Spotting is light bleeding during pregnancy. It may be pink, red or dark brown and is often noticed after using the restroom or seeing a few drops of blood on your underwear. Of course, spotting during pregnancy is typically lighter than your regular flow and is hardly enough to cover a panty liner. As terrifying as it may sound, spotting is not always an indication that something bad is wrong with the mother or fetus. Many women who experience spotting during pregnancy carry their baby to full term and eventually deliver healthy babies.

Spotting during pregnancy can actually be caused by a number of reasons, depending on how old the pregnancy is. For instance, it is estimated that about 15-25% of pregnant women experience spotting during the first trimester of pregnancy.¹ That said, spotting in the first trimester is always associated with implantation bleeding, ectopic pregnancy, miscarriage or other unknown causes such as infections and hormonal changes. There should be no cause for concern if the spotting is a result of implantation bleeding. However, if it’s becoming severe and heavy, then there is a need to see the doctor for more investigations as ectopic pregnancy and a miscarriage require prompt medical attention.

Most often spotting in the second trimester is caused by irritation of the cervix after sex or after a cervical exam. This usually means nothing. Nevertheless, spotting during the second trimester could also be a result of a harmless growth in the cervix called a cervical polyp. Pregnant women are advised to see their doctor immediately if they experience heavy vaginal bleeding during pregnancy as it could be a sign of medical emergencies such as placenta previa, premature labor, and late miscarriage.

In the third trimester of pregnancy, it is normal for most women to experience light bleeding after sex or after a cervical exam. This shouldn’t be anything to worry about. However, women in the third trimester may also experience spotting due to a bloody show. A bloody show is a sign that labor is starting so there is a need to see your doctor at this juncture. That said, heavy vaginal bleeding in the third trimester requires emergency medical care as it can be caused by placenta previa, placenta abruption or vasa previa.

In a nutshell, spotting during pregnancy is common and could be caused by a number of factors. Pregnant women are advised to seek emergency care whenever they experience heavy bleeding in any trimesters they are in.

Reference:
1) Bleeding During Pregnancy. American College of Obstetricians and Gynecologists Website. https://www.acog.org/womens-health/faqs/bleeding-during-pregnancy. Last accessed April 22, 2021.

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