What should you know about black spotting during pregnancy?

Blood can look brown, very dark red, or nearly black after it has remained in the vagina longer and oxidised. Spotting may follow sex or an examination because pregnancy can make the cervix more prone to bleeding. Infection, cervical changes, a polyp, or a problem involving the uterus can also cause bleeding. The colour alone cannot show whether the pregnancy is progressing normally.

The timing in pregnancy, whether the blood is only seen when wiping or reaches a pad, and whether there is pain are all useful details. Bleeding between periods is not the same situation as bleeding during pregnancy, so do not rely on an old explanation for a new episode.

Contact your maternity team, obstetrician, or another pregnancy-care clinician and describe the colour, amount, onset, and any pain. Use a pad if needed so you can observe the bleeding; avoid tampons while it is happening. Keep a note of clots, fluid, dizziness, fever, or reduced fetal movement when relevant to your stage of pregnancy. Do not self-treat with medicines or assume that dark blood is harmless without advice.

Seek urgent assessment for bleeding that becomes heavy, severe or one-sided abdominal pain, shoulder-tip pain, faintness, marked dizziness, fever, or feeling very unwell. Seek immediate maternity advice if you pass tissue, have watery fluid leaking, or notice reduced fetal movement when you are at a stage where movements are established. Pain with bleeding can need rapid assessment even when the blood looks dark. If you cannot reach your pregnancy-care team, use local emergency services.

Ask: What level of bleeding should prompt urgent review for me? Could my cervix or an infection be contributing? Do I need an examination, ultrasound, or blood tests? Are there activities or medicines I should avoid until the bleeding stops?