Brownish discharge during pregnancy is a relatively common occurrence. This discharge is essentially old blood that has taken time to exit the body, allowing the hemoglobin to oxidize, which changes the color from bright red to brown. The reproductive system experiences a significant increase in blood flow during pregnancy, making the tissues, especially the cervix, more sensitive to minor disturbances. This heightened sensitivity, coupled with hormonal shifts, can cause small amounts of blood to be expelled. Although many instances of brown discharge are considered benign, it is always a change that should be reported to a healthcare provider to ensure a healthy pregnancy.
Common Reasons for Brown Discharge in Early Pregnancy
The first trimester is the most frequent period for noticing light brown spotting. One of the earliest reasons is implantation bleeding, which can occur when the fertilized egg embeds itself into the highly vascular uterine lining. This light spotting usually happens between six and twelve days after conception and is often scant and short-lived.
The surge of hormones early in pregnancy increases blood flow to the cervix. Minor physical activities, such as sexual intercourse or a routine pelvic examination, can cause small blood vessels on the cervix to bleed slightly. When this small amount of blood is not immediately discharged, it oxidizes and appears brown.
Some women may experience brown discharge due to a subchorionic hematoma, which is a collection of blood between the uterine wall and the gestational sac. While the presence of a hematoma can be concerning, many are small, resolve on their own, and do not negatively affect the pregnancy outcome.
Brown Discharge During the Second and Third Trimesters
Brown discharge in the later stages of pregnancy often stems from mechanisms that are distinct from those in the first trimester. Cervical irritation remains a possibility, as the cervix continues to be highly vascularized throughout the second and third trimesters. As the pregnancy progresses, the cervix begins to soften and prepare for labor, making it more prone to minor bleeding after activities like a physical examination or sexual activity.
A more specific late-pregnancy cause is the loss of the mucus plug, often referred to as the “bloody show”. The mucus plug seals the opening of the cervix, and its expulsion indicates that the cervix is beginning to dilate. This discharge is typically thick or stringy and may be tinged with brown, pink, or red blood, appearing a few days or even weeks before labor begins.
While less common, brown discharge in the third trimester can sometimes be associated with placental issues or preterm labor, especially if it is accompanied by other symptoms. Any new bleeding or brown spotting in the second half of pregnancy should be promptly discussed with a provider.
Identifying Serious Concerns and Associated Red Flags
The color of the discharge alone is not the sole indicator of an issue; the volume, texture, and presence of pain are far more important markers. Heavy bleeding that is bright red, or discharge that soaks through more than two pads in an hour, necessitates immediate attention.
Severe abdominal pain or persistent, intense cramping can be a red flag for several serious issues, including a potential miscarriage or an ectopic pregnancy. Ectopic pregnancy, where the fertilized egg implants outside the uterus, may present with severe pain, often localized to one side, and can be accompanied by dizziness or fainting. Passing any tissue or large blood clots along with the discharge is also a sign that requires emergency evaluation.
Infections can also cause brown or discolored discharge, which is often accompanied by a foul odor, itching, or a fever above 100.4°F. Late in pregnancy, if the brown discharge is accompanied by regular, painful uterine contractions before 37 weeks, it could indicate preterm labor. Any combination of brown discharge with severe pain, fever, or a sudden change in volume warrants seeking urgent medical care.
Steps to Take and Communication with Your Provider
Upon noticing any brown discharge, wear a sanitary pad, not a tampon, to accurately track the amount, color, and consistency of the discharge. Try to rest and avoid strenuous activity to see if the spotting resolves on its own.
You should document the time the discharge started, how long it lasted, and whether it was associated with any specific activities, such as exercise or sexual intercourse. Note any accompanying symptoms, including pain, cramping, or fever, as this information is crucial for your provider to make an accurate assessment. For mild, light, and short-lived brown spotting without any other concerning symptoms, call your healthcare provider during regular business hours.
If the discharge suddenly turns bright red, increases significantly in volume, or is accompanied by severe, debilitating pain, you should proceed immediately to an emergency department. Clearly communicate the specific red flags you are experiencing, such as passing tissue or experiencing dizziness, to the medical staff.