Spotting during early pregnancy

Spotting is light vaginal bleeding that can happen when you're pregnant.

It is very common during the first 12 weeks of pregnancy. It happens in around 1 in 2 pregnancies.

What spotting looks like

Spotting can be pink, red or brown.

The amount of blood you lose is small. It may look like a few drops of blood in your underwear or on toilet paper. It is not enough blood to cover a sanitary pad.

Spotting does not last as long as a period. It usually stops after 1 or 2 days.

Spotting is usually harmless. But sometimes it can be a sign that something is wrong.

Causes of spotting

The main causes of light bleeding during early pregnancy include:

• implantation bleeding - 3 weeks after your period when the fertilised egg attaches to the lining of your womb
• hormonal changes - pregnancy hormones can cause changes to your cervix

Bleeding can also be a sign that your pregnancy is not developing properly. It may be a sign of a miscarriage or an ectopic pregnancy.

Warning signs during pregnancy

What happens at your appointment

Your GP will ask you about your bleeding.

They may ask you:

• the date of your last period and how often you usually have periods
• what contraception you used in the last 3 months - including emergency contraception
• about your history of cervical screening
• how many weeks pregnant you are and when you did a pregnancy test
• if it's your first pregnancy
• what the bleeding is like - tell them about the colour, any clots and how heavy the bleeding is
• if you have any other symptoms such as tummy pain or dizziness

Describe your bleeding in detail. It will help your GP understand if the bleeding is a sign of a problem.

Your GP is there to help you and they talk about things such as bleeding all the time.

But if you feel uncomfortable talking about your bleeding, you could:

• write down what you need to say before your appointment - you can give your notes to your GP if you need to
• tell your GP how you feel - this can help you feel less nervous
• use everyday words - you do not need to know medical terms

Examination

Your GP may ask you for your consent to do a physical examination.

They may:

• check your blood pressure
• check your pulse
• press on your stomach

Tests

Your GP may do other tests, such as a:

• urine test - to check for infection
• pregnancy test - if it is your first appointment during your pregnancy
• blood test - to measure the levels of pregnancy hormone in your blood (beta hCG)

If they do a blood test, your GP will send the sample to a lab in a hospital.

Referral

What happens next depends on:

• the stage of the pregnancy you're at
• how heavy the bleeding is
• what your GP found out at your appointment

Your GP may refer you to:

• your maternity hospital - for an ultrasound scan
• the early pregnancy unit (EPU) - to investigate the bleeding
• the emergency department (ED) - if you have severe stomach pains or heavy vaginal bleeding

You may need to wait a while to be seen. It may help to bring a support person in case you get bad or unexpected news.

Before you go, check if the hospital has any service disruptions or visiting restrictions.

You may not need to go a hospital if you are less than 6 weeks pregnant and:

• the bleeding is very light
• you have no other symptoms

Going to the maternity hospital about spotting

You may have tests and examinations at the hospital. This is to look for the cause of the bleeding.

Pelvic or vaginal examinations

Your doctor or obstetrician may recommend a pelvic or vaginal examination.

Before doing an examination, they will:

• explain why they recommend the examination
• ask for your consent to do the examination
• ask if you want a midwife or another person with you

These examinations may feel uncomfortable. Tell the doctor or midwife if you feel pain. You can ask them to stop at any time.

Examination using a speculum

Your doctor or obstetrician may use a speculum to see your cervix. A speculum is a smooth, tube-shaped tool. It holds the walls of the vagina open.

When you are ready, they:

1. Gently put a speculum into your vagina. They may use a small amount of lubricant.
2. Open the speculum so they can see your cervix.
3. Gently remove the speculum.

Examination without a speculum

Your doctor or obstetrician wears gloves for this examination.

When you are ready, they:

1. Gently put 1 or 2 fingers inside your vagina.
2. Feel inside your vagina to see if there is any pain, lumps, swelling or anything unusual.

Ultrasound scan

Your doctor will often request an ultrasound scan. This is usually a transvaginal ultrasound. This is the best way to get a clear picture in early pregnancy.

Blood tests

You may have a blood test to check the levels of pregnancy hormone in your blood.

To check how your hormone levels change, you may have another test 2 days later.

What happens next

The next steps depend on the cause of the bleeding. You may need to be admitted to hospital for observation or treatment. But most women with light bleeding are discharged home.