What Does Pregnancy Spotting Look Like & Is it Safe

Published May 23rd, 2022 by Bridget Reed
Fact Checked by
Camille Freking
Medically Reviewed:
Chris Riley

When you’ve had a missed menstrual period, have taken an at home pregnancy test, and visited your healthcare provider to confirm the good news, you know your body has many changes in store. 

If you notice blood in your underwear after recently finding out you’re pregnant, it’s totally natural to feel alarmed.

However, in early pregnancy, light bleeding can be an early symptom of pregnancy, and is usually nothing to worry about. 

Many pregnant women experience early pregnancy symptoms, like a trace of blood on their underwear, some of which may even turn into light bleeding.

Spotting sometimes occurs after the fertilized egg has attached to the uterine lining. As long as it’s not enough to cover a panty liner, it’s usually not a sign of something more serious. 

However, some instances of bleeding during pregnancy can be a sign that something is wrong, such as when a fertilized egg implants outside of the uterus, a molar pregnancy occurs, or there’s a miscarriage.

To help you recognize signs that you should seek medical attention, this guide from USA Rx goes over what can cause pregnancy spotting, what implantation bleeding looks like, and when it’s a sign that you should see a doctor. 

What Does Pregnancy Spotting Look Like?

Spotting looks like a trace amount of red, pink, or dark brown blood. You may notice it on your underwear, when using the bathroom, or when wiping with toilet paper.

In some cases, spotting may be a little heavier than just a few drops of blood, but it’s usually still less than a light period. 

If you are already used to very light blood flow during menstrual bleeding, it may be hard to tell what spotting is. However, spotting is never heavy enough to cover a panty liner like it would during menstrual bleeding. 

Spotting may happen just once during pregnancy, or it can happen often. Even if it happens often, it usually isn’t a cause for concern.

pregnancy spotting

Normal pregnancy spotting should occur on its own, without symptoms like pain or cramping. 

If other symptoms are present, it can be a sign of another condition (which we’ll discuss in more detail below). 

What Causes Pregnancy Spotting?

The American College of Obstetricians and Gynecologists (ACOG) reports that up to 20% of pregnant women can experience bleeding in the first trimester.

It’s an early sign of pregnancy, and is most common in the sixth or seventh week of pregnancy.

Second or third trimester spotting is less common and should be reported to a healthcare provider as soon as possible so they can check for possible issues like cervical polyps. 

In most of these cases, there isn’t any underlying issue.

However, there is a small chance that spotting during pregnancy may be a sign that something is wrong, and you should schedule a visit with your obstetrics and gynecology provider as soon as possible. 

Here are five potential medical issues that may cause pregnancy spotting: 

1. Ectopic Pregnancy

An ectopic pregnancy affects about 1% of pregnant women. It happens when the fertilized egg attaches itself to a reproductive organ outside of the uterus, usually the fallopian tubes. 

When this happens, the pregnancy cannot safely continue. This condition is resolved with medication (in the earlier stages) or surgery (in the later stages).

In addition to symptoms such as abdominal pain and pelvic floor pain, spotting or bleeding is commonly experienced by women with an ectopic pregnancy. 

2. Miscarriage

Bleeding is often one of the most common symptoms of a miscarriage. It can be accompanied by other symptoms such as back pain, abdominal cramping, white-pink discharge, and blood clots.

Pregnancy symptoms such as nausea, vomiting, and breast tenderness will seem to suddenly decrease after a miscarriage. 

Most miscarriages happen in the first 13 weeks of pregnancy, and are extremely rare after 15 weeks.

According to some estimates, miscarriages are very common, with an estimated 26% of all pregnancies ending in a miscarriage. 

Once a miscarriage begins, very little can be done to try and achieve a viable pregnancy. However, it’s important not to assume that a miscarriage has happened until your doctor confirms it. 

Your doctor can order blood tests to check your levels of a pregnancy hormone called human chorionic gonadotropin (hCG).

They will do two tests that are 24-48 hours apart to check if hCG levels are declining. If there’s a decline in hCG levels, it can indicate a pregnancy loss. 

Doctors don’t know what exactly causes some women to miscarry, although there are some risk factors, such as age and certain pre-existing medical conditions.

Regardless, having a miscarriage is not a sign that the mother did something wrong. In addition, having a miscarriage doesn’t necessarily mean there will be difficulties getting pregnant in the future. 

3. Implantation Bleeding 

Implantation bleeding is most common in the first two weeks of pregnancy. After a sperm fertilizes an egg, it becomes an embryo.

The embryo travels to the uterus and implants itself into the lining. In some cases, this process can cause light bleeding that’s much lighter than a normal period, and lasts much shorter than the typical menstrual cycle. 

4. Cervical Changes 

When you become pregnant, extra blood begins to flow to the cervix, which is the lower part of the uterus.

This happens because of an increase in blood vessels in the area.

Having sexual intercourse, getting a pap smear test, or doing anything else that involves prodding around this area can trigger light bleeding that usually isn’t something to worry about. 

5. Infection 

A sexually transmitted infection (STI) — such as chlamydia or gonorrhea — can cause bleeding, which is most common in the first trimester.

Although rare, sometimes the vagina or the cervix can get infected as well, which can lead to spotting.

Any infection can quickly become a serious problem during pregnancy, and requires prompt diagnosis and treatment. 

Is Pregnancy Spotting Safe?

Spotting and even light bleeding are very common during a healthy pregnancy, especially in the first trimester. 

However, if you feel abdominal or pelvic floor pain, cramping, dizziness, or anything else that’s not a typical pregnancy symptom, then the bleeding could be a sign of something more serious. 

Schedule a visit as soon as possible with your healthcare provider.

Summary 

Pregnancy causes your body to go through many changes.

Some of these changes can cause spotting to happen, which affects about 20% of pregnant women. Many times, it’s nothing to worry about.

However, in some cases, spotting or light bleeding can be caused by a miscarriage, an ectopic pregnancy, or an infection.

Some of these conditions can lead to complications, which is why it’s important to see a doctor as soon as possible.

If you experience symptoms such as cramping, pain, or dizziness in addition to light spotting or heavy bleeding, make sure to see your doctor as soon as possible.

Even if there is no underlying condition leading to the symptoms, getting examined by a doctor can give you the peace of mind you need for a happy, healthy pregnancy.

References and Sources: 

Association Between First-Trimester Vaginal Bleeding and Miscarriage | PMC 

Ectopic Pregnancy | NCBI Bookshelf 

Miscarriage | NCBI Bookshelf 

Age-Specific Risk of Fetal Loss Observed in a Second Trimester Serum Screening Population | NCBI