Causes of spotting during pregnancy

Light bleeding can follow changes in the cervix, sex or a vaginal examination. Early in pregnancy it may occur around implantation, while bleeding at any stage can also accompany infection, pregnancy loss or a problem with the pregnancy. Later bleeding can arise from the placenta, so timing and associated symptoms matter.

Spotting means a small amount of blood, often noticed on underwear or toilet tissue. Colour may be pink, red or brown; brown blood is generally older blood. The appearance alone cannot identify the cause. A clinician considers how far along the pregnancy is, whether the bleeding is increasing, and whether there is pain, dizziness, fever, unusual discharge or fluid leakage.

The cervix receives more blood during pregnancy and may bleed after contact. Cervical or vaginal infection may also cause spotting, sometimes with odour, irritation or pain when urinating. Conditions outside pregnancy can contribute to unusual bleeding, but pregnancy-related causes must be assessed first.

Contact your obstetrician, midwife or maternity unit for guidance, even if the amount is small. Note when it began, its colour, whether clots or tissue appeared, and any pain or other symptoms. Use a pad rather than a tampon so you can monitor the flow. Your care team may recommend an examination, ultrasound, blood tests or infection testing according to the stage of pregnancy and your symptoms.

Tell the clinician your blood group if known, your medicines, recent sex or examination, and any previous pregnancy complications. Do not stop prescribed medicine or take a new remedy for bleeding without medical advice.

Get urgent medical assessment for bleeding with severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked dizziness, fever, heavy flow, or passing clots or tissue. These symptoms can occur with pregnancy complications that need prompt evaluation. Later in pregnancy, fresh bleeding, contractions, reduced fetal movement or leaking fluid also requires immediate maternity advice.

If you feel weak, collapse, have intense pain or the bleeding is rapidly soaking a pad, call local emergency services rather than travelling alone.

Ask what causes fit your stage of pregnancy, whether you need an ultrasound or blood test, and which changes should bring you back urgently. You can also ask whether pelvic rest is appropriate, when to resume usual activity, and how to contact the maternity team if bleeding returns.