Spotting or Light Bleeding in Pregnancy: What Should You Do?
Light bleeding in pregnancy often has a harmless cause, but you should always tell your doctor so the cause can be checked.
In this article 5 sections
If you notice light bleeding or spotting during pregnancy, try not to panic: note how much blood there is and any other symptoms, and tell your doctor as soon as possible. Light bleeding in early pregnancy often has a harmless cause and the pregnancy continues normally, but sometimes it can signal a serious problem, so the cause needs to be checked. In the video, Dr Sharmin Afroz briefly explains this topic.
01Causes of bleeding in early pregnancy
Some common causes of light bleeding in the first three months (first trimester) include:
- Implantation bleeding: a little bleeding can occur as the embryo settles into the wall of the womb, usually around the time a period would have been due.
- Changes in the cervix: blood flow to the cervix increases in pregnancy, so light bleeding may follow sex or an internal examination.
- Infection: infection of the vagina or cervix can cause blood-stained discharge.
- Threatened miscarriage: even with bleeding, many pregnancies continue, but monitoring is needed.
- Ectopic pregnancy: when the pregnancy grows outside the womb, usually in a fallopian tube, there may be light bleeding with one-sided tummy pain. This is an emergency.
- Molar pregnancy: this is uncommon and is identified on ultrasound.
02Bleeding later in pregnancy
Any bleeding in the second or third trimester must be taken seriously. It may be due to a low-lying placenta (placenta praevia), the placenta partly separating from the womb wall (placental abruption) or early labour. Bleeding at this stage means going straight to hospital rather than waiting.
03What to do right away
- Try to stay calm and use a sanitary pad, not a tampon.
- Note the amount and colour (red or brown), whether there are clots and whether you have pain.
- Contact your doctor, who will decide the next steps based on how far along you are and your symptoms.
- Avoid sex while you are bleeding.
- Do not take any medicine or injection on your own.
- If your blood group is Rh negative, make sure your doctor knows, as in some situations a preventive injection may be needed to protect the baby.
04What checks your doctor may do
Usually a physical examination, an ultrasound (often a vaginal scan in early pregnancy) and, if needed, a blood test for the pregnancy hormone (beta-hCG) are done. These show whether the pregnancy is inside the womb, whether there is a heartbeat and where the placenta lies. There is no good evidence that strict bed rest prevents miscarriage, but it is sensible to avoid heavy work and follow your doctor’s advice.
It is completely natural to feel worried or frightened when bleeding happens. Support from family, without blaming the mother, matters a great deal at this time. If you have any questions, ask your doctor openly.
When to see a doctor
Tell your doctor about any bleeding. Go to hospital without delay if you have any of the following:
- Heavy bleeding, soaking a pad within an hour or passing large clots
- Severe lower tummy pain, especially on one side, or pain in the shoulder tip
- Dizziness, fainting or a racing heart
- Fever or a foul-smelling discharge
- Any amount of bleeding in the middle or later part of pregnancy
- Leaking fluid or reduced baby movements
Q & A
Frequently asked questions
It is fairly common in early pregnancy and often has a harmless cause. Still, tell your doctor so the cause can be checked.
Brown discharge is usually old blood and is often not serious. If it comes with pain or keeps happening, seek medical advice.
There is no good evidence that strict bed rest prevents miscarriage. Avoid heavy work and follow your doctor's specific advice.
The cervix is more sensitive in pregnancy, so this can happen. Avoid sex until the bleeding stops and let your doctor know.
Article & video by
Dr. Sharmin Afroz
Obstetrics, Gynaecology & Infertility Specialist and Laparoscopic Surgeon
Assistant Professor, Department of Obstetrics & Gynaecology, Anwer Khan Modern Medical College & Hospital.
