Spotting and Bleeding in the First Trimester: What Is Normal?

Published July 20th, 2022 by Bridget Reed
Fact Checked by
Camille Freking
Medically Reviewed:
Chris Riley

A lot happens when you’re pregnant, both inside and outside your body. With that in mind, it can be hard to keep up with all the symptoms so that you know what is and isn’t normal.

One of the earlier symptoms of pregnancy is spotting. And while this is a sign that things are progressing well, it can be scary at first sight. So what exactly is normal, and how do you know when to contact a doctor?

Here’s everything you need to know.

What Is Spotting?

Even though you won’t get your period during pregnancy, about one in four individuals still experience light bleeding from the vagina, known as spotting.

Spotting usually doesn’t mean that there’s a problem. This type of bleeding can be a sign that a baby is starting to form. 

During menstruation, the body sheds its uterine lining during ovulation—this results in what we call “period bleeding.”

After about two weeks, ovulation occurs, meaning that the ovaries release an egg into the fallopian tube. Implantation (when the egg attaches to the uterine lining after fertilization) occurs 10 to 14 days after ovulation.

This process can cause the uterine wall to bleed, known as implantation bleeding.

This is one of the most common reasons for early pregnancy spotting or drops of blood in your liners or underwear.

Spotting usually doesn’t look much different from your menstrual blood, though it is sometimes darker or lighter. Additionally, there is usually much less of it at a time—spotting is so light that the blood wouldn’t cover a panty liner.

When Should You Be Concerned About Spotting?

You learned a little about implantation bleeding, which is one of the main reasons you’re likely to experience some spotting during pregnancy. It’s usually never a cause for concern.

However, it’s important to watch for signs of something being wrong.

The first conclusion that a pregnant mother might jump to is a miscarriage.

A miscarriage is a pregnancy loss during the first 23 weeks.

The most common sign of miscarriage is vaginal bleeding. While it might present as just light spotting, more often than not, it presents as heavy bleeding with bright-red blood or clots.

Bleeding can even come and go over several days.

Miscarriages often coincide with other symptoms such as cramping and pain in the abdomen, vaginal discharge, and loss of pregnancy symptoms like breast tenderness or morning sickness.

If you experience one or more of these symptoms, you should go to the emergency room for further treatment.

Additionally, the timing is important to consider as well. Spotting during the first trimester is normal and usually not a cause for concern.

However, you should contact a healthcare professional if you experience spotting in the second or third trimesters.

Ectopic Pregnancy

An ectopic pregnancy occurs when the fertilized egg implants and grows outside the uterine cavity. Ectopic pregnancies often happen in the fallopian tube, which carries eggs from the ovaries to the uterus.

An ectopic pregnancy can cause the fallopian tube to burst open. Without treatment, this can lead to life-threatening bleeding.

An early warning sign of ectopic pregnancy is light vaginal bleeding, typically coupled with pelvic or abdominal pain.

Contact a medical professional immediately if you notice pain coinciding with vaginal bleeding.

A fertilized egg cannot develop normally outside the uterus, so the ectopic tissue must be removed using medication or surgery, depending on when it is diagnosed.

Menstrual Bleeding vs. Pregnancy Spotting

Sometimes, a pregnancy might go unnoticed for a while because spotting looks similar to vaginal bleeding from a period.

However, there are some key differences, and knowing them can help you better prepare for your future.

The main difference is that implantation bleeding looks like drops and spots in your liner, whereas period blood is much heavier. Not to mention, period blood is usually red, whereas implantation spotting is pink or brown. 

Your period also begins around 14 days after ovulation, whereas implantation bleeding takes place about nine days after ovulation.

And if you feel cramping, hot flashes, or other symptoms of premenstrual syndrome, then there’s a good chance you’re just on your period rather than pregnant.

Of course, you can always take a pregnancy test to find out for sure.

Other Causes of Bleeding During Pregnancy

Bleeding and spotting are possible during pregnancy, and it always causes a little bit of concern.

Learn some common causes of bleeding to see if you need to contact a healthcare provider.

Sex

The cervix is the entrance to the womb that sits between the vagina and the uterus.

This organ becomes super tender during pregnancy due to hormonal changes that relax specific muscles in the body.

Because of that, penetrative sex can cause some bleeding in pregnant women. If you notice some light spotting after having sex, it’s likely not a cause for concern unless you also experience severe pain or heavy bleeding.

Urinary Tract Infection (UTI)

UTIs, or urinary tract infections, are just as common in pregnant women as in non-pregnant women.

They occur when bacteria enter and grow in the urinary tract. 

During pregnancy, it becomes harder to empty the bladder because of pressure from the expanding uterus and an increase in relaxin, a hormone that relaxes the uterus muscles.

This relaxation of muscles can make UTIs common because the longer urine stays in the body, the higher the chances it’ll grow harmful bacteria.

Symptoms of a UTI include pain or burning while urinating, frequent urination, and bloody urine. Some also feel cramping in the groin or abdomen.

Cervical Polyps

Cervical polyps are noncancerous growths that appear on the cervix because of increased levels of the hormone estrogen.

They’re often red, purple, or gray in color and range in size from millimeters to centimeters.

The exact cause is unknown, though it’s thought to be related to inflammation, hormone changes, or clogged blood vessels in the cervix.

Symptoms include vaginal bleeding after douching or intercourse, white or yellow mucus (leukorrhea), or abnormal vaginal bleeding in between periods.

Polyps are usually noncancerous, and a gynecologist or other healthcare specialist can treat them.

In Conclusion

Spotting and bleeding during pregnancy can look scary, but it’s usually not a cause for concern.

Especially during the first trimester, pregnancy spotting is a normal byproduct of implantation, which kick-starts the process of pregnancy.

However, if bleeding is heavy or accompanied by cramps and pain, you should see a doctor or OB-GYN (obstetrics and gynecology doctor) as soon as possible.

Heavy bleeding and pain might signify a miscarriage, urinary tract infection, cervical polyp, or an ectopic pregnancy

It’s essential to the health and wellness of you and your baby to address any unexpected bleeding while pregnant. 

References, Studies and Sources:

Miscarriage - Symptoms | NHS

Ectopic pregnancy - Symptoms and causes | The Mayo Clinic

UTIs during pregnancy are common and treatable | UTSouthwestern Medical Center

Cervical Polyps | Mount Sina