Spotting after a positive pregnancy test: What it could mean
Nothing in this article is or should be construed as medical advice; for any medical questions, consult your doctor.
One minute you’re auditioning baby names in your head, and the next, you feel something down there. You run to the nearest bathroom to check it out and see small spots of blood in your underwear. You’re likely worried. Early pregnancy can be an emotionally volatile time — there are many unknowns.
It’s important to call your doctor anytime you experience bleeding or spotting while pregnant. That said, it’s more normal than you may realize, and many women go on to have healthy pregnancies.1 According to the American College of Obstetricians and Gynecologists (ACOG), bleeding or spotting in the first trimester happens in 15% to 25% of pregnancies.1 Some reasons are serious, but many are not. Let’s take a closer look.
What does pregnancy spotting look like?
Just like every woman’s period and vaginal discharge differs, spotting that appears after a positive pregnancy test can vary. Light bleeding and spotting during early pregnancy can appear as:
- Brown discharge
- Light pink and brown spotting
- Bright red spotting2
If you experience abnormal discharge, spotting or bleeding after a positive pregnancy test, make sure to contact your ob-gyn.
6 reasons for spotting after a positive pregnancy test
You may experience light pink or brown spotting after a positive pregnancy test. This could be due to implantation bleeding, which occurs when a fertilized egg implants in the lining of the uterus, one to two weeks after conception.1
Implantation bleeding can happen around the same time many women expect their next period, but there are a few key differences. (Even if you suspect it’s implantation bleeding vs. a period, give your ob-gyn a call.)
Not everyone experiences implantation bleeding. And debate still exists on whether implantation is even the mechanism for bleeding in early pregnancy. In fact, one study stated that there isn’t enough evidence to prove implantation bleeding exists, and that most bleeding occurs without a clear cause.4
Your cervix can bleed more easily in early pregnancy
According to ACOG, blood vessels developing around the cervix can cause light bleeding or spotting. This is why light bleeding or spotting after sex or a pelvic exam during early pregnancy is not uncommon.1
Vaginitis, which is an inflammation of the vagina, is common. According to ACOG, more than one-third of women will have symptoms of vaginitis at some point in their lives.5 Vaginitis can be caused by many things, including changes in hormone levels due to pregnancy.5 Yeast infections typically produce thick, white vaginal discharge and are more common in pregnant women.6 Trichomoniasis can cause light bleeding after sex.6 Vaginitis can also be bacterial, viral and noninfectious.6 Talk to your ob-gyn anytime you experience abnormal discharge.
Cervical polyps are growths that appear in your cervix and are common in your reproductive years.7 Symptoms including bleeding and vaginal discharge.7 Most cervical polyps are benign, but your ob-gyn may biopsy them to be sure.7
Early pregnancy loss
If you’re worried that your bleeding or spotting may be related to early pregnancy loss and your ob-gyn asks that you come in for an appointment, you may want to bring someone with you for support. Remember: Bleeding and spotting in the first trimester is common, and many women go on to have healthy pregnancies.1 However, early pregnancy loss is also common, affecting around one in four pregnancies.8
The shock of discovering blood while pregnant followed by the news of an early pregnancy loss can be difficult and heartbreaking. Be gentle with yourself. It may be of some comfort to know that repeated pregnancy loss is rare, with ACOG reporting a 1% likelihood of repeated miscarriages (three or more).9
Sometimes a fertilized egg grows outside of the uterus.10 This is called an ectopic pregnancy. Most of these pregnancies occur in a fallopian tube. As the pregnancy grows, the tube can burst, resulting in a life-threatening emergency.
If you suspect an ectopic pregnancy, contact your ob-gyn immediately. Symptoms include abnormal vaginal bleeding, low back pain, mild pain in the abdomen or pelvis and cramping. More serious symptoms include sudden, severe pain in the pelvis or abdomen, shoulder pain and weakness, dizziness or fainting.10
You may have a lot of questions if you start spotting or bleeding after a positive pregnancy test. First, remember it’s a normal occurrence for many women. Second, call your ob-gyn. They will ask you questions and likely perform a physical exam, conduct an ultrasound and/or test your hCG levels, and help you determine the next best steps.
- “Bleeding During Pregnancy,” (May 2021), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/faqs/bleeding-during-pregnancy.
- Hasan, R., Baird, D.D., Herring, A.H., Olshan, A.F., Jonsson Funk, M.L., & Hartmann, K.E., (2010), “Patterns and predictors of vaginal bleeding in the first trimester of pregnancy,” Annals of Epidemiology, 20(7), 524–531, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2884141/.
- “What is Implantation Bleeding?” (n.d.) American Pregnancy Association, https://americanpregnancy.org/getting-pregnant/what-is-implantation-bleeding/.
- E.W. Harville, A.J. Wilcox, D.D. Baird, C.R. Weinberg, (September 2003), “Vaginal bleeding in very early pregnancy,” Human Reproduction, 18(9), 1944–1947, https://doi.org/10.1093/humrep/deg379.
- “Vaginitis,” (March 2020), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/faqs/vaginitis.
- “Vaginitis,” (n.d.), John Hopkins Medicine, https://www.hopkinsmedicine.org/health/conditions-and-diseases/vaginitis.
- Alkilani, Y.G., Apodaca-Ramos, I., “Cervical Polyps,” (updated September 9 2021), StatPearls Publishing, https://www.ncbi.nlm.nih.gov/books/NBK562185/.
- Hardy, K., & Hardy, P. J, (April 2015), “1st trimester miscarriage: four decades of study,” Translational Pediatrics, 4(2), 189–200. https://doi.org/10.3978/j.issn.2224-4336.2015.03.05.
- “Early Pregnancy Loss,” (February 2020), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/faqs/repeated-miscarriages.
- “Ectopic Pregnancy,” (February 2018), The American College of Obstetricians and Gynecologists, https://www.acog.org/womens-health/faqs/ectopic-pregnancy.