Spotting During Pregnancy: What to Expect

It's common but concerning, especially for first-time moms. Here's what you should know and when to worry when it comes to prenatal bleeding.

Pregnancy can be a wonderful time for expecting moms, but it can also be the scariest – especially for first-timers. From the high cost of diapers to the health risks, there’s no shortage of worries for expecting parents. But one of the biggest is miscarriage and prenatal bleeding. So what amount of spotting is normal and when should you wake your doctor up at 3 a.m.? Dr. Karoline Puder, the director of obstetrics at DMC Hutzel Women’s Hospital in Detroit, has some information and advice that might just put your mind at ease.

“(The) importance of spotting varies during stages of pregnancy,” Puder says. “Most spotting in early pregnancy does not mean miscarriage. Most often it’s benign.”

Spotting can happen throughout a pregnancy, but is more concerning as the pregnancy progresses, she explains. In early pregnancy, spotting usually means there is some sort of irritation to the cervix. Second trimester spotting could indicate a thinning cervix or other cervical changes, and third trimester spotting could indicate an abnormal placenta.

Light spotting and cramping are not unusual during an early pregnancy, but if the bleeding becomes heavier or persistent, or the cramping becomes intense, Puder advises a woman to tell her doctor.

“If there’s a small amount of blood, there’s no reason to panic and call in the middle of the night,” she says. “Anytime there’s blood flowing down their legs, they can call during the middle of the night.”

All women are at risk for spotting during pregnancy, and there is really no way to stop it. Puder says miscarriages are the body’s way of discontinuing an abnormal pregnancy.

“One in six pregnancies will result in miscarriage under normal circumstances (a pregnancy confirmed by a doctor),” Puder says. “Miscarriages are common and are usually not controllable. … If the miscarriage is going to happen, it’s going happen; if it’s not, it’s not.”

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