Spotting During Pregnancy: When Should You See Your Gynecologist?

spotting pregnancy
Spotting is defined as the presence of a few drops of blood in your underwear. This is normal, particularly if you’re approaching your menstruation or if you’re on the last days of your period. However, if you’re pregnant, you shouldn’t be too complacent when you experience spotting.

Causes of Spotting During Pregnancy

Spotting is not a normal part of pregnancy, but it’s usually not cause for alarm. This is especially true when you when you experience it during the first trimester. Around 20 percent of pregnant women have spotting in the first 12 weeks of pregnancy, and some of the common causes include:

  • Implantation Bleeding — When the fertilized egg attaches itself to the lining of your uterus, it can cause some spotting that can last for a few days. Many women interpret this as a sign that their period is approaching, although they later confirm that they’re pregnant through a pregnancy test.
  • Breakthrough Bleeding — This happens when the hormones that regulate your menstrual cycle trigger slight bleeding even when you’re already pregnant. This usually occurs in the early part of the pregnancy, and you might experience it a couple of times.
  • Cervical Irritation — When you’re pregnant, a larger amount of blood flows to the cervix to support the growth of your baby. This makes your cervix more sensitive and more prone to irritation and bleeding when you get a Pap smear or when you have intercourse.
  • Cervical Polyp — If you have a cervical polyp, it responds to the higher estrogen levels that pregnancy brings and becomes more prone to bleeding. It can also bleed during sex or when you have a gynecological exam.
  • Uterine Fibroids — These are non-cancerous tumors in your uterus that often don’t interfere with your pregnancy. However, spotting can ensue if your placenta embeds in an area where a fibroid is present.
  • Infections — Spotting can happen if you have a cervical or vaginal infection or if you have a sexually transmitted infection (STI) such as gonorrhea or chlamydia.
  • Miscarriage — Many women immediately think that they’re having a miscarriage when they experience spotting in the first 12 weeks of pregnancy. While miscarriage is definitely a big threat, oftentimes it’s not the cause of spotting. According to experts, more than 90 percent of women who experience spotting during the first trimester continue their pregnancy and have a healthy baby.

Once the first trimester has passed, spotting should no longer occur. If it does occur, one of the common causes is subchorionic bleeding. This happens when the blood that pools within the outer fetal membrane (called chorion) or within the placenta leaks out of the uterus and into the vagina.

Subchorionic bleeding usually causes light to heavy spotting but eventually resolves on its own, although it can put you at risk for other complications like premature labor.

When you’re in the third trimester and nearing your due date, spotting can be a sign that you have lost the cover of your uterus’s opening, called the mucus plug. This results in blood-streaked mucus and signals the start of your labor.

What to Do When You Observe Spotting

No matter how little or how much spotting you have, it’s important to tell your doctor about it as soon as possible. Wear a pad so you can record how much blood is flowing out, and avoid wearing tampons so you won’t further irritate your vagina (in case your spotting is caused by vaginal irritation). Avoid having intercourse as well.

Take note of the type of blood that you see, such as its color (e.g. dull brown or pale pink) and its consistency (if it’s smooth or has clots). If any tissue passes through your vagina, preserve it and bring it to your doctor. This way, she can schedule a lab test for the tissue and determine the cause of your spotting.

Call 911 right away if the spotting turns into heavy bleeding, you experience any pain or cramps, and/or your vaginal discharge includes tissue as well as blood. This is also the right step to take if you feel dizzy or faint, have chills, and/or a fever that’s beyond 100.4 degrees Fahrenheit. Don’t wait for your next doctor’s appointment; these signs and symptoms can signal that you’re having a miscarriage or another serious problem, so it’s important that you seek medical attention ASAP.

How to Avoid and Manage Pregnancy Spotting

You can’t really predict when you’ll experience spotting, so the best thing you can do is to keep yourself healthy. Schedule a check-up with your gynecologist as soon as you get a positive pregnancy test, and take the vitamin and mineral supplements that she/he prescribes for you.

Remove the junk food and fast food from your diet, and switch to healthier foods like fresh fruits, vegetables, lean meat, and whole grains. Ask your doctor for advice on the types of exercises you can do, and try to do moderate workouts for at least 30 minutes each day. Getting plenty of rest and sleep and keeping your stress levels low can also help.

Spotting vs. Bleeding

It’s important to note that there’s a difference between spotting and bleeding. The former, as mentioned above, involves several small droplets of blood that won’t soak your underwear or pad, and it usually involves pink or brown blood (similar to what you can find at the end of your period).

Bleeding, on the other hand, is a heavier flow that will seep and stain your clothes if you don’t wear a pad, and it commonly involves bright red blood. Heavy bleeding is usually a sign of a serious problem (such as an ectopic pregnancy, placenta previa, or uterine rupture) and should prompt you to see your gynecologist ASAP or call 911.

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