Spotting when pregnant: is it normal?

Spotting when pregnant: is it normal?

While spotting or bleeding during pregnancy is normal, it is certainly unexpected and unnerving. In this article, you will learn the causes of bleeding during pregnancy, know when it is serious and what to do if it happens to you.


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We all know that any bleeding during pregnancy is terrifying, especially for the moms that are pregnant for the first time. Thankfully, light bleeding or spotting in early pregnancy that is not heavy like a menstrual period, occurs for nearly one-third of all mom-to-be and often poses no threat to either mom or baby.


For instance, it is common for a few pregnant women to have spotting after intercourse, while others may have bleeding for reasons that have nothing to do with pregnancy, such as tears to the vaginal wall or infections.


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Alyssa Stephenson-Famy, M.D., Maternal-Fetal Medicine Specialist at the University of Washington says, “The vast majority of spotting is harmless.” But bleeding or spotting, no matter how small, can be indicative of a variety of complications, including placenta previa, ectopic pregnancy and miscarriage. Thus you should never ignore it.


Spotting when pregnant: is it normal?

Causes of spotting or bleeding in the first 20 weeks

According to Dr. Stephnson-Famy, it has been estimated that 25-40 percent of women will experience some vaginal bleeding during early pregnancy and more often than not the pregnancy will progress completely normally.


America Pregnancy Association says, “There are a number of possible causes of innocuous bleeding or spotting in the first half of pregnancy.” Some of them include:


1. Implantation bleeding

The implanting of the egg in the uterus occurs about 4 weeks into the pregnancy as the fertilized egg attaches to the uterine wall. If you see a small amount of bleeding about one week to 10 days after conception, it is likely caused by implantation bleeding and it is nothing to worry about.


2. Infections

The infection causes cervical bleeding in some women – usually a sexually transmitted disease like Chlamydia. The underlying condition here has to be treated.


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3. Sexual intercourse

During the second and third trimester, the cervix of a pregnant woman becomes swollen because of the increased blood supply in the area. So, when you have vigorous intercourse, it may cause spotting during pregnancy.


4. Internal exam done by your midwife or obstetrician

It isn’t uncommon to bleed after a pelvic exam or Pap smear, which in many practices is conducted between the sixth and twelfth week of pregnancy. Bleeding may occur within 24 hours after the visit and usually goes away within a day.


Bleeding during the first half of pregnancy can be a sign of a more serious condition

  • Chemical pregnancy: This occurs when an egg is fertilized not fully implants in the uterus.


  • Subchorionic hemorrhage: This is bleeding around the placenta. When this occurs, it is possible to continue with a normal pregnancy but prompt diagnoses and treatment is necessary. Dr. Stephenson-Famy says, “Most subchorionic hemorrhages resolve, but it does put the woman at an increased risk for other complications like preterm labor.”


  • Miscarriage (imminent or threatened): This is the spontaneous loss of pregnancy in the first 20 weeks. Spotting or bleeding which occurs during a miscarriage often accompanied by other symptoms like abdominal pain or cramping.


  • Molar pregnancy: This is a nonviable pregnancy characterized by an abnormal placenta growth, and usually an abnormal fetus.


  • Ectopic pregnancy: This occurs when a fertilized egg implants in a place which is not the uterus, most often in the fallopian tube. Also known as a tubal pregnancy, ectopic pregnancy can’t progress normally and may threaten the life of the mother if it is not diagnosed.


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Causes of spotting or bleeding past 20 weeks

Although after the first 20 weeks the risk of miscarriage or stillbirth diminishes after the first trimester, along with several early complications such as molar and ectopic pregnancy, bleeding during the second half of pregnancy should be taken seriously, especially if it is ongoing.


Causes of bleeding or spotting in the second half of pregnancy are:

  • Cervical checks: This can cause bleeding late in the third trimester when they become more frequent.


  • Sexual intercourse


  • Preterm labor: This is a situation where vaginal bleeding is accompanied by contractions, cramping, pelvic pressure, back pain or diarrhea before 37 weeks. It could have serious repercussions for the baby if not managed. The symptoms could be a normal beginning to labor after 37 weeks.


  • Placental abruption: This is a situation in which the placenta tears away from the wall of the uterus. It could cause severe vaginal bleeding and become life-threatening to mother and baby. This condition is the most common cause of serious bleeding during late pregnancy but it is rare as it occurs only in about 1% of all pregnancies.


How to know when bleeding or spotting during pregnancy is serious

Vaginal bleeding during pregnancy isn’t uncommon, but it is also usually not normal. It can mean many things, depending on whether it is light or heavy, what color it is, at what point of the pregnancy and how long it lasts.


Signs that bleeding is due to serious conditions like preterm labor, problems with the placenta or miscarriage, include heavy bleeding, bleeding in conjunction with cramps or/and fever, or bleeding and passing some tissue.


The blood color is also vital. Blood that is bright red is usually more worrisome than brownish blood.


Spotting when pregnant: is it normal?

When to see your doctor when you are bleeding or spotting during pregnancy

No matter the time it occurs, even if have less than a dime-size spot of blood, call your midwife or doctor immediately to be safe, because any vaginal bleeding during pregnancy can mean a symptom of a bigger problem.


You will be asked about the amount of blood you have lost and the description of how you are feeling overall. Your practitioner will tell you if there is a cause for concern. If there is a cause for concern, she may want to monitor the situation.


If the bleeding is due to a miscarriage, there is nothing your doctor can do about it. However, if the spotting is due to preterm labor, there are steps your doctor can take to prevent it such as recommending medication or bed rest.


If the bleeding or spotting is due to placenta previa, which is a condition where the placenta covers the mouth of the uterus, doctor may put you on modified bed rest.


The bottom line

It is not abnormal for you to bleed during pregnancy, but it can be a sign of serious concern. That is why you need to see your doctor whenever you bleed to confirm it is not something serious.

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