Early Spotting in Pregnancy - Is It a Sign of a Miscarriage?

Learn Why Women Bleed Early In Pregnancy - and What the Risks Are

Pensive pregnant woman holding stomach in examination room
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Any kind of bleeding or spotting early in pregnancy can feel scary, especially if you have a history of miscarriage. But don't panic. Researchers have found that as many as 20 to 40 percent of women experience vaginal bleeding in the first trimester, and it doesn't always signal a problem. In fact, 50 percent of pregnancies with early bleeding result in normal pregnancies.

You should always call your doctor if you experience any bleeding during pregnancy.

Problems Caused by Early Spotting

Bleeding in the first trimester is associated with problems including:

The outlook for early spotting is best if your bleeding is light and happens early in your pregnancy, especially earlier than the first six weeks. The outlook can be less positive if your bleeding is heavy or keeps going into the second trimester, although even women with heavy bleeding can sometimes deliver a healthy baby.

What Causes Early Spotting?

Bleeding or spotting in the early stage of pregnancy can be light or heavy, on-and-off or constant and painless or painful. There are four main causes of early spotting:

    Why Implantation Can Cause Bleeding

    Some pregnant women notice a small amount of blood around the time they would have had their period if they weren't pregnant. It's assumed that this is a sign of the fertilized egg implanting in the lining of the uterus. When it happens, "implantation bleeding" occurs soon after conception - some sources say 6 to 12 days later, others say 10 to 14 days later.

    This bleeding usually comes with cramping or a lower back ache. It will stop on its own within a few days and doesn't require any treatment. But you should call your doctor to report the symptoms just in case.

    Spotting and the Risk of Miscarriage

    Miscarriage is the most common cause of early bleeding in pregnancy.

    However, it's important to note that the statistics include something called threatened miscarriage. This is diagnosed when there's uterine bleeding but the cervix is closed and an ultrasound shows that the baby's heart is beating.

    Fortunately, threatened miscarriages don't always result in pregnancy loss, even when there's a lot of blood and more than one incident. Studies show that most threatened pregnancies (90 to 96 percent) that occur between 7 and 11 weeks don't miscarry.

    There's nothing you can do to change things if you have bleeding early in your pregnancy. If you experience early spotting, bed rest won't change the outcome.

    If you experience spotting or bleeding that's concerning, your doctor may perform an ultrasound to check on the baby's status.

    Signs of a Miscarriage - What to Look Out For

    According to the American Pregnancy Association, these are the signs and symptoms of miscarriage to look out for:

    • Bleeding - brown or bright red, with or without cramps 
    • Clots of tissue passing from the vagina
    • Mild to severe back pain that's worse than normal menstrual cramps
    • Weight loss
    • White-pink mucus
    • Very painful contractions every 5 to 20 minutes
    • A sudden decrease in the signs of pregnancy, such as breast tenderness or morning sickness

    Contact your doctor if you notice any of these symptoms.

    Sources:

    Norwitz, E.R., and Park, J.S. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. UpToDate. July 17, 2015.

    Miscarriage: Signs, Symptoms, Treatment and Prevention.American Pregnancy Association. August 2015.

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