Spotting is usually a light amount of pink, red, or dark brown blood on your underwear. It’s lighter than your period and won’t cover a panty liner. During pregnancy, spotting is usually nothing to worry about.

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

It’s important to note that spotting different from heavier bleeding, where you’d need a pad or tampon to stop blood from soaking through your underwear. Seek emergency care if you experience heavy bleeding during pregnancy.

Let your doctor know if you notice spotting or bleeding at any time during pregnancy. They can determine whether 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 because some people with certain blood types require medication if they experience this at any time during their pregnancy.

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

According to the American College of Obstetricians and Gynecologists, about 15 to 20 percent of pregnant people experience bleeding in the first trimester.

In a 2010 study of 4,539 pregnant women, about 1 in 4 experienced bleeding during the first trimester. The study found that spotting was most commonly seen in the sixth and seventh weeks of pregnancy. It wasn’t always a sign of miscarriage or that something was wrong.

Spotting during the first 12 weeks of pregnancy 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 lodging into the wall of the uterus.

Not everyone will experience implantation bleeding, but for those who do, 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 or 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 you’re pregnant and experience brown or bright red bleeding with or without cramps, speak with 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 the 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 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 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 you’ll have difficulties getting pregnant in the future. It also doesn’t necessarily increase your risk for future miscarriages, though 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.

Unidentified causes and more

It’s also possible to have spotting for an unidentifiable reason. In early pregnancy you’re going through so many bodily changes.

In some people, changes to the cervix can cause mild spotting. Other times, hormonal changes may 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 with your doctor about any spotting during pregnancy. They can rule out more serious causes and put your mind at ease.

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 there.

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:

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 your safety and that of your baby.

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

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, also known as D and E.

A second or third-trimester miscarriage requires physical and emotional care. If you work outside your home, ask your doctor when you can return to your office or work site.

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.

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

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 fetus developing appropriately and to check for a heartbeat.

During early pregnancy, you may also need an hCG blood test. This tests for a standard 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 people experience implantation bleeding during early pregnancy. It’s also typical 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 people who experience spotting go on to have healthy pregnancies. Your doctor can help evaluate your symptoms.

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