What is spotting and is it normal?
Spotting is light bleeding from the vagina. It is similar although lighter than a menstrual period. The blood varies in colour from red to brown. Spotting is more common after IVF or other form of assisted conception. Two embryos may implant but then one may not go on to develop. This is called a vanishing twin and it can trigger some bleeding. Most of the time, spotting is nothing to worry about.
However, it can be a warning sign of something severe including miscarriage. This is why it is always best to take any bleeding seriously and get it checked out.
Some women find that they are spotting or slight bleeding in the first few weeks of pregnancy, mostly around the time they would normally have their menstrual period. This happens because the pregnancy hormone levels are not quite adequately high to discontinue the bleeding which comes from the lining of the womb. No treatment is required but you may find that it assists to rest more, if you can.
Occasionally, bleeding in early pregnancy may be caused by a vaginal infection which will require to be treated by your doctor. It can also happen as a result of a change taking place in the cells of your cervix (known as cervical attrition). This kind of bleeding sometimes takes place after you have sexual intercourse. Your doctor will suggest whether you need any treatment. Slight bleeding in late pregnancy may be a sign that your labor is about to begin, particularly if you have a jelly-like discharge (known as a show) at the same time.
Causes of bleeding
In early pregnancy, spotting and bleeding is usually harmless and caused by:
Certain hormones that control the menstrual cycle giving rise to bleeding when your period would have been due. This is known as advanced bleeding. You may have this at least once, around the times you would have had a menstrual period if you were not pregnant.
The fertilized egg embedding into your uterus lining can cause bleeding. This is known as implantation bleeding. This kind of light bleeding generally lasts a day or two.
Other factors that can cause bleeding
There may be other things taking place in your body that are causing some bleeding. They are:
The cervix which opens to the uterus may be irritated. Pregnancy hormones can change the surface of the cervix, making it more likely to bleed.
Sex could trigger some spotting.
Fibroids are growth in the lining of the uterus and are not cancerous. Occasionally, the placenta embeds where there is a fibroid.
A small growth on the cervix known as a cervical polyp is not injurious. Cervical or vaginal infection may occur.
An inherited disorder such as Von Willebrand disease which makes it more difficult for blood to clot, can cause bleeding.
Other causes
Early miscarriage
This usually happens when a baby is not developing properly. It goes with stomach pain and cramps. Bleeding from a miscarriage becomes steadily heavier. Some women even have a miscarriage before they realize they are pregnant and assume they are having a period. If you encounter excessive bleeding in early pregnancy, you should get medical advice immediately. It may be a sign of miscarriage. Through vaginal bleeding in the course of the first 20 weeks without any other signs like passing tissue cramps is also known as threatened abortion, most women with initial spotting will go on and have a healthy baby. Threatened abortion suggests that it is likely that the early bleeding could be an early indication of miscarriage. An actual miscarriage is more likely if there is clear red blood, typically heavier than a period, together with cramping. A miscarriage can take place over a period of several days although the pregnancy in most women with some bleeding and a threatened abortion will proceed as usual and they will have a healthy baby. Many doctors suggest that patients with a threatened miscarriage bleeding stay in bed.
Ectopic pregnancy
This occurs when the fertilized egg embeds outside of the uterus. Bleeding in the first 2-3 months and especially with pain in the lower abdomen could be an ectopic pregnancy. For an ectopic pregnancy, the bleeding may keep going and may be dark and watery. An ectopic pregnancy is dangerous so it has to be removed quickly.
Molar pregnancy
It is very unlikely that your bleeding is caused by this. It affects only about 1 in 1000 pregnancies. A molar pregnancy takes place when the embryo does not develop properly but some of the cells that produce the placenta go on to grow and multiply. To protect and maintain your health, a molar pregnancy has to be removed as soon as possible.
A hit to your belly
It is possible for a hit to the outside of your tummy to trigger bleeding. A hit can occur due to a fall, a car accident or as a result of domestic violence. What should I do if I notice bleeding? Consult your doctor immediately to find out more about why you have had some bleeding.
Emotional and physical stress just before conception and in early pregnancy can cause bleeding in pregnancy.