Is Spotting in Early Pregnancy Normal?

Seeing blood at any point after receiving a positive pregnancy test can feel scary. After all, spotting and bleeding are common signs of miscarriage. If you're in early pregnancy, weeks 4 through 12, it's important and helpful to know that spotting is normal, common, and usually not a cause for concern. (However, you should always check with your midwife or OB if you experience spotting at any time in pregnancy, just to be on the safe side.) 

Reasons for Spotting in Early Pregnancy

Spotting in early pregnancy can occur for a couple of reasons. The most common reason for spotting is due to implantation. Often called "implantation bleeding" or "implantation spotting," this common symptom of early pregnancy happens when the fertilized egg implants or burrows into and attaches to the lining of the uterus -- a movement that disturbs blood vessels in the lining, which often causes spotting or light bleeding. 

Implantation spotting/bleeding is often characterized by the following:

• Light pink to dark brown in color
• No clots
• Small in amount, sometimes seen only when wiping and/or scant amounts on underwear/pantyliner
• Not enough to fill a pad, tampon, or menstrual cup
• Occurs 10-14 days after conception (~9 days after ovulation)
• Only lasts 1-2 days
• May be accompanied by other physical symptoms like faint cramping, low backache, breast tenderness

Other reasons for bleeding in early pregnancy include:

Cervical polyp - A harmless, non-cancerous growth on your cervix that, when disturbed or "bumped" (like, during sex or a vaginal exam), can cause spotting or light bleeding. 

Sexual intercourse / penetrative sex - Anything that penetrates the vagina is capable of bumping the cervix, which is extra sensitive and vascular during pregnancy and more prone to spotting or light bleeding when disturbed. 

Vaginal exam or vaginal ultrasound - For the same reasons listed above, these procedures can also cause spotting. 

Heavy lifting or too much exercise - Unusually strenuous activities can also cause spotting. If this is the case, you may need to reduce your physical activities. Contact your care provider to discuss. 

What Does Spotting Look Like?

Spotting has telltale characteristics that are different than bleeding that we would typically associate with menstrual/period blood and/or bleeding that indicates a more serious problem in pregnancy, like miscarriage. In general, spotting is:

• Light pink to brown in color
• Very small in amount
• No clots present
• May appear with stringy/sticky mucous
• Short in duration  (1-2 days) 

When Should I Be Concerned?

Bleeding that goes beyond the typical spotting classifications as listed above could be cause for concern and should be reported to your OB or midwife right away. Bleeding (different than spotting) in early pregnancy could signal a miscarriage, ectopic pregnancy, infection, or molar pregnancy. Spotting or bleeding that is accompanied by painful cramping/contractions, pelvic/abdomen pain, dizziness/feeling faint, or fever/chills is cause for you to contact your provider right away or visit the nearest ER during after office hours. 

Learn more about early pregnancy by taking an early pregnancy class with a Lamaze educator. 

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