Brown spotting when i wipe 4 weeks pregnant

Having small amounts of brown discharge during pregnancy is common and usually isn't concerning. However, it is possible that there are other issues going on, like infections, pH changes or cervical dilation.

In early pregnancy, scant amounts of light-colored, mucus-like discharge is typical and usually not worrying, but dark discharge with a foul odor may indicate more serious concerns.

In any case, you should report your findings to your obstetrician. He or she will assess you and order testing to determine the cause of the discharge and to start indicated treatment promptly.

Main causes for brown vaginal discharge

Fluctuations in vaginal pH can result in small amounts of brown discharge. This is typically not concerning, as it usually lasts for 2 to 3 days and resolves spontaneously.

Brown discharge in scant amounts can also occur in pregnant women, particularly after performing any physical activity (e.g. working out, climbing stairs with shopping bags, or after moderate-level house chores like cleaning).

It is important to note, however, whether the discharge is dark, has a foul odor, or causes any burning or itching, as these symptoms may this may indicate a more serious problem like:

• Infection (like sexually transmitted infections, which pregnant women are at increased risk for)
• Possibility of miscarriage
• Ectopic pregnancy (which is usually also accompanied by severe abdominal pain and blood)
• Cervical infection

Darker discharge in large amounts or heavy bleeding, especially in later pregnancy, is more likely associated with complications like premature delivery or rupture of the amniotic sac. It's important to contact your obstetrician whenever you see dark discharge, even in small amounts. He or she will likely perform an ultrasound to ensure your health and the baby's. Learn more about common symptoms of miscarriage that you should be aware of. 

When is brown vaginal normal?

Small amounts of brown discharge that ranges from fluid to mucus-like consistency is common, particularly in the early stages of pregnancy. It is also normal to have some dark discharge following sexual intercourse.

Symptoms that can accompany brown discharge and shouldn’t be ignored include vaginal itching, foul odor and cramping. These signs don’t always indicate something serious, but it is better to be cautious and to contact your doctor.

Dark brown discharge resembling coffee grounds may indicate loss of old blood, and should be reported immediately to the obstetrician. If you are nearing the end of pregnancy, and notice that discharge is heavy and light brown with a few streaks of blood, it may be a mucus plug, indicating that you will go into labor soon.

Treatment for brown discharge during pregnancy

If an infection is confirmed, treatment can be started using medication like antifungals (for treatment of a yeast infection) or antibiotics (for treatment of a sexually transmitted infection). However, if an infection has been ruled out, your doctor may just recommend rest and avoidance of any strenuous activity.

Regardless of the cause, you can help to prevent the occurrence of brown discharge by:

• Avoiding the use of soaps with moisturizing cream or antibacterial/antifungal agents
• Performing vaginal douching only at the advice of your gynecologist
• Ensuring underwear fabric is light, loose and made of cotton
• Avoiding use of softeners or bleach on underwear
• Washing underwear with a mild soap and water
• Avoiding use of panty liners
• Ensuring you do not wash the genital area more than twice a day, as this can decrease the natural-occurring bacteria that helps to protect you from infection

Is brown discharge a sign of pregnancy?

Brown discharge may be a sign of pregnancy, but it isn’t always the case. The color of menstrual blood can vary depending on the cycle day and on the woman's flow. For example, menstrual flow usually slows in the last days of menstruation, and because it takes longer for the blood to travel, it can become more concentrated and darker in color. Read more about brown discharge before a period and what it means. 

Even if your period is late, although your may suspect pregnancy, dark discharge may indicate early or incomplete shedding of the endometrium (which lines the uterus). Regardless, a thorough examination by your doctor is recommended. Understand what brown discharge can mean and what you should do. 

In this article

• Will my baby be safe if I have red or brown spotting or discharge?
• What causes red or brown discharge in pregnancy?
• Will I have any tests after early vaginal bleeding or brown discharge?
• What are the more serious causes of brown discharge or bleeding in pregnancy?

Light bleeding, or spotting, during pregnancy is common and usually nothing to worry about. Spotting is similar to a period but much lighter, and can vary in colour. You may notice anything from red to dark brown discharge. If you have brown discharge this just means the blood is a little older and no more a reason to worry than red spotting. Let your doctor or midwife know if you have red or brown discharge in pregnancy though even if it stops, just in case.

Will my baby be safe if I have red or brown spotting or discharge?

Your baby is likely to be fine, as spotting or light bleeding is often harmless (NHS 2015a, RCOG 2016a).

In the early weeks red or brown discharge, spotting or bleeding is very common. As many as one mum in four with a healthy pregnancy has some sort of bleeding or spotting in the first trimester (Hasan et al 2010, van Oppenraaij et al 2009).

Many pregnancies carry on, despite early bleeding problems (Norwitz and Park 2016, RCOG 2016a).

Sometimes, though, spotting can be a sign of something more serious, such as miscarriage. This is why it’s always best to tell your midwife or doctor if you have any type of vaginal bleeding, even if it stops.

If the bleeding signalled a miscarriage, you’d develop tummy cramps as well, and the bleeding would usually get heavier (Hasan et al 2010, Norwitz and Park 2016).

More often, though, spotting or light bleeding stops on its own and the pregnancy carries on as normal (Hasan et al 2010, van Oppenraaij et al 2009).

Spotting or light bleeding is likely to turn out to be no more than a worrying blip in your pregnancy (Hasan et al 2010, Norwitz and Park 2016) that you’ll soon be able to put behind you.

What causes red or brown discharge in pregnancy?

Light bleeding is likely to be caused by the developing placenta. Once you're about six weeks pregnant, there's a step-change in your pregnancy. The placenta takes over from your body the job of making pregnancy hormones (Hasan et al 2010, van Oppenraaij et al 2009) and this is thought to be associated with light bleeding.

You're most likely to have spotting or bleeding when you're between five weeks and eight weeks pregnant (Hasan et al 2010).

The bleeding is unlikely to last longer than three days (Hasan et al 2010). You may only realise you're bleeding when you go to the loo and wipe, or notice spotting in your pants.

You may have heard that light bleeding is caused by menstrual hormones breaking through around the time you would have had a period. Another theory is that bleeding happens when the embryo implants in the womb wall.

While you may get some bleeding at the time you’d expect your period, it is unlikely to be anything to do with menstrual hormones or implantation. Most normal bleeding happens about five days after implantation (Harville et al 2003).

Aside from the placenta developing, there may be other things going on inside your body that have caused some bleeding:

• Irritation to your cervix. Pregnancy hormones can change the surface of the cervix, making it more likely to bleed, such as after you have sex.
• Fibroids, which are growths in the lining of your womb. Sometimes, the placenta embeds where there is a fibroid.
• A small, harmless growth on your cervix (cervical polyp).
• A cervical or vaginal infection. (Norwitz and Park 2016)

Inherited bleeding disorders, such as Von Willebrand Disease, that make it more difficult for your blood to clot, can also cause bleeding in pregnancy (Shahbazi et al 2012).

What does the placenta do?

Our midwife explains how the placenta develops into your baby's lifelineMore pregnancy videos

Will I have any tests after early vaginal bleeding or brown discharge?

If the bleeding occurred early in your pregnancy, your midwife or doctor can refer you to your nearest early pregnancy assessment unit (EPAU) for further tests. You can also see a doctor at your local hospital (RCOG 2016a).

Tests to check how your pregnancy is going may include:

• An ultrasound scan to check that your baby is well. Your baby will be tiny at this stage, so you may need to have a scan via your vagina to get a good image. The person doing the scan (sonographer) will ask your permission to gently insert a probe into your vagina. It's perfectly safe for you and your baby.
• A vaginal examination. Your obstetrician will ask to check the neck of your womb for any cause of bleeding. She'll insert a speculum, the same instrument that's used during a cervical screening test, to gently widen your vagina to give her a view of your cervix.
• A test for chlamydia. Chlamydia can make ectopic pregnancy more likely to happen (NHS 2015b).
• Blood tests to check your blood group, rhesus status, and perhaps also the levels of the pregnancy hormone, human chorionic gonadotrophin (hCG) in your blood (RCOG 2016a).

What are the more serious causes of brown discharge or bleeding in pregnancy?

Unfortunately, bleeding in early pregnancy can be a sign of a miscarriage or an ectopic pregnancy. In both cases, you also usually develop tummy or pelvic pain and cramps (Norwitz and Park 2016).

Early miscarriage usually happens when a baby is not developing properly, and the bleeding becomes steadily heavier (Hasan et al 2010, Norwitz and Park 2016).

Early miscarriage is a heartbreaking event, but it is common (NICE 2013, RCOG 2016a). It affects about one pregnancy in four (Tommy's 2016).

An ectopic pregnancy happens when the fertilised egg implants outside of your womb. Unfortunately, a baby can't grow if this happens. The bleeding may continue, and may look dark and watery (RCOG 2016b).

An ectopic pregnancy can make you seriously ill, so you'll need to see an obstetrician at your nearest hospital quickly (Elson et al/RCOG 2016, NHS 2016, RCOG 2016b).

You’re slightly more likely to have spotting if you conceived twins. Sadly, sometimes one twin can stop developing and eventually disappear altogether. This is called a vanishing twin (Anderson-Berry 2016), and it may trigger some bleeding (Anderson-Berry 2016, Norwitz and Park 2016).

A rare cause of bleeding is a molar pregnancy (Cancer Research UK 2016, RCOG 2010, 2011). A molar pregnancy happens when an egg is fertilised but a baby can't grow, because the wrong number of chromosomes come together. A cluster of abnormal cells grows instead of a healthy baby (NHS 2017). A molar pregnancy must be treated to remove the abnormal tissues (NHS 2017, RCOG 2010, 2011).

It is also possible for a blow to your belly, perhaps after a fall, to trigger bleeding (Norwitz and Park 2016).

You may be offered extra care if you've had vaginal bleeding. Bleeding raises the chance of complications happening later in pregnancy (Saraswat et al 2010), especially if the bleeding was heavy or carried on into the second trimester (Norwitz and Park 2016).

Complications include premature birth, and having a baby with a low birth weight (Norwitz and Park 2016). Your medical team can keep a close eye on your pregnancy and your baby's growth, with extra scans and clinic appointments.

Bleeding in late pregnancy is much rarer and more serious than early bleeding. Read more about bleeding in late pregnancy.

See these other pregnancy symptoms you should never ignore.

References

Anderson-Berry AL. 2016. Vanishing twin syndrome. MedScape. emedicine.medscape.com [Accessed January 2018]

Cancer Research UK. 2016. Gestational trophoblastic disease: risks and causes. www.cancerresearchuk.org [Accessed January 2018]

Elson CJ, Salim R, Potdar N, et al on behalf of RCOG. 2016. Diagnosis and management of ectopic pregnancy. Royal College of Obstetricians and Gynaecologists / Association of Early Pregnancy Units joint guideline, Green-top guideline, 21. onlinelibrary.wiley.com [Accessed January 2018]

Elson CJ, Salim R, Potdar N, Chetty M, Ross JA, Kirk EJ on behalf of the Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy. BJOG 2016;.123:e15–e55.

Harville EW, Wilcox AJ, Baird DD, et al. 2003. Vaginal bleeding in early pregnancy. Hum Reprod 18(9):1944-7

Hasan R, Baird DD, Herring AH, et al. 2010. Patterns and predictors of vaginal bleeding in the first trimester of pregnancy. Ann Epidemiol 20(7):524-31. www.ncbi.nlm.nih.gov [Accessed January 2018]

NHS. 2015a. Vaginal bleeding in pregnancy. NHS Choices, Health A-Z. www.nhs.uk [Accessed January 2018]

NHS. 2015b. Chlamydia. NHS Choices, Health A-Z. www.nhs.uk [Accessed January 2018]

NHS. 2016. Ectopic pregnancy. NHS Choices, Health A-Z. www.nhs.uk [Accessed January 2018]

NHS. 2017. Molar pregnancy. NHS Choices, Health A-Z. www.nhs.uk [Accessed January 2018]

NICE. 2013. Miscarriage. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed January 2018]

Norwitz ER, Park JS. 2016. Overview of the etiology and evaluation of vaginal bleeding in pregnant women. UpToDate 08 Nov

RCOG. 2010. The management of gestational trophoblastic disease. Royal College of Obstetricians and Gynaecologists, Green-top guideline, 38. www.rcog.org.uk [Accessed January 2018]

RCOG. 2011. Information for you: gestational trophoblastic disease. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk [Accessed January 2018]

RCOG. 2016a.Information for you: bleeding and/or pain in early pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk [Accessed January 2018]

RCOG. 2016b.Information for you: Ectopic pregnancy. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk [Accessed January 2018]

Saraswat L, Bhattacharya S, Maheshwari A, et al. 2010. Maternal and perinatal outcome in women with threatened miscarriage in the first trimester: a systematic review. BJOG 117(3):245-57

Shahbazi S, Moghaddam-Banaem L, Ekhtesari F, et al. 2012. Impact of inherited bleeding disorders on pregnancy and postpartum hemorrhage. Blood Coagul Fibrinolysis 23(7):603-7

Tommy's. 2016. Miscarriage information and support. www.tommys.org [Accessed January 2018]

van Oppenraaij RHF, Jauniaux E, Christiansen OB, et al, on behalf of the ESHRE Special Interest Group for Early Pregnancy (SIGEP). 2009. Predicting adverse obstetric outcome after early pregnancy events and complications: a review. Hum Reprod Update 15(4):409-21. academic.oup.com [Accessed January 2018]

Is brown discharge normal at 4 weeks pregnant?

Why do I see Brown when I wipe while pregnant?

How long does brown discharge last in 4 weeks of pregnancy?

Is brown spotting normal 5 weeks pregnant?