Dark spotting during pregnancy: what to know

Brown or dark blood may be older blood that is leaving slowly. The cervix can become more sensitive during pregnancy, and light spotting may occur after sex or an examination. Early pregnancy bleeding can also occur around the time a period would have been expected. Infection, a cervical polyp, or a problem affecting the pregnancy are other possibilities; the colour alone cannot distinguish them. A pregnancy clinician may consider your stage of pregnancy, blood group, pain, bleeding amount and previous pregnancy history when deciding what assessment is needed.

Contact your maternity team or obstetric clinician and describe the colour, amount, start time and whether the spotting is continuing. Mention cramps, pelvic pain, dizziness, fever, discharge, recent sex or an examination. Use a pad or liner to monitor bleeding and avoid inserting tampons. Keep any pregnancy records available. Do not start, stop or change medicines without checking with the clinician who prescribed them. They may recommend an examination, blood tests or an ultrasound depending on your symptoms and stage of pregnancy.

Seek emergency care for heavy bleeding, severe or one-sided abdominal pain, shoulder-tip pain, fainting, marked dizziness, fever, or feeling acutely unwell. Contact your maternity team promptly even when bleeding is light if it recurs, becomes brighter or is accompanied by cramps. Do not use the dark colour as reassurance: urgent symptoms matter more than whether blood looks brown. Conditions such as Chlamydia can cause bleeding, while cervical conditions may also need evaluation, but only an assessment can clarify the cause.

Ask how soon you should be assessed, whether you need testing, which activities or medicines to discuss, and which changes require emergency help. You can also ask what follow-up is planned if the spotting stops.