t Normal?

January 25, 2019

Spotting During Pregnancy: What Is and Isn’t Normal?

Spotting During Pregnancy: What Is and Isn’t Normal?

Spotting during pregnancy is one of those things that can cause your stress level to skyrocket. It’s scary to see blood anytime outside of your period, but especially when you’re pregnant, and it’s easy to start imagining the worst.

But don’t panic just yet. It’s really common—one in four pregnant women will experience spotting during pregnancy, especially in their first trimester. And there are a number of reasons it occurs, many of them totally benign. Most women who experience spotting will go on to have completely healthy pregnancies.

What causes spotting during pregnancy?

There are a few main causes of pregnancy spotting. Some are concerning, but the good news is the majority of them don’t lead to major complications, are completely treatable and aren’t cause for alarm.

  • Irritation. Pregnancy can make your cervix more sensitive, making it more prone to irritation that can cause spotting during pregnancy. Types of irritations that can lead to spotting include a transvaginal ultrasound or a gynecological exam, heavy lifting or excessive exercise, or vaginal sex.
  • Infection. A cervical infection—also called cervicitis—is an inflammation of the cervix. These bacterial infections can often cause spotting during pregnancy. If this is the cause of your spotting, your doctor can prescribe treatment.
  • Implantation bleeding. This type of bleeding can occur after conception and a few days before your menstrual cycle, often around the time that the fertilized egg attaches to your uterine lining—otherwise known as implantation. The jury’s out on whether or not there’s a true scientific correlation between implantation and spotting during pregnancy, but about one-third of all pregnant women will experience it. And the good news is it’s totally harmless.
  • Cervical polyp. A harmless growth on the cervix, a cervical polyp can often cause pregnancy spotting. That’s because when you’re pregnant, there’s an increased number of blood vessels in the tissue around the cervix, and a greater likelihood of a bleed developing.
  • Subchorionic hematoma. A subchorionic hematoma is the accumulation of blood between the uterus and the placenta within the folds of the chorion (that’s the outer fetal membrane, next to the placenta). This condition can cause anything from light spotting during pregnancy to heavy bleeding. In most cases, it doesn’t affect the health of the pregnancy and will resolve on its own, but you should talk to your doctor if your spotting continues.
  • Miscarriage and ectopic pregnancy. Although the odds are in your favor that it’s not a serious issue (light episodes of pregnancy spotting, for instance, especially when they last for 1-2 days, are not associated with a higher risk of miscarriage), spotting during pregnancy can be a sign of something more serious. In the case of a miscarriage, unfortunately, there’s no way to know what’s going on without a visit to your doctor, as the amount of spotting doesn’t always correlate with whether or not you’re miscarrying. In the case of an ectopic pregnancy (when the fertilized egg attaches to a place other than inside the uterus, most often in the fallopian tubes), if you’re experiencing spotting along with other symptoms—one-sided abdominal pain, dizziness or weakness—you need to reach out to your doctor as soon as possible for monitoring and treatment.

Is spotting normal during pregnancy?

Spotting during pregnancy may be scary, but it’s not uncommon at all.

“At least 25 percent of women have some light bleeding, especially in the first trimester,” says Dr. Clara Ward, MD, maternal-fetal medicine physician with McGovern Medical School at UTHealth/UT Physicians in Houston. “While the experience may still be worrisome, fortunately, it is generally not serious and not likely to have a negative effect on the pregnancy.”

According to Dr. Ward, the most common time for pregnancy spotting to occur is during the first trimester. Later in the pregnancy, spotting can be a sign of a more serious complication, like placental abnormalities or preterm labor.

What does pregnancy spotting look like?

Spotting is different than bleeding, and it’s important to recognize the difference, especially when you’re pregnant.

Spotting is very light bleeding—when you notice a few drops of blood on your underwear, for instance, or if you wipe yourself with toilet paper and notice a bit of blood on the paper. The blood can range in color from pink to red to brown. Bleeding, on the other hand, is a much heavier flow of blood.

A good rule of thumb is to think about spotting vs. bleeding in terms of how much blood could fill a panty liner or pad. If you’re spotting, there should not be enough blood to cover a panty liner. If you’re bleeding, however, you’ll need a panty liner or a pad to keep the blood from soaking through to your underwear.

When should you contact your doctor?

It’s always a good idea to reach out to your doctor if you’re experiencing spotting during your pregnancy—or anything else that seems out of the ordinary.

Don’t be worried about bothering them or asking too many questions. According to Dr. Ward, it’s vital to always give your doctor a full description of your symptoms; it’s what helps your healthcare provider determine if you need further evaluation.

“Additional symptoms, such as cramping or fever, almost always warrant a call, even if the spotting is mild,” Ward says. “Pain or heavy bleeding that requires a pad requires immediate attention, as does any bleeding that occurs in the second or third trimesters, as these may be signs of a bigger problem.”

With all that, try to remember that spotting during pregnancy is common, and hopefully knowing what to look out for can help you feel better.

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