Is Spotting During Pregnancy Normal?

I am in my sixth week of pregnancy. I am spotting. It is light, but at times it feels as if my period is about to begin. It began with one day of cramps but they have stopped. Is this normal?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Spotting during early pregnancy can be very normal. Sometimes it is accompanied by low back pain and cramping in the lower abdomen.

The endometrium builds up a thick bed of blood vessels and as the "blastocyst" implants, some blood is released from the uterine wall. Of course, this is typically how miscarriage begins as well, so it is a good idea to notify your care provider and monitor the spotting. For example, does it increase after exercise, sex, a busy day? If it does, it is best to limit such activities until the spotting goes away.

Bleeding in the second and third trimesters is much more ominous, but first trimester bleeding is very common. Some authors say it happens frequently when the next menses would have been due.

Warning signs that this may not be normal would be heavy bleeding, passage of clots or tissue, increase in pain and/or fever. The fact that it is brown or pink is a good sign. If it turns bright red, I would call your provider immediately.

It is not too early to see your doctor or midwife. It can be very reassuring to hear a fetal heartbeat (often heard as early as eight to nine weeks with a doppler) and to make sure the uterus is growing as expected. An ultrasound may also be indicated.

All expectant mothers should also be checked for infections like chlamydia and bacterial vaginosis, which may cause preterm labor and spotting. Checks for hepatitis and beta strep should also be done sometime during the pregnancy.

Despite the fact that bedrest is sometimes recommended for early spotting, no well controlled studies have confirmed its usefulness.

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