As someone who experienced a fair amount of bleeding in the first trimester of pregnancy, I wanted to share my thoughts on the topic. The good news is both of my pregnancies had bleeding in the first trimester and both pregnancies resulted in healthy babies.

Having been through the stress of seeing blood quite a bit in my first trimester. In this article I will try to make sense of it all and share when it really is a cause for concern.

DISCLAIMER: This article details my personal experience with bleeding in first trimester pregnancy. This is not medical advice and any concerns should be discussed with your physician.

How Much Blood?

The first thing you might notice if you have bleeding in first trimester is how much you are bleeding. Is it just a little bit of spotting on the toilet paper? Or, are you needing to wear a pad.

The less blood you see the better, but even if you require a pad it does not mean a miscarriage is inevitable. For reference, the bleeding I experienced was mostly spotting.

However, there were a few days I needed a pad or had quite a bit of blood on the toilet paper when I went to the bathroom.

Color Of The Blood

The color of the blood you see is an indication of how old the blood is. If the blood is fresh it will be bright red or pink.

If it’s not fresh blood it will be more brown in color. In my case, most of the spotting I had was bright red, so it was fresh blood.

What Causes Bleeding In First Trimester Pregnancy?

There are a whole bunch of things that can cause bleeding in first trimester pregnancy. But, don’t be concerned if your doctor cannot determine the cause.

It’s annoying to not know why, but as long as everything else looks normal with your pregnancy then it doesn’t really matter. This was the case for me, the cause of my bleeding was never determined.

But, I ended up with 3 healthy children and that’s all I can ask for.

Bleeding during pregnancy, when to be concerned.

Pregnancy Bleeding When Carrying Multiples

Being a twin mom, I was made aware that having twins or higher order multiples puts you at higher risk for breakthrough bleeding during pregnancy. I was actually surprised that I experienced a similar amount of bleeding when I was pregnant with my singleton.

Even though my experience was different, being pregnant with multiples could be a reason for bleeding in first trimester pregnancy.

Infertility Medication

Since I did IVF to become pregnant with my twins, I needed to take progesterone to maintain the pregnancy. At first I was using progesterone suppositories.

This means I would insert a progesterone pill inside my vagina once a day. When I reported bleeding, my fertility doctors did an ultrasound.

Thank goodness they determined the babies were fine and had heartbeats. At first, I continued with the progesterone suppositories, but the bleeding seemed to be getting worse.

I was so nervous to be bleeding everyday the doctors said I could switch to getting a daily progesterone injection in my lower back. I decided to go this route since I was extremely stressed.

This meant my husband injected me each night with progesterone. By switching to the shot I continued to experience bleeding, but it was not as severe as before.

Bleeding With Twins Versus A Singleton

Surprisingly, bleeding in first trimester pregnancy was similar for both my twin pregnancy and singleton pregnancy. One good thing, the bleeding didn’t cause as much stress for me during my second pregnancy.

Additionally, I did not do IVF or any fertility treatments to become pregnant the second time.


The first time I reported spotting to my fertility doctors I was given an ultrasound to confirm the pregnancy was still viable. I was eventually transferred from my fertility doctor to the OB/GYN around 8-10 weeks pregnant.

I reported the bleeding / spotting to the OB as well. It was interesting that the OB was much more concerned with the bleeding than the fertility clinic.

I received an ultrasound at the OB as well and again everything looked good. It was definitely crazy to have so many ultrasounds during the first trimester, but at least it was comforting to know the pregnancy was still developing as it should.

Causes For Concern

The biggest thing I learned about bleeding in first trimester pregnancy, was there is much less cause for concern if cramping does not accompany the bleeding.

In my case, I never had much cramping at all.

What To Do If You See Blood

There was one time in each of my pregnancies I felt the need to call the OB for help because the bleeding had become heavier than the spotting I was used to seeing.

Not to be too graphic, but both times a large amount of blood was in the toilet after using the bathroom. Both times I received the same answer, if you are only bleeding and no cramping is associated with it, it will probably be okay.

Additionally, I was instructed to lay down and rest. I did this, and by the next day, the bleeding returned to the spotting I was used to seeing. I never experienced any cramping during these episodes.

The doctor also told me that if the bleeding got heavier and I started cramping to call him back.

Will The Bleeding Stop?

One big question is when will the bleeding stop? I know I asked my doctors this and was told it could stop tomorrow or it could last the entire pregnancy.

Really comforting, I know.

I will share that my spotting slowed down near the end of the first trimester and was completely gone early into the second trimester.

Pregnancy and bleeding, when to be concerned.

When To Get More Help

Should you call the doctor? Go to the emergency room? If you are having a miscarriage, the emergency room will not be able to stop it.

For regular business hours, call your doctor. If it’s off hours and you go to a practice with an on call number, I think it is best to call that number.

You can talk to a doctor directly, tell him or her what’s going on. The doctor will be able to advise if an emergency room visit is necessary.

That’s just my tip on what I would do. If you can avoid having to hang out in the emergency room and get some answers to your questions over the phone, that’s probably the best option.

What’s Next?

Bleeding in first trimester pregnancy is never fun. It can lead to a lot of stress and worry over the viability of your pregnancy.

If cramping does not accompany the bleeding that’s a very encouraging sign. If you are ever concerned about bleeding in pregnancy, call your doctor and get guidance.

More Pregnancy Help

One more thing before I go. Most people that end up on this post, arrived here because they are pregnant with twins and have had some sort of bleeding.

Or, they are wondering if the bleeding they are seeing is caused from being pregnant with twins. I wanted to share something that could be helpful as you move along in your hopefully healthy pregnancy.

If everything does turn out to be fine, then I highly recommend you sign up for our FREE, customized twin baby registry guidebook. Just fill in your information below and check your email.

If you don’t see it, be sure to check your spam folder too. In the email you receive, you will select the book that applies to you. There are different books depending on the sex of the baby, if you plan to breastfeed, and how many floors your home has.

Picture of twin baby registry guidebook

FREE, CUSTOMIZED Twin Baby Registry Guidebook

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I hope this article helped quell your fears regarding bleeding in first trimester pregnancy. Thanks, and good luck with the rest of your pregnancy.

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  1. Thank you for sharing this story, Jeanne. I am currently having an alarming amount of spotting, mostly rust colored but some of it bright red, though not heavy, no serious cramps and no big clots so everyone keeps saying it’s normal. I had to start wearing a pad. I was reassured when a pregnancy test this morning was still fully positive. I’m 6 weeks along and haven’t had an ultrasound yet (out of town at work but scheduled for my first appointment in 2 weeks and my doctors are aware of the spotting). I was so stressed, but reading your story has settled my mind more than anything, to be honest. Thank you.

    1. Hi Elizabeth,
      Thanks for your message and I’m glad you found the post helpful. This is the reason I wrote it because there was just nothing out there when I was going through the same thing. I really hope everything turns totally fine with your pregnancy, I know it is so stressful to deal with bleeding.

    2. Thanks Elizabeth!
      8 weeks pregnant with twins and today I saw red spotting vs my usual brown/pinkish spotting from last week. No cramping so far but will call my OB tomorrow. It makes me a little less anxious knowing it doesn’t necessarily mean the worst. Thanks again for sharing your experience.

  2. Thank you so much for this article!! I’m 5 weeks pregnant and had some bleeding today, went to ER & we discovered 2 sacs!! No heavy cramping so feeling positive & I’m gonna take it easy, this post gives me so much hope!! Stay healthy everyone !! <3

    1. Wow! Congratulations and I wish a very healthy pregnancy. We have a lot of twin pregnancy resources on the blog, so definitely come back and visit as you move further along in your pregnancy.

  3. This was super helpful. I’ve been back and forth to the doctor and am 11 weeks pregnant with twins. I was pregnant with triplets but lost one so I’ve been really stressed out by the on and off again bleeding. Just hoping I make it to the second trimester maybe I’ll feel more hopeful and the bleeding will stop

    1. Hi Skye, I’m glad you found the article helpful. I’m so sorry about the loss of one of your triplets, so hard. Good luck with the rest of your pregnancy and feel free to come back and read up on the rest of our twin pregnancy and twin baby articles too.

  4. I can’t thank you enough for sharing your experience. I just woke up and the was light spotting with no cramping. I have already had a miscarriage and a blighted ovum in the past. My ultrasound is tomorrow. You really helped to calm me down. Thanks again!

  5. Thank you! Thank you! Thank you!
    I so needed this today. I’m 6 weeks pregnant from an FET and was lightly spotting today. My heart instantly jumped to my throat. This was so reassuring. You have made me calm for now ❤️

  6. 6 weeks gone with twins the spotting still continues each time i use the rest room.
    Brown colour no cramping this article puts my heart at ease.
    My ultrasound is in a week..

    1. Thanks for your comment Nelly, good luck during this stressful time. I’m glad it helped to give you hope and feel better little bit better.