What should I do if I notice spotting or bleeding during pregnancy?
Call your doctor or midwife right away, even if the bleeding seems to have stopped. While it may turn out to be something minor, it could be a sign of a serious problem. What your healthcare practitioner does next will depend on your individual situation.
You'll probably need an evaluation, which may include a physical exam, an ultrasound, and blood tests, to make sure you and your baby are fine and to rule out any complications.
If you're actively bleeding or have severe pain of any kind and can't immediately reach your practitioner, head straight for the emergency room.
How is spotting different from bleeding during pregnancy?
Spotting is very light bleeding, similar to what you may have at the very beginning or end of your period. It can vary in color from pink to red to brown (the color of dried blood).
What can cause spotting or bleeding during pregnancy?
It's not always possible to determine the reason behind prenatal spotting or bleeding. Here are some of the most common causes:
Sex. More blood flows to your cervix during pregnancy, so it's not unusual to notice spotting after intercourse. A cervical polyp (a benign growth on the cervix) can also cause spotting or bleeding after sex.
Pap smear or internal exam. You may have spotting after you've had a Pap smear or internal exam for the same reasons – greater blood flow to the cervix or a cervical polyp.
Miscarriage or ectopic pregnancy. Spotting or bleeding in the first trimester, especially if accompanied by abdominal pain or cramping, can be an early sign of miscarriage or an ectopic pregnancy (when the embryo implants outside the uterus, usually in one of the fallopian tubes). An ectopic pregnancy can be life-threatening, which is one of the reasons it's important to let your practitioner know immediately if you have bleeding or pain in your first trimester.
Up to a quarter of pregnant women have some spotting or bleeding in early pregnancy, and about half of these women miscarry. But if you have an ultrasound that shows a normal heartbeat between 7 and 11 weeks, your chances of continuing the pregnancy are greater than 90 percent.
Infection. Spotting can also be caused by conditions unrelated to pregnancy. A vaginal infection (such as a yeast infection or bacterial vaginosis) or a sexually transmitted infection (such as trichomoniasis, gonorrhea, chlamydia, or herpes) can cause your cervix to become irritated or inflamed. An inflamed cervix is particularly prone to spotting after sex or a Pap smear.
Placental problems or premature labor. In the second or third trimester, bleeding or spotting can be a sign of a serious condition such as placenta previa or placenta accreta, placental abruption (in which the placenta separates from the uterus), a late miscarriage (between 13 weeks and midpregnancy), or premature labor (which can happen between midpregnancy and 37 weeks).