Spotting in pregnancy

Noticing spotting or light bleeding during pregnancy can feel terrifying, but it isn’t always a sign that something is wrong. Many women who spot during pregnancy go on to deliver a healthy baby.

Spotting is considered a light or trace amount of pink, red, or dark brown (rust-colored) blood. You may notice spotting when you use the restroom or see a few drops of blood on your underwear. It will be lighter than your menstrual period. There won’t be enough blood to cover a panty liner.

During pregnancy, spotting can be caused by a number of factors. Spotting is different from heavier bleeding, where you’d need a pad or tampon to stop blood from getting on your clothing. Seek emergency care if you experience heavy bleeding during pregnancy.

When to call your doctor

Let your doctor know if you notice spotting or bleeding at any time during pregnancy. They can determine if you need to come in for monitoring or to be evaluated. They may ask you about other symptoms along with spotting such as cramping or a fever.

It’s also important to notify your doctor of vaginal bleeding, as some women with certain blood types require medication if they experience vaginal bleeding anytime during their pregnancy.

If you experience bleeding in your second or third trimester, let your doctor know right away or seek emergency medical care.

Spotting in the first trimester

About 25 percent of pregnant women are estimated to experience spotting during their first 12 weeks of pregnancy.

One study from 2010 found that spotting is most commonly seen in the sixth and seventh weeks of pregnancy. Spotting wasn’t always a sign of miscarriage or meant that something was wrong.

Spotting during the first trimester may be attributed to:

  • implantation bleeding
  • ectopic pregnancy
  • miscarriage
  • unknown causes

Here’s what you need to know about these possible causes:

Implantation bleeding

Implantation bleeding occurs 6 to 12 days following conception. It’s believed to be a sign that the embryo is implanting into the wall of the uterus. Not every woman will experience implantation bleeding, but for women who do experience it, it’s usually one of the first symptoms of pregnancy.

Implantation bleeding is usually light pink to dark brown. It’s different from your usual menstrual period because it’s only light spotting. You won’t be bleeding enough to need a tampon or to cover a sanitary pad. The blood also won’t drip into the toilet when you use the restroom.

Implantation bleeding lasts for a few hours, up to 3 days, and will stop on its own.

Ectopic pregnancy

An ectopic pregnancy is a medical emergency. It occurs when the fertilized egg attaches itself outside the uterus. Light to heavy vaginal spotting or bleeding can be a symptom of an ectopic pregnancy.

Bleeding or spotting during an ectopic pregnancy is usually experienced along with:

  • sharp or dull abdominal or pelvic pain
  • weakness, dizziness, or fainting
  • rectal pressure

Contact your doctor immediately if you experience these symptoms.

Early pregnancy loss or miscarriage

Most miscarriages occur in the first 13 weeks of pregnancy. If you know that you’re pregnant and experience brown or bright red bleeding with or without cramps, speak to your doctor.

With a miscarriage, you may also notice the following symptoms:

  • mild to severe back pain
  • weight loss
  • white-pink mucus
  • cramping or contractions
  • tissue with clot-like material passing from your vagina
  • a sudden decrease in pregnancy symptoms

Once a miscarriage has started, there’s very little that can be done to save the pregnancy. You should still call your doctor, though, so that they may rule out ectopic pregnancy or another complication.

Your doctor will likely do two or more blood tests to check your pregnancy hormone levels. This hormone is called human chorionic gonadotropin (hCG).

The tests will be 24 to 48 hours apart. The reason you’ll need more than one blood test is so that your doctor can determine if your hCG levels are declining. A decline in hCG levels indicates a pregnancy loss.

Having a miscarriage doesn’t mean that you’ll have difficulties getting pregnant in the future. It also doesn’t increase your risk for future miscarriages, although it may if you’ve already had multiple miscarriages.

It’s important to note that a miscarriage is also generally not caused by something you did or didn’t do. Studies show that miscarriages are common and happen in up to 20 percent of people who know they’re pregnant.

Unidentified causes and more

It’s also possible to have spotting for an unidentifiable reason. In early pregnancy your body is going through many changes. Changes to your cervix can be responsible for mild spotting in some women. Hormonal changes may also be responsible.

You may also experience mild spotting after sexual intercourse or if you’re very active.

Infection is another possible cause for spotting, which is why it’s important to talk to your doctor about spotting during pregnancy. They can rule out more serious causes.

Spotting during the second trimester

Light bleeding or spotting during the second trimester may be caused by irritation to the cervix, usually after sex or a cervical exam. This is common and not usually cause for concern.

A cervical polyp is another possible cause for bleeding in the second trimester. This is a harmless growth on the cervix. You may have spotting from the area around the cervix due to an increased number of blood vessels in the tissue around the cervix.

If you experience any vaginal bleeding that’s heavy like a menstrual period, let your doctor know right away. Heavy bleeding in the second trimester may be a sign of a medical emergency, such as:

Spotting during the third trimester

Light bleeding or spotting during late pregnancy may occur after sex or a cervical exam. This is common and not usually cause for concern. It can also be due to a “bloody show,” or a sign that labor is starting.

If you experience heavy vaginal bleeding during late pregnancy, seek emergency medical care. It could be caused by a:

Timely emergency care is necessary for the safety of you and your baby.

If you experience a lighter flow or light spotting, you should still call your doctor right away. Depending on your other symptoms, you may need an evaluation.

Signs of a miscarriage

First trimester

Most miscarriages occur in the first 13 weeks of pregnancy. About 10 percent of all clinically recognized pregnancies end in miscarriage.

Let your doctor know if you experience vaginal spotting or bleeding that doesn’t stop on its own after a few hours. You may also experience pain or cramping in your lower back or abdomen, or fluid or tissue passing from your vagina along with the following symptoms:

  • weight loss
  • white-pink mucus
  • contractions
  • a sudden decrease in pregnancy symptoms

In the early weeks of pregnancy, your body may expel fetal tissue on its own and not require any medical procedure, but you should still let your doctor know if you think you’re experiencing or have experienced a miscarriage. They can make sure that all of the tissue has passed, as well as do a general check to make sure everything’s fine.

Further along in the first trimester, or if there are complications, you may require a procedure called dilation and curettage — commonly called a D and C — to stop bleeding and prevent infection. It’s important to also care for yourself emotionally during this time.

Second and third trimester

Symptoms of a late pregnancy miscarriage (after 13 weeks) include:

  • not feeling movement of the fetus
  • vaginal bleeding or spotting
  • back or abdominal cramping
  • unexplained fluid or tissue passing from the vagina

Let your doctor know if you’re experiencing these symptoms. If the fetus is no longer alive, you may be given medication to help you deliver the fetus and placenta vaginally or your doctor may decide to surgically remove the fetus using a procedure called dilation and evacuation (D and E).

A second or third-trimester miscarriage requires physical and emotional care. Ask your doctor when you can return to work. If you think you need more time for emotional recovery, let your doctor know. They may be able to provide documentation to your employer to allow you to take additional time off.

If you plan to get pregnant again, ask your doctor how long they recommend you wait before trying to conceive again.

Finding support

Experiencing a miscarriage can be devastating. Know that a miscarriage is not your fault. Lean on family and friends for support during this difficult time.

You can also find a grief counselor in your area. Allow yourself as much time as you need to grieve.

Many women go on to have healthy pregnancies following a miscarriage. Talk to your doctor when you’re ready.

How will your doctor diagnose spotting?

If you experience spotting that isn’t implantation bleeding or that doesn’t stop on its own after a few hours, your doctor may recommend you come in for an evaluation. They’ll likely perform a vaginal exam to assess the amount of bleeding. They may also take an abdominal or vaginal ultrasound to confirm a healthy, normally developing fetus and to check for a heartbeat.

During early pregnancy, you may also need a human chorionic gonadotropin (hCG) blood test. This tests for a normal pregnancy and can help diagnose an ectopic pregnancy or rule out a potential miscarriage. Your blood type will also be confirmed.


Spotting during pregnancy isn’t always cause for alarm. Many women experience implantation bleeding during early pregnancy. It’s also normal to experience some spotting after sex, for example.

Let your doctor know if the spotting doesn’t stop on its own or gets heavier. Also let your doctor know if you experience other symptoms along with spotting, such as cramps, backache, or a fever.

Remember that many women who experience spotting go on to have healthy pregnancies. Your doctor can help evaluate your symptoms.

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