Spotting During Pregnancy: Should You Be Worried?

But take a deep breath; bleeding doesn’t automatically mean you are losing the baby. In fact, spotting is surprisingly common in healthy pregnancies.

So, is it a period? Technically, no. You cannot have a menstrual period while pregnant. However, there are several reasons why you might bleed, ranging from harmless shifts in your body to issues requiring medical attention.

In this article, our medical team breaks down why you might be bleeding, how to tell the difference between spotting and a period, and exactly when to call your doctor.

Can I Be Pregnant and Still Have a Period?

If you’ve been trying to conceive and noticed your flow is much lighter this month, you might wonder if you’re actually expecting.

Here is the short answer: No, you cannot have a true period while pregnant.

A period is your body shedding the lining of the uterus because an egg wasn’t fertilized. If you are pregnant, that lining stays put to support the baby. However, up to 25% of pregnant women still experience vaginal bleeding, which mimics a light period.

While many women experience irregular bleeding or spotting during early pregnancy, a “light period” can also be caused by non-pregnancy factors, including:

• Stress: High stress can mess with your cycle.
• Hormonal imbalance: Issues like PCOS or thyroid problems.
• Birth control: Recent changes in your pill or IUD.
• Lifestyle factors: Poor nutrition, low body weight, or excessive exercise.

If the bleeding is pregnancy-related, it is typically dark brown (old blood) or light pink. It should never be bright red.

Furthermore, there should not be enough blood to fill pads or tampons over a few days. If you are soaking through hygiene products, it is highly unlikely you are pregnant.

Although some women claim they were still having their period during pregnancy, according to the medical community, this is not possible and is most likely due to other reasons that require consultation by a health care professional. Spotting is normal, especially in the first trimester. However, heavy or consistent bleeding should not occur during pregnancy.

Editor's Note:

Dr. Njoud Jweihan, MD

If you are expecting, look for these other common symptoms alongside the spotting:

• Breast changes such as swelling, tenderness, or darker areolas.
• Nausea and vomiting (morning sickness).
• Extreme fatigue.
• Lightheadedness.
• Constipation.
• Loose stools or diarrhea.
• Food aversions or cravings.
• Mood swings.
• Frequent urination.
• Headaches.

If you have spotting and suspect a pregnancy, take a home test. For the most accurate results, wait until one week after your “missed” period and use your first-morning urine.

Causes of Light Bleeding During Pregnancy

Seeing blood in your underwear is scary, but it’s often due to benign causes, especially in the first trimester.

Here is why you might see spotting while expecting:

1. Implantation Bleeding

Implantation bleeding occurs when the fertilized egg attaches to the uterine lining. This is one of the first signs of pregnancy. It can be confusing because it often happens right around the time your period is due and comes with implantation cramps.

The difference? Implantation bleeding is much lighter in color (pink or brown), lighter in flow, and lasts only a day or two.

2. Sex

During pregnancy, your cervix swells with increased blood flow. The blood vessels in this area become fragile and can easily break during intercourse. It is not unusual to notice light spotting after sex ⁽¹⁾. This is generally harmless. You might try positions like side-lying to reduce pressure on the cervix.

3. Vaginal Exams

Routine procedures, such as a pap smear or cervical check, can irritate your sensitive cervix. Spotting might occur within 24 hours of your exam but typically stops within a day. Your provider will likely warn you about this and offer a panty liner.

4. Subchorionic Hematoma

This sounds scary, but it’s relatively common. A subchorionic hematoma is a pool of blood that forms between the uterine wall and the chorionic membrane (the outer layer of the amniotic sac). It can cause bleeding that ranges from light spotting to heavy flow. Many resolve on their own, but your doctor will want to monitor it via ultrasound.

5. Nearing Labor

If you see light bleeding toward the end of your pregnancy, get your hospital bag ready. As your body preps for labor, the cervix softens and dilates. You may lose your mucus plug, which looks like stringy, thick discharge often tinged pink or brown (the “bloody show”).

Losing your mucous plug does not always mean you are in labor. Labor may not start until hours or even days after. Even though it might not mean you are about to be in labor, let your doctor or midwife know if you lose your mucus plug before reaching 37 weeks of pregnancy.

Editor's Note:

Dr. Njoud Jweihan, MD

When Do I Need to Worry?

Most women who experience light bleeding go on to have healthy pregnancies. However, bleeding can sometimes signal a complication.

Red Flags: Call your doctor if bleeding is heavy, bright red, lasts more than three days, or comes with fever, fainting, or severe cramps.

Here are the more serious causes associated with pregnancy bleeding:

1. Miscarriage

Sadly, miscarriages are common, usually occurring in the first 12 weeks. Roughly half of women who bleed early in pregnancy eventually miscarry. Call your doctor immediately if bleeding gets heavier, contains clots or tissue, or is accompanied by painful cramping or back pain.

2. Chemical Pregnancy

A chemical pregnancy is a very early miscarriage where the egg is fertilized but never fully implants. This happens so early that an ultrasound wouldn’t yet see a fetus. Doctors can check HCG levels to confirm. Because this occurs so early, many people mistake it for a regular, albeit slightly late, period ⁽²⁾.

3. Ectopic Pregnancy

This occurs when the embryo implants outside the uterus, usually in the fallopian tubes. This is a life-threatening medical emergency. If the tube ruptures, it causes internal bleeding.

Go to the ER immediately if you have bleeding coupled with:

• Severe pelvic or abdominal pain (often on one side).
• Shoulder tip pain.
• Extreme lightheadedness or fainting.

4. Placenta Problems

After 20 weeks, bleeding might indicate a placenta issue:

• Placenta Previa: The placenta covers the cervical opening. Bleeding is usually painless but dangerous.
• Placental Abruption: The placenta separates from the uterine wall before birth. This usually causes abdominal pain, clotting, and back pain and cuts off oxygen to the baby ⁽³⁾.

Both conditions require immediate medical attention.

5. Uterine Rupture

This is rare and usually affects those with a prior C-section scar that tears during pregnancy. It is dangerous for both parent and baby and requires an emergency C-section.

6. Preterm Labor

Bleeding in the second or third trimester can be a sign your body is trying to deliver early. Along with spotting, watch for pelvic pressure, rhythmic cramping, backaches, or fluid leakage. Doctors can sometimes use medication and bed rest to stop or delay labor.

7. Infection

A vaginal infection or STI can cause cervical inflammation, leading to spotting. While not always directly related to the pregnancy, infections need treatment because they can affect the baby. Symptoms include itching, burning during urination, unusual discharge, or sores.

What Should I Do if I’m Bleeding?

First, don’t panic. If you haven’t confirmed your pregnancy yet, take a home pregnancy test. If it’s positive, call your doctor.

If you already know you are pregnant:

1. Wear a pad: This helps you monitor how much you are bleeding and what color it is. Do not use a tampon.
2. Call your provider: Even if it’s light spotting, let them know. They may want to bring you in for an ultrasound or blood work to rule out complications.
3. Rest: Avoid strenuous activity and sex until your doctor gives you the all-clear.

FAQs

Does a Light Period Mean Low Fertility?

Not necessarily. A light period isn’t usually a sign of infertility. However, if your periods are consistently very light, absent, or irregular, it could indicate a hormonal imbalance or ovulation issue that might make conceiving harder. It is worth discussing with your doctor.

How Long Does a Light Period Last During Pregnancy?

If you are pregnant, you aren’t having a period; you are experiencing spotting or implantation bleeding. Implantation bleeding is usually very short, lasting anywhere from a few hours to 1 or 2 days. It stops on its own and is much lighter than a standard menstrual cycle.

Can You Get a Negative Pregnancy Test With a Very Light Period?

Yes. If you test too early, your HCG levels may not be high enough for the test to detect. If you have a “light period” that feels unusual and get a negative result, wait 2 or 3 days and test again using your first-morning urine.

What Color Is Pregnancy Spotting?

Pregnancy spotting is typically pink (mixed with vaginal discharge) or brown (older blood). It usually looks like the very beginning or very end of a period. If the blood is bright red, like a fresh cut or heavy flow, that is more concerning and warrants a call to your doctor.

The Bottom Line

Light bleeding or spotting during pregnancy is frightening, but it is also incredibly common.

While it is physically impossible to have a menstrual period while pregnant, bleeding can occur from implantation, hormonal shifts, or irritation after sex. However, because bleeding can also signal complications like miscarriage or ectopic pregnancy, you should never ignore it.

If you see blood, put on a pad and call your doctor. It might be nothing, but getting checked out will give you peace of mind.