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Is spotting during pregnancy normal?

Spotting is light bleeding from the vagina similar to, but lighter than, a period. It varies in colour from red to brown.

While it’s not exactly normal, light bleeding or spotting during pregnancy – particularly during the first three months – is fairly common. It’s estimated that about 15 to 25 per cent of women experience some sort of bleeding in the first trimester.

Often it turns out to be caused by something minor or “just one of those things”. However, it can be a sign of a more serious condition that could put you and your pregnancy at risk. This is why it’s always best to take any bleeding in pregnancy seriously and get the bleeding checked out.

What causes bleeding during early pregnancy?

There are many causes for spotting or bleeding early in pregnancy, some of which are more of a concern than others. Two common causes of early bleeding, which usually clear up on their own without any problems are:

• “Breakthrough” bleeding – the hormones that control your menstrual cycle can cause breakthrough bleeding when your period would have been due. Some women experience this sort of bleeding more than once during their pregnancy, generally at times that fitted their previous menstrual cycle.

• “Implantation” bleeding – when the fertilised egg attaches itself to the wall of the uterus causing bleeding. You may experience some spotting or light bleeding, which usually lasts a day or two.

Another much rarer cause of bleeding is a molar pregnancy. This happens when the embryo doesn’t develop properly but some of the cells that form the placenta continue to grow abnormally. For your safety, both molar and ectopic pregnancies have to be removed as soon as possible.

Bleeding can also be a sign of an underlying condition, which may need treating or for you to take precautions during the rest of your pregnancy. Bleeding can be caused by:

• An irritated or inflamed cervix – pregnancy hormones can change the surface of the cervix (the lower section and entrance to your uterus) making it more likely to bleed. You may bleed a bit after sex or a cervical smear, for instance.

• A cervical or vaginal infection.

• A cervical polyp – a small, benign growth that has formed on the cervix.

• Fibroids – particularly large fibroids that have formed within the lining of the uterus, or fibroids situated where the placenta has implanted.

• An inherited bleeding disorder – such as, Von Willibrande disease.

• A “vanishing twin” – when one or more embryos in a multiple pregnancy miscarries leaving an embryo behind. This can happen in naturally conceived pregnancies but it has been seen more frequently in assisted conception pregnancies where more than one embryo has been implanted.
Bleeding can also be set off by trauma of some kind, such as a fall, a car accident, or as the result of domestic violence.

What does bleeding in early pregnancy mean?

The worst case scenario is that the bleeding is a sign that your pregnancy is going to come to an end. Spotting or light bleeding can be an early sign of miscarriage or an ectopic pregnancy, especially if accompanied by abdominal pain or cramping.

Try to prepare yourself, but don’t lose all hope. Depending on the cause, many pregnancies continue despite early bleeding problems. It is estimated that about half of women who seek help because of bleeding in early pregnancy go on to have their baby successfully.

What causes bleeding in late pregnancy?

In the third trimester bleeding or spotting can signal a condition called placenta previa, placenta abruptio (whereby the placenta separates from the uterus), or premature labour.

If you notice spotting after 37 weeks, it’s most likely to be just a sign that the cervix is beginning to soften, maybe even dilate. You may notice a blood-tinged mucus discharge – part of the mucus plug that has sealed your cervix shut during pregnancy coming away. This is more commonly known as “a show” and is one of the signs that labour is going to start.