Is Spotting Normal During Pregnancy?

Spotting during pregnancy can be very scary and cause all kinds of concern, so here’s the short answer: yes. Some spotting during pregnancy is completely normal, and the occurrence of spotting and/or light bleeding doesn’t automatically mean you’re going to have a miscarriage.

That said, spotting can be an indication of problems, so how do you know when to worry? And how do you know when to get your healthcare provider involved?

In this article we’ve rounded up everything you need to know about spotting during pregnancy— why it happens, when it usually happens, and when it’s a cause for concern. Armed with this information, we hope you’ll be able to put your mind at ease, and get back to your main priority: taking care of yourself and your growing child.

Spotting: A Common Experience

Jill was enjoying a Major League Baseball game one October afternoon when she noticed she had begun to spot.

“My heart sank,” she recalls. “My first thought was ‘Oh no, here we go again.’” After suffering through a miscarriage seven months prior, Jill had felt much more optimistic about her current pregnancy. Eight weeks in, her symptoms were strong, she had gotten A+ results on all of her early wellness checks, and she hadn’t been plagued with the headaches and weakness she had felt during the earlier pregnancy, which had ended at seven weeks.

“I though that everything in this new pregnancy was going right, and I thought I was able to leave the experience of my miscarriage behind me—but all it took was a few spots of blood, and the fear and anxiety all came flooding back.”

While frightening, Jill’s experience wasn’t all that unusual. According to the American Pregnancy Association, 20 to 30 percent of pregnant women experience some form of bleeding during their first trimester, and about half of those women will go on to have a normal pregnancy. Only 15 to 20 percent of pregnancies end in miscarriage, so even for those experiencing vaginal bleeding, the odds of avoiding a miscarriage are still heavily in their favor.

As further reassurance, a 2009 medical study found that “spotting or light bleeding episodes, especially [in] those without pain and lasting only a day or two, do not increase the risk of miscarriage above baseline risk, i.e. the risk for women with no bleeding.” Meaning a woman who does experience a brief episode of spotting or light bleeding is statistically at no higher risk for losing her pregnancy than a woman who never bleeds at all—a huge comfort to hear when the fear factor is high.

Of course, all of this data doesn’t mean that spotting in early pregnancy isn’t an unsettling experience. It’s important to arm yourself with information on how and why spotting happens so that you can feel confident assessing when bleeding might be a cause for concern.

Spotting: What It Is and Why It Happens

Spotting is typically defined as intermittent bleeding that occurs outside of the regular menses period. Very light, it may only appear as a few drops of blood on underwear or on a pad, and it is almost never accompanied by the typical menstrual symptoms. Light bleeding might be more substantial than spotting, but still less than the output experienced during a normal period. If it only needs a pantyliner to contain the flow, that’s light bleeding.

Both spotting and light bleeding can be experienced during early pregnancy, as the body shifts gears and gets all systems aligned for the rigors of growing a child. In all of this frenetic activity, a few biological conditions make the likelihood of early-pregnancy bleeding much higher.

Prime culprits include:

• Implantation bleeding. After fertilization, it’s not uncommon for some spotting or light bleeding to occur when the egg nestles itself into the blood-rich surroundings of the uterus. Called implantation bleeding, this type of spotting commonly occurs just after conception, often before a woman even knows she’s pregnant; in fact, many women can mistake this bleeding for an unusually light period, as it happens around when menstruation would be expected to start.

• Hormonal changes that make the cervix more sensitive, and more prone to bleeding. The flood of hormones that accompany pregnancy brings a substantial increase in blood flow to the cervix, making it softer and enriching it with delicate blood vessels that can easily burst. This means that any activity that disturbs the cervix—sexual intercourse, intense physical exercise, or even just a routine internal/physical exam—can burst those vessels and cause some light bleeding. This bleeding is typically very light and usually stops within 1-2 days.

As you can see, transitional changes brought on by pregnancy hormones can up the chances of spotting or light bleeding early in pregnancy, which is why temporary bleeding in the first trimester is often of no concern.

When to Worry and When to Contact Your Doctor

In general, the earlier in the pregnancy and the lighter the bleeding, the less reason for concern. As your pregnancy progresses, however, even light bleeding should be reported to your healthcare provider within a short timeframe, as potential complications escalate the closer you move towards birth.

Helpful details from the Mayo Clinic summarize how to react to bleeding throughout your pregnancy, and when you should call your doctor. In brief:

• Light bleeding or spotting that occurs in the first trimester and disappears within a day should be mentioned at your next appointment.
• After the first trimester, inform your doctor within 24 hours of any light bleeding that occurs.
• Heavy bleeding or bleeding accompanied by pain, cramping, fever, or chills that occurs anytime during your pregnancy is urgent, and you should contact your doctor immediately.

In addition to the above, remember to listen to your gut. If you have a nagging feeling that something is wrong, or if you’re having a hard time quieting your fears, check in with your doctor and let them know what’s going on. Sometimes all it takes is a quick exam or a few calming words to give you peace of mind.

Taking It In Stride

Jill knows firsthand that it’s easy to get swept away in a panic if spotting or bleeding starts during early pregnancy. But learning about the warning signs of miscarriage and the normalcy of spotting/light bleeding in pregnancy can help clear away the fear.

“When I was at that baseball game and I first saw the blood, all I wanted to do was cry,” she remembers. “But after taking a few deep breaths, I realized that although I was spotting, I wasn’t experiencing any of the painful cramping or nausea I had felt during my recent miscarriage. In fact, I felt perfectly fine! The spotting was very light and only went on for about an hour before it stopped altogether. I was on pins and needles waiting to see if the situation would get worse, but it never did. A quick check with my OB/GYN a few days later proved that everything was fine, and she reassured me that the pregnancy looked strong.”

Happily, Jill gave birth to a healthy ten-pound baby boy the following spring. She’ll never forget the anxiety and fear that plagued that day when she was spotting, but being well-informed helped her avoid unnecessary anxiety and stress. Armed with the above information, we hope you can take the normal occurrence of spotting during pregnancy in stride as well.