Early pregnancy pictures of spotting during pregnancy

Q: What does spotting look like in early pregnancy?

Spotting is light vaginal bleeding that can happen when youre pregnant. It is a very common and tends to happen in early pregnancy, during the first trimester. Spotting is usually red or pink in colour. It can also look brown, like old blood or like the bleeding at the start and end of your period.

Spotting is light vaginal bleeding that can happen when you're pregnant. It is a very common and tends to happen in early pregnancy, during the first trimester.

Table of Contents Show

Spotting is usually red or pink in colour. It can also look brown, like old blood or like the bleeding at the start and end of your period. The amount of blood you lose when spotting is small – less than a light period bleed.

Causes of spotting

The main causes of spotting during early pregnancy include:

implantation bleeding - caused by the fertilised egg attaching to the inner lining of your womb
hormonal changes - pregnancy hormones can cause changes to your cervix

Spotting can also be a sign that your pregnancy is not developing properly and may be a sign of a miscarriage or an ectopic pregnancy.

Seeing your GP about spotting

Your GP will ask you about your bleeding.

They may ask you:

when your last period was
how many weeks pregnant you are
if it's your first pregnancy
what the bleeding or spotting is like
if you have any other symptoms such as stomach pain or dizziness

Be honest with your GP. There's nothing to be embarrassed about. Tell them about the colour, any clotting, and how heavy the bleeding was. Be as graphic as you need to. Remember, your GP sees people with personal issues like bleeding all the time.

Examination

Your GP may ask to give you a physical examination.

This may include:

checking your blood pressure
checking your pulse
pressing on your stomach

Tests

Your doctor may also do some tests, such as a:

urine test - to check for infection
pregnancy test - if it's their first time seeing you during your pregnancy
blood test - to measure the levels of pregnancy hormone (βhCG) in your blood

If you get a blood test done in your GP's surgery, it'll be sent to the lab in the hospital.

Referral

What happens next depends on:

the stage of the pregnancy you're at
if you have had bleeding before
anything your GP found out at your appointment

If your maternity hospital has an Early Pregnancy Unit (EPU), your GP may refer you to investigate the spotting. You may also need to go to your maternity hospital for an ultrasound scan.

Sometimes they may refer you to the emergency department if you have severe stomach pains or heavy vaginal bleeding.

EPUs and emergency departments are usually quite busy. Bring a magazine or a book to keep you busy. It's also good to bring a support person in case you receive bad or unexpected news. Be aware that your hospital may have COVID-19 restrictions on partners and support persons.

Going to the maternity hospital about spotting

You may have tests and examinations at the hospital. This is to try and find out the cause of the bleeding.

Pelvic or vaginal examinations

Your doctor or obstetrician might want to examine your cervix. This is to check the bleeding. It's normal to feel a little uneasy about this. Sometimes you can have a midwife there to support you.

They may need to use a speculum. This is an instrument used to gently open your vagina so your doctor can see your cervix more easily.

Your doctor may also ask your consent to do a vaginal examination. This is when they insert their gloved fingers into the vagina to see if there is any pain. It helps then to make a correct diagnosis.

Blood tests

You may need to have a blood test, even if your GP did blood tests. Sometimes your doctor will want to compare your pregnancy hormone to the levels in the blood taken by your GP. Occasionally, blood tests are repeated 2 days later. The combined results can help with the correct diagnosis.

Ultrasound scan

An ultrasound scan is often needed. In early pregnancy, this is usually a transvaginal ultrasound. It's the best way to get a clear picture of your baby.

In the second and third trimesters, it'll usually be an abdominal ultrasound instead.

What happens next

This depends on what is causing the bleeding. You may need to be admitted to hospital for observation or treatment. Most women with spotting are discharged home.

Bleeding during pregnancy is relatively common and does not always mean there's a problem – but it can be a dangerous sign.

Urgent advice: Call your midwife or GP immediately if:

you have any bleeding from your vagina

Coronavirus (COVID-19) update

If you're well, it's really important you go to all your appointments and scans for the health of you and your baby.

If you're pregnant, hospitals and clinics are making sure it's safe for you to go to appointments.

If you get symptoms of COVID-19, or you're unwell with something other than COVID-19, speak to your midwife or maternity team. They will advise you what to do.

Find out more about pregnancy and COVID-19

Causes of bleeding in early pregnancy

Implantation bleeding

In early pregnancy, you might get some harmless light bleeding, called "spotting". This is when the developing embryo plants itself in the wall of your womb. This type of bleeding often happens around the time your period would have been due.

Cervical changes

Pregnancy can cause changes to the cervix, and this may sometimes cause bleeding – after sex, for example.

Miscarriage or ectopic pregnancy

During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy.

However, if you bleed at this stage of pregnancy it's likely you will go on to have normal and successful pregnancies.

Miscarriage

If a pregnancy ends before the 24th week, it's called a miscarriage. Around 1 in 5 pregnancies ends this way.

Many early miscarriages (before 14 weeks) happen because there is something wrong with the baby. There can also be other causes of miscarriage, such as hormone or blood clotting problems.

Most miscarriages occur during the first 12 weeks (3 months) of pregnancy and, sadly, most cannot be prevented. Other symptoms of miscarriage include:

cramping and pain in your lower abdomen
a discharge or fluid from your vagina
a discharge of tissue from your vagina
no longer experiencing the symptoms of pregnancy, such as feeling sick

If you have bleeding or any of the symptoms above, contact your midwife or GP straightaway.

Ectopic pregnancy

An ectopic pregnancy is when a fertilised egg implants outside the womb – for example, in the fallopian tube.

It can cause bleeding and is dangerous because the fertilised egg cannot develop properly outside the womb. The egg has to be removed, which can be done through an operation or with medicines.

Symptoms of an ectopic pregnancy tend to develop in the 6th week of pregnancy but can happen later.

Other signs of ectopic pregnancy can include:

tummy pain low down which may be on one side
vaginal bleeding or a brown, watery discharge
pain in the tip of your shoulder
discomfort when peeing or pooing

Call 111 if you have symptoms of an ectopic pregnancy.

Causes of bleeding in later pregnancy

Cervical changes

These can lead to bleeding, particularly after sex.

Vaginal infections

Your midwife or doctor can discuss tests and treatment with you.

A 'show'

This is when the plug of mucus that has been in the cervix during pregnancy comes away, signalling that the cervix is getting ready for labour to start. It may happen a few days before contractions start or during labour itself.

Find out about the signs of labour and what happens in labour.

Placental abruption

This is a serious condition in which the placenta starts to come away from the womb wall. Placental abruption usually causes stomach pain, and this may occur even if there is no bleeding.

Low-lying placenta (placenta praevia)

This is when the placenta is attached in the lower part of the womb, near to or covering the cervix. Bleeding from a low-lying placenta can be very heavy, and put you and your baby at risk.

You may be advised to go into hospital for emergency treatment, and a caesarean section will usually be recommended. The Royal College of Obstetricians and Gynaecologists has more information on placenta praevia.

Vasa praevia

This is a rare condition where the baby's blood vessels run through the membranes covering the cervix.

When your waters break, these vessels may be torn and cause vaginal bleeding. The baby can lose a life-threatening amount of blood.

Finding out the cause of bleeding in pregnancy

To work out what is causing the bleeding, you may need to have a vaginal or pelvic examination, an ultrasound scan or blood tests to check your hormone levels.

Your doctor will also ask you about other symptoms, such as cramp, pain and dizziness. Sometimes it might not be possible to find out what caused the bleeding.

If your symptoms are not severe and your baby is not due for a while, you'll be monitored and, in some cases, kept in hospital for observation.

How long you need to stay in hospital depends on the cause of the bleeding and how many weeks pregnant you are.

Being in hospital allows staff to keep an eye on you and your baby, so they can act quickly if there are further problems.

Find the answers to common health problems in pregnancy

Video: What should I do if I start bleeding during early pregnancy?

In this video, a midwife tells you what to do if you start to bleed during early pregnancy.

Media last reviewed: 20 March 2020
Media review due: 20 March 2023

What does spotting look like in early pregnancy?

Spotting is light vaginal bleeding that can happen when you're pregnant. It is a very common and tends to happen in early pregnancy, during the first trimester. Spotting is usually red or pink in colour. It can also look brown, like old blood or like the bleeding at the start and end of your period.

How much spotting is normal during early pregnancy?

About 20% of women have some bleeding during the first 12 weeks of pregnancy. Possible causes of first trimester bleeding include: Implantation bleeding. You may experience some normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus.

What kind of spotting is normal in early pregnancy?

How long can pregnancy spotting last?

Only about a third of pregnant women experience implantation bleeding after they get pregnant, but it's considered a normal symptom of pregnancy. In most cases, implantation spotting only lasts from a few hours to a couple days, but some women report having implantation spotting for up to seven days.