Amos Grünebaum, MD FACOG
Obstetrician & Gynecologist and Maternal-Fetal Medicine Specialist

Spotting in Early Pregnancy

About 20-30% of all pregnant women normally experience some spotting early in pregnancy, and the majority go on to have a healthy baby. Spotting during the first 3-4 months of the pregnancy is often normal, but bleeding after the 14th-16th week is much more ominous. Call us immediately if you experience bleeding in the 2nd and 3rd trimester. Sometimes the spotting is accompanied by mild low back pain and cramping in the lower abdomen. The endometrium, the uterine lining, builds up a thick bed of blood vessels and as the "blastocyst", the fetus, implants, some blood is normally released from the uterine wall. Spotting and pain can be the first sign of an ectopic pregnancy, a pregnancy outside the uterus. If your doctor has already diagnosed that your pregnancy is inside the uterus, then the spotting cannot come from an ectopic pregnancy. Brown discharge with no pain is less likely associated with a miscarriage. Spotting and heavy red blood is typically how a miscarriage begins as well, but there is no treatment to prevent an early miscarriage and with spotting it’s often difficult to predict whether you are going to have a miscarriage or whether it’s normal. Despite the fact that bedrest is sometimes recommended for early spotting, no well controlled studies have confirmed its usefulness. Warning signs of a miscarriage would be: heavy bleeding, like a period or more passage of clots or tissue, increase in pain and/or fever. If you experience any of these signs please call us immediately. The fact that the spotting is brown or pink is a more reassuring sign.  For many women it can be reassuring to see or hear a fetal heartbeat and to make sure the fetus is growing as expected. For reassurance with spotting we can arrange a sonogram in our ultrasound division. Please call us during business hours and we can schedule a sonogram for you.