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Spotting During Pregnancy: When Should You Be Alarmed?

Published | 4 min read

Spotting during pregnancy is a common occurrence. Learn more about vaginal bleeding during this time so you can be prepared for it.

Young pregnant woman with a worried expression against a white background.

Spotting during the early stages of pregnancy is not unusual. It’s similar to the pink, brown, or red scant spotting at the beginning or end of your period. But if you’re spotting or bleeding in the second or third trimesters of your pregnancy, it could be a sign of something more alarming.

Learn about the causes of pregnancy spotting and bleeding, and how Traditional Chinese Medicine (TCM) can help.

Causes of Spotting During Pregnancy 

“The first three months of pregnancy is a crucial period when the embryo goes through developmental changes. Before the placenta is fully formed, the embryo may experience unstable adhesion to the surface of the endometrium (uterine lining).”

TCM Physician Tiang Sack Sing

There are a few reasons for this instability, including: 

  • Inadequate progesterone in the mother’s body 
  • The embryo is in a bad placement after implantation 
  • Being overworked and stressed 

This type of light bleeding that’s not accompanied by abdominal pain usually goes away with enough rest and avoiding too much movement or exercise. 

When It Could be More Serious 

Different symptoms accompanying spotting or bleeding during pregnancy can indicate different conditions.

Early or natural miscarriage 

Occasionally, newly pregnant women experience a natural or early miscarriage. Vaginal bleeding is accompanied by abdominal pain, discomfort and cramps in the lower abdomen, and backache. 

“Bleeding during the first trimester isn’t normal and shouldn’t be taken lightly, but don’t let anxiety wash over you. Instead, the first thing you should do is to go for tests to rule out all possibilities,” Physician Tiang advises. 

Illustration of human embryo attaching itself to the endometrium.
Spotting is usually just a little bit of endometrial shedding once the embryo has implanted.

Miscarriage later in the pregnancy 

Issues with a pregnancy can also lead to a miscarriage later. In this case, bleeding is accompanied by:  

  • Abdominal pain 
  • Backache 
  • A palpable sinking sensation in the lower abdomen 
  • Your baby feeling restless in the womb 

Ectopic pregnancy 

An ectopic pregnancy is when the embryo implants outside of the uterus. Not only can this stop the embryo from growing, but this condition also poses a great danger to the mother. Bleeding is accompanied by symptoms of a miscarriage, plus the below additional symptoms: 

  • Severe abdominal pain 
  • Extreme light-headedness or fainting 
  • A pale appearance 

Causes of Spotting and Bleeding During Pregnancy in TCM 

TCM believes that pregnancy requires sufficient blood and qi (vital life force) to nourish the foetus,” Physician Tiang states. The onset of pregnancy depends on an environment that is good for fertilisation and embryo growth.

First-trimester bleeding usually indicates issues with blood, Kidney qi, and Kidney yin (cool, passive energy). These Deficiencies which are yin in nature can result in an imbalance where there is a hyperactivity of yang (warm, active energy). This leads to Heatiness and shows symptoms including

  • Bleeding 
  • Dizziness 
  • Heart palpitations 
  • Dry mouth 
  • Insomnia 
  • Irritability 

Nourish Your Yin and Blood 

Preventing spotting and bleeding while you’re pregnant should begin even before your pregnancy. The central goal of TCM is to nourish your yin to prevent your yang from being overpowering.

Tonify your body to strengthen your blood qi with these herbal foods: 

Hand holding a small glass jar with lid containing herbal essence of chicken.
Pure essence of chicken helps nourish and strengthen your body as you go through pregnancy.

Physician Tiang notes that nourishing yin is especially important for pregnant mothers with weak constitutions. But for all pregnant women, this is a time of calm and rest while your baby grows and you take care of yourself. Avoid overworking, stress, and excessive sexual intimacy.

She lists a few other things to avoid that are obvious but still worth reminding: 

  • Drinking alcohol 
  • Consuming too much caffeine or foods that can cause uterine contractions 

Lastly, Physician Tiang reminds mothers to not diagnose themselves when experiencing spotting or bleeding during pregnancy. She says, “Apart from regular health screenings at the hospital, it’s recommended that you consult a trusted TCM practitioner to regulate your constitution to keep your foetus in a healthy state.

When consuming supplements, do check with your doctor to ensure they are appropriate for the optimal health of you and your baby and heed the advice of a TCM practitioner before taking tonics to nourish your yin and blood.” 

Just found out you’re pregnant and worried about spotting and bleeding? Bookmark this article and share it with other mums!


  1. Cleveland Clinic. 2022. Implantation Bleeding. [online] [Accessed 31 January 2023]  
  2. Cleveland Clinic. 2021. Bleeding During Pregnancy. [online] [Accessed 31 January 2023] 
  3. Evidence-Based Complementary and Alternative Medicine. 2014. Systematic Review of Chinese Medicine for Miscarriage during Early Pregnancy. [online] [Accessed 31 January 2023]  
  4. Frontiers in Nutrition. 2022. Chemical composition and anti-aging effects of standardized herbal chicken essence on D-galactose- induced senescent mice. [online] [Accessed 31 January 2023] 

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