Light spotting is fairly common in early pregnancy, but tell your provider. Heavy bleeding or pain needs urgent care.
How common
About 20% of pregnant women have spotting in the first trimester.
Causes
- Implantation bleeding.
- Cervical changes.
- Infection.
- Subchorionic hematoma.
- Miscarriage or ectopic pregnancy.
Tell your provider
Always report bleeding.
Emergency
Heavy bleeding, severe pain, dizziness or tissue passing. Call right away.
Many outcomes
Most women with spotting have healthy pregnancies.
Frequency and timing
Spotting occurs in roughly 15 to 25 percent of pregnancies in the first trimester, according to ACOG. Light spotting at implantation, about 6 to 12 days after conception, is common. Later spotting may follow sex or cervical exams because the cervix is more sensitive.
- Causes include implantation bleeding, cervical changes, infections and subchorionic hematoma.
- More serious causes include miscarriage, ectopic pregnancy and molar pregnancy in early weeks, and placenta previa or abruption later.
- Spotting is light blood that does not fill a pad, while bleeding that soaks a pad is heavier.
What to do
Tell your provider about any bleeding. Use a pad to track amount and color. Rh-negative women may need an anti-D immunoglobulin injection after bleeding, which prevents complications in later pregnancies. Go to the emergency department for heavy bleeding, severe pain, fainting, shoulder pain or passing tissue. Roughly half of women with first trimester bleeding go on to have a healthy pregnancy.
Frequency and timing
Light bleeding or spotting happens in about 15 to 25 percent of pregnancies in the first trimester, according to the American College of Obstetricians and Gynecologists. Causes include implantation, cervical changes, infection, or more serious issues such as miscarriage or ectopic pregnancy. Bleeding in later pregnancy can be caused by placenta previa or placental abruption, which are emergencies.
What to do
Contact a healthcare provider about any bleeding in pregnancy. Go to emergency care for heavy bleeding, cramping, dizziness, shoulder pain or tissue passing. Avoid intercourse and tampons until evaluated. A provider may do an ultrasound and blood tests for hCG and Rh type. Rh negative mothers may need an anti-D injection.
Causes by trimester
First trimester spotting arises from implantation, hormonal changes, cervical irritation after sex or exams and polyps. Heavier bleeding with cramps suggests miscarriage. Second and third trimester bleeding can be placenta previa (about 1 in 200 pregnancies), abruption (about 1 in 100) or preterm labor.
What providers do
An exam, ultrasound and blood tests check hCG, blood type and hemoglobin. Rh negative women need anti-D immune globulin after bleeding. Avoid tampons, douching and sex until cleared. Seek emergency care for soaking more than one pad per hour, severe pain or tissue passage.
Based on data from the American College of Obstetricians and Gynecologists
