Bleeding and spotting from the vagina during pregnancy
Bleeding and spotting from the vagina during pregnancy are common. Up to half of all pregnant women have some bleeding or spotting during their pregnancy.
Bleeding and spotting in pregnancy don’t always mean there’s a problem, but they can be a sign of miscarriage or other serious complications. Miscarriage is when a baby dies in the womb before 20 weeks of pregnancy.
Call your health care provider if you have any bleeding or spotting, even if it stops. It may not be caused by anything serious, but your provider needs to find out what’s causing it.
What’s the difference between bleeding and spotting?
Bleeding or spotting can happen anytime, from the time you get pregnant to right before you give birth. Spotting is light bleeding. It happens when you have a few drops of blood on your underwear. Spotting is so light that the blood wouldn’t cover a panty liner. Bleeding is when the blood flow is heavier, enough that you need a panty liner or pad to keep the blood from soaking your underwear and clothes.
What should you do if you have bleeding or spotting during pregnancy?
Call your health care provider and do these things:
- Keep track of how heavy your bleeding is, if it gets heavier or lighter, and how many pads you are using.
- Check the color of the blood. Your provider may want to know. It can be different colors, like brown, dark or bright red.
- Don’t use a tampon, douche or have sex when you’re bleeding.
Call your health care provider right away or go to the emergency room if you have:
- Heavy bleeding
- Bleeding with pain or cramping
- Dizziness and bleeding
- Pain in your belly or pelvis
What causes bleeding or spotting early in pregnancy?
It’s normal to have some spotting or bleeding early in pregnancy. Bleeding or spotting in the first trimester may not be a problem. It can be caused by:
- Having sex
- An infection
- Implantation. When a fertilized egg (embryo) attaches to the lining of the uterus (womb) and begins to grow.
- Hormone changes. Hormones are chemicals made by the body.
- Changes in your cervix. The cervix is opening to the uterus that sits at the top of the vagina.
Sometimes bleeding or spotting in the first trimester is a sign of a serious problem, like:
- Miscarriage. Almost all women who miscarry have bleeding or spotting before the miscarriage.
- Ectopic pregnancy. This is when a fertilized egg implants itself outside of the uterus and begins to grow. An ectopic pregnancy cannot result in the birth of a baby. It can cause serious, dangerous problems for the pregnant woman.
- Molar pregnancy. This is when a mass of tissue forms inside the womb, instead of a baby. Molar pregnancy is rare.
What causes bleeding or spotting later in pregnancy?
Bleeding or spotting later in pregnancy may be caused by:
- Having sex
- An internal exam by your health care provider
- Problems with the cervix, like an infection or cervical insufficiency. This is when a woman’s cervix opens too early.
Bleeding or spotting later in pregnancy may be a sign of a serious problem, like:
- Preterm labor. This is labor that happens too early, before 37 weeks of pregnancy.
- Placenta previa. This is when the placenta lies very low in the uterus and covers all or part of the cervix.
- Placental abruption. This is when the placenta separates from the wall of the uterus before birth.
- Uterine rupture. This is when the uterus tears during labor. This happens very rarely. It can happen if you have a scar in the uterus from a prior cesarean birth (also called c-section) or another kind of surgery on the uterus. A c-section is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus.
How are bleeding and spotting treated?
Your treatment depends on what caused your bleeding. You may need a medical exam and tests.
Most of the time, treatment for bleeding or spotting is rest. You may need to take time off from work and stay off your feet for a little while. You may need medicine to help protect your baby from Rh disease. Rh disease is when your blood and baby’s blood are incompatible (can’t be together). This disease can cause serious problems — even death — for your baby.
See also: Miscarriage, Ectopic and molar pregnancy
Last reviewed April 2014
Frequently Asked Questions
What is mononucleosis?
Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.
You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:
- Achy muscles
- Belly pain
- Fatigue (feeling tired all the time)
- Sore throat
- Swollen glands in your neck
If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.
There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.
Can Rh factor affect my baby?
The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.
If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.
If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.
I had a miscarriage. How long should I wait to try again?
Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.
Are gallstones common during pregnancy?
Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.