Brown spotting during pregnancy

Is brown discharge normal during pregnancy?

Sometimes. Your body produces more vaginal discharge – including brown discharge – in pregnancy, thanks to a boost in the hormone estrogen. But when the discharge is brown, it's usually because it's tinged with old blood. (Blood turns brown as it dries, and blood can sometimes take a while to come out.)

Brown discharge can be normal, for example if you bleed a bit after sex or a pelvic exam. But it can also be a sign of a problem, such as a vaginal infection.

Early in pregnancy, brown discharge might signal something serious, such as a miscarriage, ectopic pregnancy, or a molar pregnancy. Later on, brown discharge can be a sign of preterm labor or a problem with the placenta.

In many of these instances, you'll most likely notice red bleeding, but it's possible the blood might appear brown.

"Brown discharge can be concerning when you're pregnant, but it's common," says Layan Alrahmani, ob-gyn and maternal-fetal medicine specialist in Chicago. "The overwhelming majority of pregnant people with brown discharge don't have anything dangerous to be worried about."

What causes brown discharge during pregnancy?

Here are the likely causes of brown spotting or brown discharge while you're pregnant.

Normal reasons you may have brown discharge:

Implantation bleeding

About seven to 14 days after you conceive (about the time you might otherwise get your period), the fertilized egg implants in your uterus. When it does, it can cause the bursting of small blood vessels and a small amount of vaginal bleeding. You might have some light cramping at the same time you have implantation bleeding.

Sex

You could have some brown, blood-tinged discharge after sex. Friction during sex can cause some trauma to your vaginal or cervical tissues, especially if you're not well-lubricated, and that can cause some spotting. And the cervix (which is especially sensitive now) can become bruised with deep penetration.

Pelvic exam

Your cervical tissues are particularly delicate during pregnancy, so you might notice some spotting or brown discharge after your practitioner has done a pelvic exam or checked your cervix.

Mucus plug

The mucus plug is a collection of gelatinous secretions from your cervix. These secretions fill the cervical canal in early pregnancy and create a protective barrier that remains for most of pregnancy.

As you get closer to delivery and your cervix begins to thin out and open up (effacement and dilation), these mucus-like secretions may come out of your vagina and look like a glob of thickened mucus that's clear, pinkish, brownish, or tinged with a bit of blood. This can be a sign of early labor.

Bloody show

Bloody show is another sign that labor's on the way. When your cervix starts to soften or dilate, you may notice pink or brown discharge or bright-red blood. If this happens at the same time you lose your mucus plug, the mucus may be tinged with blood, but it can also happen independently.

Concerning reasons you may have brown discharge:

Infection

Bleeding or brown discharge can be a sign of vaginal or cervical infection, such as bacterial vaginosis (BV), trichomoniasis, chlamydia, or gonorrhea. Having an infection during pregnancy can increase your risk of complications, such as preterm birth and premature rupture of the membranes (PROM). Your doctor can test you for infection and treat you with antibiotics if necessary.

Miscarriage

Bleeding or spotting is often the first sign of a miscarriage. Miscarriage is most common in the first trimester, though it can happen anytime up to 20 weeks. That said, keep in mind that most pregnant women who have spotting or bleeding in early pregnancy don't have a miscarriage.

Ectopic pregnancy

This happens very early in pregnancy, when a fertilized egg implants outside the uterus. The bleeding tends to be red but may appear brown, like the color of dried blood. Other signs include abdominal or pelvic pain and shoulder pain. Only 1 to 2 percent of pregnancies are ectopic, but it's important to get treatment immediately, because it's potentially dangerous for you.

Molar pregnancy

This means that the fertilized egg has developed into a growth called a mole instead of into a normal embryo. Bright-red bleeding or brown discharge can start as early as 6 weeks. Other symptoms include severe nausea and vomiting, abdominal cramping, and pelvic pressure or pain. You may also pass cysts (fluid-filled sacs). It's important to get immediate treatment for a molar pregnancy.

Preterm labor

Bleeding later in pregnancy (but before 37 weeks) can be a sign of preterm labor. Other signs include cramping and contractions. You may also feel your water break. Call your doctor or midwife at the first sign of preterm labor.

Placenta previa

Placenta previa means that your placenta is lying unusually low in your uterus. It may be covering or touching the cervical opening. There usually aren't symptoms, though the most common symptom is bleeding in the second half of pregnancy, as your cervix begins to open up and disrupt the blood vessels in the area. You may also feel contractions.

Placenta accrete

Placenta accrete means the placenta is embedded too deeply in the uterine wall, which can cause severe bleeding. There are often no symptoms until delivery, but vaginal bleeding during the third trimester can be a sign.

Placental abruption

This means that the placenta separates from the uterus before the baby's born, either before or during labor. Most of the time placental abruption causes vaginal bleeding or spotting. Other symptoms include cramping, back pain, or contractions.

When to call the doctor for brown discharge during pregnancy

While brown discharge is usually nothing to worry about, it's worth mentioning to your healthcare provider.

Call your provider right away if you have:

• Any bleeding or spotting (bright red or brown)
• Any vaginal discharge with a strong odor, or that's green or yellow and frothy
• Abdominal or pelvic pain or cramping
• Shoulder pain
• Severe nausea and vomiting

Learn more:

Pregnancy symptoms not to ignore

Steps to a healthy pregnancy

Your pregnancy week by week