Pregnancy brings on so many bodily changes for expectant moms, and unsurprisingly, a lot of them involve bodily fluids. Vaginal discharge can change throughout your pregnancy, but is pink discharge during pregnancy normal? It can really feel panicky to see that tiny bit of pink on the toilet paper, but here's what you should know if you notice some.
Sometimes, discharge looks a little pink because it’s mixed with a small amount of blood. Christie Bryant, certified nurse midwife and clinical coordinator at the Birth Center of Denver, tells Romper in an interview that spotting during pregnancy is more common than many women think. It’s important to pay attention to, and can have a number of causes.
“Spotting can be related to the pregnancy, but is often related to something else entirely,” she explains. “Some common causes for spotting include vaginal or cervical infection, postcoital spotting, or even a urinary tract infection. It’s also important to know that there are several other factors we need to know before we can call pink-tinged discharge normal. That’s why your healthcare provider will likely ask you to let them know if you have spotting of any kind.”
While these causes for pink discharge may not seem that serious, you’ll still need to contact your doctor to treat any infections. Bryant also encourages pregnant women to let their providers know anytime they’re experiencing spotting or off-colored discharge to rule out anything serious.
“There are many reasons to have harmless pink discharge, but the very same discharge can also be a warning sign of something more dangerous. That’s why it’s important to let your healthcare provider know if you are experiencing spotting. There are things your healthcare provider can look at that can reassure you — and us — that your spotting is normal,” Bryant explains.
“Pink discharge is actually discharge tinged with blood and represents some spotting. So, pink discharge is spotting, but on the lower end of the spectrum, so to speak,” Kendra Gillespie, M.D. of River City OB-GYN and Baptist Health in Jacksonville, Florida, tells Romper.
Pink discharge and spotting can be caused by everything from your baby implanting into your uterus as early as four weeks into pregnancy, to ectopic pregnancy, when the pregnancy implants outside the uterus, per Healthline.com. Healthline adds that spotting late in the pregnancy can indicate you’re about to lose your mucus plug. In rare cases, it can be an early sign of a miscarriage, which usually occurs with other symptoms like cramping and pain. Both physicians agree that, while at some points in the pregnancy spotting or pink discharge is normal, it’s a concern at others.
“Spotting can occur in the first trimester with, among other things, implantation, sex, and finding of a subchorionic hemorrhage,” says Gillespie. “Spotting most commonly occurs again toward the end of the third trimester when the cervix is preparing for birth and starts to dilate and get thinner. At this point, pregnant women are likely seeing their doctor weekly and can address it at that appointment unless it becomes heavy bleeding. So, spotting is expected in the first and third trimesters — not necessarily normal, but expected and not dangerous. Second trimester spotting is less common and may require further evaluation to see if there is a clot, an issue with your placenta and its location, or early thinning of the cervix. As a rule of thumb, it should always be disclosed to the doctor and may warrant an immediate ER visit if there is heavy bleeding.”
“You should know that it can be difficult to evaluate your spotting over the phone, and that’s why when you call your healthcare provider, you’ll likely get many questions!” says Bryant. “If you’re in your first trimester and have had an early ultrasound showing the pregnancy is in the uterus, we are not going to be concerned about an ectopic pregnancy, which can be a life-threatening event. On the other hand, if you’re near full-term — 37 weeks to 40 weeks — we might suspect the beginning of labor, but are not concerned about preterm labor. That leaves a lot of time in between when things might not be so clear.”
Also, be sure to pay attention to whether your discharge is obviously pink, or blending with spotting. This distinction will be important to your doctor, Bryant explains.
“A pink tinge to your discharge indicates a very small amount of blood added to a larger amount of discharge,” she says. “This can happen as very small blood vessels rupture, as happens when you have sex. This is often noted on a tissue when you wipe after you urinate. Spotting is more pronounced and is often bright red, dark red, or brownish. Any time you have bleeding during pregnancy, it should be treated as an emergency, at any gestational age.”
Ultimately, no matter what you’re experiencing, if what you notice about your body is abnormal or concerning, it’s worth a call to your doctor. They want to ensure you and your baby are healthy, or at least put your mind at ease if it’s no big deal.
“The bottom line is you’ll feel better if you have a conversation with your provider should you have pink discharge,” says Bryant. “It could be completely normal and you will breathe a sigh of relief, or it could be a complication that requires attention. We understand the fears associated with a change in your discharge and really would value a chance to help.”
Christie Bryant, MS, FACNM, certified nurse midwife and clinical coordinator at the Birth Center of Denver
Kendra Gillespie, MD, OB-GYN at River City OB-GYN and Baptist Health in Jacksonville, Florida