Light spotting can be common in early pregnancy, but tell your provider. Heavy bleeding or pain needs urgent care.
Early pregnancy
About 20% of women have spotting or bleeding in the first trimester. Most go on to have healthy pregnancies.
Causes
- Implantation.
- Cervical changes.
- Infection.
- Subchorionic hematoma.
- Miscarriage or ectopic pregnancy.
Always tell your provider
Any bleeding in pregnancy should be reported.
Emergency
Heavy bleeding, severe pain, dizziness or tissue passing. Call 911.
Later pregnancy
Bleeding can signal placenta problems.
Early and late patterns
About 15 to 25 percent of pregnant women have bleeding or spotting in the first trimester, and roughly half of those pregnancies continue without problems. Causes include implantation, cervical irritation, subchorionic hematoma, infection, miscarriage and ectopic pregnancy. In the second and third trimesters, bleeding is less common and needs prompt evaluation.
- Placenta previa and placental abruption cause painless or painful bleeding in later pregnancy.
- Bleeding with a cervix that is opening may signal preterm labor.
- Light “bloody show” with mucus plug passage near term can precede labor.
What to do
Report any bleeding to your provider. Use a pad and note the color and amount. Rh-negative women may need Rho(D) immune globulin. Go to the emergency department for heavy bleeding (soaking a pad per hour), bleeding with pain, dizziness, fever or fluid leaking. Avoid tampons, douching and intercourse until a provider advises.
Early and late patterns
Light bleeding affects 15 to 25 percent of early pregnancies. Late pregnancy bleeding can reflect placenta previa, abruption or labor. Bleeding after 20 weeks is more concerning.
What to do
Contact a provider for any bleeding. Go to emergency care for heavy bleeding, pain or dizziness. Rh negative women may need injections.
Types and frequency
Light bleeding or spotting occurs in about 15 to 25 percent of pregnancies in the first trimester, and many go on to have healthy babies. Causes include implantation, cervical changes, infection and subchorionic hematoma. Bleeding can also signal miscarriage, ectopic pregnancy (a medical emergency) or molar pregnancy.
When to get help
Any bleeding in pregnancy should be reported to a clinician. Go to emergency care for heavy bleeding that soaks a pad within an hour, severe abdominal or shoulder pain, dizziness or fainting, or passing tissue. In later pregnancy, bleeding can be from placenta previa or placental abruption, which are emergencies. Providers may check an ultrasound, hCG levels and blood type, since Rh negative mothers need Rh immune globulin. Avoid inserting anything into the vagina until evaluated. This is general information, not a diagnosis.
Based on data from the American College of Obstetricians and Gynecologists and the Mayo Clinic
