Pregnancy is a time of nerves and excitement – you’re growing a baby inside you and are patiently waiting to meet him.
If you're expecting your first baby, or if you're expecting a rainbow baby (a baby after a previous loss), you might be extra concerned about pregnancy symptoms. You love and want this baby so much, and his wellbeing matters to you more than anything else in the universe right now.
For many women, the first sign of pregnancy is a missed period. From that point on, we expect to have no bleeding or spotting until after the birth. What might come as a surprise is that nearly 50% of all expectant mothers experience some spotting or bleeding in their pregnancies.
Here’s what you need to know about spotting during pregnancy, for your peace of mind as an informed mama-to-be:
What Is Spotting?
Spotting is very light bleeding. This would be finding a little bit of blood in your underwear, but not soaking through. It's finding a bit of blood on the toilet paper after wiping. If you need a liner or pad, have a menstrual like flow or see any clots, that would be referred to as bleeding, not spotting.
What Causes Spotting During Pregnancy?
With nearly 50% of women experiencing bleeding or spotting during pregnancy, we assume that it isn't always an alarming signal. In some cases we are never sure why the spotting or bleeding occurred. In other cases, we know the cause.
Some causes of spotting during early pregnancy:
- Implantation, when the embryo attaches to the uterine lining
- Having sex
- Hormonal changes
- Internal exam by your midwife or doctor
- Cervical changes or irritation of the cervix
Some causes of spotting later in pregnancy:
- Cervical insufficiency
- Having sex
- Internal Exam
- Preterm labour
- Cervical changes
What Should I Do If I Notice Spotting?
If you notice spotting during pregnancy, it can be helpful to put on a panty liner to see if the spotting continues or turns into bleeding (it can be hard to gauge with underwear). Note if you recently had intercourse, as well as how many days it's beensince ovulation and if you recently had an internal exam. All of these things can cause spotting during pregnancy.
When Should I Contact My Midwife or Doctor?
It's a good to mention to your care provider if you are spotting, but it's rarely necessary to contact your provider after hours for simple spotting. If you don't have any pain or concerning symptoms, and your spotting doesn't increase in frequency or amount, the spotting isn't likely an emergency.
Contact your care provider as soon as possible if:
- Your spotting becomes bleeding
- You have pain
- You have pain or irritation when you urinate, or,
- You are uneasy
You should seek medical attention immediately if your spotting is accompanied by severe localized pain, as it can be a sign of a rare but serious concern, ectopic pregnancy. According to a study, the main risk factors for ectopic pregnancy are having pelvic inflammatory disease, smoking, and previous ectopic pregnancy.
You should also seek medical attention if your spotting quickly becomes bleeding and you soak through a pad in less than 1-2 hours.
What Will My Care Provider Do For Spotting During Pregnancy?
In many cases, spotting during pregnancy is not a concern and nothing needs to be done. Your care provider is likely to begin by asking you about your recent activities and symptoms.
If you had an internal exam or intercourse in the last day or two it is most likely from cervical irritation. In this case nothing is usually done. If you experience spotting every time you have intercourse your provider might recommend pelvic rest (nothing in the vagina) or they might reassure you it is a common pregnancy ailment.
If you're experiencing any pain or discomfort, especially with urination, your provider might do a urine sample and vaginal swab. This is to check for a urinary tract infection, such as a bladder infection, bacterial vaginosis or a yeast infection. Depending on the results you might be prescribed a medication or cream.
Your provider might ask if you know when you ovulated. In some cases spotting is simply due to implantation. Implantation bleeding can occur 6-12 days after fertilization. In many cases women aren't aware they are pregnant when this occurs, but a few are and notice the spotting.
Spotting that occurs frequently and without any known triggers might be a hormonal concern. Your provider may want to do some lab work to check your hCG and progesterone levels. This can give them an idea of what might be going on. If your progesterone levels are borderline low they might prescribe progesterone supplements. If your hCG levels or progesterone are off, they may simply repeat the test in a few days to see how your pregnancy is progressing.
If you are far enough along in your pregnancy an ultrasound might be useful. Your provider will check your placenta, cervix and baby to see if there is a cause for spotting and if the pregnancy is viable. Their course of action would be dependent upon results.
In many cases though, little investigation or treatment is necessary.
Things To Keep In Mind
Pregnancy is a good span of time, so it is likely many mamas will experience some concerns. Outside of pregnancy many women occasionally experience spotting, UTIs, and cervical irritation so spotting, even when occurring during pregnancy, isn't always a pregnancy problem and reason to worry.
It's a good idea to notify your care provider of any bleeding or spotting during pregnancy. Depending on your blood type, Rh disease might be a concern (for those who are Rh negative). However, this is easily prevented with medication.
As mentioned, nearly 50% of expectant mamas experience spotting or bleeding during pregnancy. While miscarriage is unfortunately a possibility, spotting in and of itself does not always equal a cause for concern. Many women that experience spotting go onto have a healthy full-term baby.