Is Spotting Normal During Pregnancy? Here’s What You Need to Know

Content medically reviewed by Andrea Kratzke Nelson, MD

When you are pregnant, light bleeding — sometimes called spotting — is not always a sign that something is wrong. If you're wondering if spotting is normal during pregnancy, Essentia Health has answers.

Sometimes Spotting Can Be Normal

For some women, spotting is common, especially early in pregnancy.

“The American College of Obstetrics and Gynecology estimates that up to 25% of pregnancies have some spotting,” said Dr. Andrea Kratzke Nelson, family medicine physician at Essentia Health. 

There are two factors to keep in mind about spotting during pregnancy –

• How far along are you in your pregnancy?
• How light or heavy is your bleeding or spotting?

Generally, spotting, which is often brown or bright red and light enough to use a panty liner, is less likely to be a problem in the first 12 weeks of pregnancy. 

“If you are in early pregnancy and you’ve had spotting that goes away within a day, you can tell us at your next prenatal visit or through a message in your online portal,” Dr. Kratzke Nelson said. “However, if your spotting lasts longer than a day or has become anything more than spotting, call your provider right away.”

Causes of Spotting During Early Pregnancy

Many different things can cause spotting or bleeding early in pregnancy, including –

• Having sex
• Hormonal changes in your body
• Infection or inflammation
• Pap test or other tests performed by your provider during a prenatal exam
• Smoking
• Heavy bleeding in the first trimester can be a sign of a more serious condition, such as –
• Ectopic pregnancy, a condition when the fertilized egg implants outside of the uterus
• Miscarriage
• Molar pregnancy, a condition involving unusual growth of cells in the uterus 

“If you’ve had issues in the past, you should be more mindful of possible problems,” Dr. Kratzke Nelson said. “If you have had an ectopic pregnancy, have high blood pressure, or use recreational drugs or smoke, reach out to your provider earlier rather than later.”

While ectopic and molar pregnancies are rare, they need prompt treatment to prevent complications. Miscarriage is unfortunately not rare—up to one-third of women will experience at least one.

“A miscarriage is almost always due to something a woman could not have controlled, often a genetic abnormality in the fetus,” Dr. Kratzke Nelson said. “If you are experiencing bleeding and it is ultimately a miscarriage, please know that it is not your fault.” 

Bleeding Later in Pregnancy

Bleeding during the second or third trimester should always be taken seriously. Call your provider as soon as possible. While sometimes bleeding can be caused by having sex, it could also be a sign of –

• Going into labor
• Infection
• Placental abruption, a condition where the placenta separates from the wall of the uterus
• Placenta previa, a condition where the placenta grows over the opening to the cervix
• Preterm labor, or labor that starts before your 37th week
• Uterine rupture, when your uterus tears during labor (often in women who have had a cesarean section)

If you have pre-existing medical conditions or have had complications in previous pregnancies, make sure your OB/GYN knows your entire medical history.

Treatment for Spotting and Bleeding 

Treatment for vaginal bleeding during pregnancy will vary depending on the cause, the type of bleeding, and your stage of pregnancy. Your provider will likely perform a pelvic exam or a vaginal ultrasound to best determine what is causing the bleeding. Some women with high-risk pregnancies may need modified activity for the remainder of their pregnancies. Some women may also need medication.

“Pregnancy can often feel overwhelming, but there is no need to panic,” Dr. Kratzke Nelson said. “Instead, reach out to your care team and ask questions.”