When you want to be pregnant, any bleeding might make you worry. The truth is, there is a whole range of normal during early pregnancy. Some people experience spotting or even bleeding and go on to have healthy pregnancies and babies, while others do not have any bleeding during pregnancy at all. Read on to learn what is within the range of normal, but remember that if you have questions or concerns, your care provider is just a phone call away.
The first type of bleeding you might experience during pregnancy is implantation bleeding, which happens when the fertilized egg implants into the lining of the uterus or womb. It can be one of the first signs of pregnancy. Implantation bleeding—if it happens, as it does in about a quarter to a third of pregnancies—is likely to show up six to twelve days after fertilization. It is easier to identify implantation bleeding if you are tracking your cycle and know the day on which you ovulated.
While you might think your period has come early, implantation bleeding or spotting tends to be pink or brown, not bright red, and unlike your period, is not usually accompanied by menstrual cramps. You might not even notice this spotting, and it usually only lasts a day or two if it happens at all. If you think you might be pregnant, but are having bright red bleeding that increases in volume or have any kind of severe pain, you should talk to your care provider to rule out miscarriage or ectopic pregnancy. [1,2]
Other Bleeding and Spotting During Pregnancy
Aside from implantation bleeding, there are a number of other reasons that you might experience bleeding or spotting during your pregnancy. Some of them are cause for concern and some are not. Here are some examples of other reasons you might experience spotting or bleeding:
- You have been active. The changes in hormones during pregnancy can make your cervix, the neck of your uterus, much more sensitive. Sometimes that means that any activity that jostles things around—such as exercise or lifting something heavy—can cause light spotting.
- Spotting after sex. Just like being active can cause spotting, having sex, especially where vaginal penetration is involved can, too. Light pink or brown spotting that goes away quickly is likely nothing to worry about, but bright red bleeding is worth a call to your care provider, as it could signal an issue with the placenta, such as placenta previa.
- You have a subchorionic hemorrhage. This condition, which means that there is bleeding between your uterine wall and the sac around your placenta, can lead to a lot of vaginal bleeding during pregnancy and is especially common early in pregnancy. Sometimes it can affect the baby, but many people with subchorionic hemorrhages go on to have healthy babies. You should definitely consult with your care provider if you have bright red bleeding during pregnancy.
- You are experiencing an ectopic pregnancy. In this scenario, the fertilized egg implants somewhere that is not the uterus, often in the fallopian tube instead. Vaginal bleeding can be one of the first signs of ectopic pregnancy, which is also usually accompanied by abdominal or shoulder pain. 
- Miscarriage. Bleeding, especially when it is accompanied by cramping, can be a sign of a miscarriage. Spotting can signal the start of a miscarriage, but bleeding often then increases in volume and becomes bright red.
What To Do About Spotting
Most spotting does not need managed in any way. If you would like to protect your clothes, a panty liner is often sufficient. Note the possible triggers for your spotting—such as implantation, exercise, or sex—and monitor it to see how long it lasts. When spotting continues for more than a couple of days or turns into heavier or brighter red bleeding, it is a good idea to consult with your care provider. They can advise you what to watch for to make sure that your pregnancy and baby are healthy. While bleeding can be a sign that something is wrong, it is no guarantee. While it can be really scary, it is important to remember that many people experience both spotting and bleeding during pregnancy and go on to have healthy pregnancies and babies.