Spotting during pregnancy: what you should know

Spotting means a small amount of blood from the vagina, often seen on toilet paper or underwear rather than soaking a pad. In early pregnancy, the cervix can bleed more easily because of hormonal and blood-flow changes, including after sex or an examination. Other causes include infection, a threatened miscarriage, miscarriage, or an ectopic pregnancy. Later in pregnancy, bleeding can involve the cervix, placenta, or the start of labour. The colour may be pink, red, or brown, but colour alone cannot show whether the cause is minor or serious.

Bleeding between periods has different causes outside pregnancy; after a positive pregnancy test, any new bleeding deserves pregnancy-specific advice.

Contact your obstetrician, midwife, maternity unit, or the service that confirmed your pregnancy. Tell them when the spotting began, how much blood you have seen, its colour, whether clots or tissue are present, and whether you have cramps, one-sided pain, fever, unusual discharge, or urinary symptoms. Use a pad so you can monitor the bleeding; avoid tampons. Follow the clinician’s advice about sex, activity, and medicines, and do not start or stop treatment without checking. Assessment may include questions, an examination, blood tests, or an ultrasound depending on your pregnancy stage and symptoms.

Get urgent medical help now for bleeding that is heavy or increasing, severe or persistent abdominal pain, pain mainly on one side, shoulder-tip pain, dizziness, fainting, marked weakness, fever, or feeling very unwell. These symptoms can occur with complications that need prompt assessment, including ectopic pregnancy or significant blood loss. Do not drive yourself if you feel faint. If you are later in pregnancy, contact your maternity unit urgently for bleeding, regular contractions, fluid leakage, or reduced fetal movement.

Ask what causes are most relevant at your stage of pregnancy, whether you need an examination or ultrasound, what changes should trigger emergency care, and whether you should change activity or avoid sex until the bleeding stops. Ask how and when you will receive test results, and who to contact if the spotting returns.