Seeing black blood during pregnancy can be alarming, but it does not necessarily mean there is a problem. Here is a quick overview of what black blood may indicate in pregnancy:
Quick Answers
– Black blood during pregnancy is often due to old blood mixing with cervical mucus. This is usually normal, especially after a pelvic exam.
– Slow blood flow and clotting from hormonal changes can also lead to black discharge. This is common in early pregnancy.
– Heavy, gushing black blood with clots likely indicates a miscarriage. Seek urgent medical care.
– Persistent black discharge or foul odor could signal an infection. Contact your OB.
– Black specks in vaginal fluid may just be cervical mucus. Monitor and contact your OB if concerned.
– Rarely, black discharge may indicate a molar pregnancy. Follow up with your OB.
Now let’s explore this topic in more detail.
What Causes Black Blood During Pregnancy?
There are several possible causes of black vaginal discharge or blood during pregnancy:
Old Blood Mixing with Cervical Fluid
One of the most common reasons for black discharge is old blood mixing with normal cervical mucus. After an internal exam like a Pap smear or pelvic exam, some old blood can get stirred up and then slowly discharged over the next few days.
As blood ages in the vagina, it turns dark brown or black as it oxidizes. When this old blood tinted fluid mixes with creamy cervical mucus, it can create streaks or spots of black.
This type of black discharge is usually normal, especially if it happens right after a pelvic exam. The black streaked mucus may last for a couple days after the exam as the cervix continues producing discharge.
Slow Blood Flow and Clotting
Another common reason for black vaginal discharge is slow blood flow in early pregnancy. Slower circulation combined with blood vessel growth in the cervix causes old blood to accumulate and turn black.
Hormonal changes also make blood thicker and more prone to clotting in pregnancy. Small clots can turn discharge black or brown.
This type of dark, thickened discharge is often seen in the first trimester as the body adjusts to hormonal changes. It typically resolves by the second trimester as blood flow improves.
Miscarriage
Heavy black discharge with clots, cramps, and gushing blood may indicate a miscarriage. The black color comes from old blood mixing with the fresh red blood of active bleeding.
Miscarriage most often occurs in the first trimester, though later pregnancy loss is also possible. If you have heavy black vaginal bleeding along with severe cramps, it is essential to seek urgent medical care to assess for miscarriage.
Infection
A vaginal infection can also cause dark or black discharge. Bacteria, yeast or viruses can all lead to abnormal fluid that may appear black, green or yellow.
Infections are more likely when the immune system is suppressed, such as during pregnancy. Symptoms may include itching, burning, odor and discomfort along with the unusual discharge.
Black discharge due to infection may be light or heavy depending on the type of infection. It is important to contact your OB provider promptly if you notice black discharge along with odor or other symptoms.
Cervical Mucus
As hormones fluctuate, pregnant women may notice more cervical mucus discharge. This mucus can pick up old blood cells and tissue as it exits the cervix.
Resulting discharge may contain small dark specks or be streaked with black. If the mucus itself is white or clear, this is likely normal. However, unusual mucus colors like green, yellow or gray may require evaluation.
Molar Pregnancy
In very rare cases, black vaginal discharge may be a sign of a molar pregnancy. This is when tissue grows abnormally in the uterus, forming clusters of swollen tissue or cysts.
Molar pregnancies may cause symptoms like bleeding, severe nausea, uterine size larger than expected and abnormal hCG levels. Black discharge due to a molar pregnancy is uncommon.
However, any time black bleeding occurs alongside unusual pregnancy symptoms, it is important to contact your OB right away to check for potential complications.
When to See a Doctor
Here are some guidelines on when to seek medical care for black vaginal discharge or bleeding during pregnancy:
- Heavy black discharge or bleeding – Get immediate care to assess for miscarriage
- Black discharge along with cramps, pain, odor or other symptoms – Contact your OB promptly
- Persistent black discharge lasting more than a few days – Seek evaluation to check for potential infection
- Black discharge with abnormal pregnancy symptoms like severe nausea – Get assessed for potential complications
In most cases, a small amount of dark brown spotting or black-tinged discharge is harmless. But unusual textures, colors or smells should always be evaluated quickly.
Diagnosing the Cause of Black Discharge
To diagnose the cause of black vaginal discharge, your OB provider will typically:
- Ask about your symptoms and medical history
- Perform a pelvic exam to inspect the cervix and vagina
- Check your uterus and ovaries by palpation or ultrasound
- Test discharge samples under a microscope to look for infection
- Order blood work to check hormone levels and check for infection
- Assess pregnancy status and viability with ultrasound if concern for miscarriage
Based on the exam and test findings, your doctor can determine if the black discharge is due to a normal cause like old blood or cervical mucus, or if treatment is needed for infection, miscarriage or other problems.
Treatment for Black Discharge in Pregnancy
Treatment depends on the underlying cause of black vaginal discharge.
- No treatment: If old blood or normal cervical mucus, no specific treatment is needed.
- Infection treatment: Antibiotics, antifungals or antivirals will be prescribed based on lab cultures.
- Miscarriage management: Options include medication, D&C procedure or letting nature take its course.
- Molar pregnancy treatment: Removal of abnormal tissue growths. Follow-up monitoring is essential.
Regardless of cause, your OB provider will advise on any restrictions and follow-up needed during your pregnancy.
When Black Discharge is Normal
Here are some instances when black vaginal discharge is usually normal and not a cause for concern:
- After a Pap smear or pelvic exam stirring up old blood
- Occasional small amounts early in pregnancy from hormonal changes
- Dark brown spotting after intercourse from irritated cervix
- Dark specks in cervical mucus from picking up old tissue
- Right before your period is due – old blood mixing with mucus
As long as you are not experiencing heavy bleeding, pain or other abnormal symptoms, these causes of black discharge are typically harmless.
When to Worry About Black Discharge
Seek prompt medical evaluation if you notice:
- Bleeding that soaks a pad in an hour or less
- Large clots or clumps of black discharge
- Severe cramps or belly pain with bleeding
- Bad odor coming from vaginal discharge
- Black discharge accompanied by fever, chills, vomiting or lightheadedness
- No known cause like a recent exam to explain black discharge
These signs may indicate more serious issues like miscarriage, infection, or complications. Contact your OB right away if you have any of these red flag symptoms.
How is Black Discharge Diagnosed?
Black vaginal discharge is diagnosed based on a combination of:
- Medical history – other symptoms, pregnancy status, recent procedures
- Visual exam – color, amount, odor, source of discharge
- Microscope exam – looking for yeast, bacteria or other signs of infection
- Lab tests – urine culture, vaginal culture, blood counts, hormone levels
- Pelvic ultrasound – evaluates pregnancy, ovaries and uterus
Based on these findings, your OB doctor can identify the cause and determine appropriate treatment steps.
What Color Vaginal Discharge is Normal During Pregnancy?
Here are the normal vaginal discharge colors during pregnancy:
- White: Thick, white discharge is the most common. It prevents infections.
- Clear: Watery, clear discharge can increase due to hormones.
- Pink: Light spotting after intercourse or exam is usually normal.
- Brown: Old blood, especially early in pregnancy, causes brown discharge.
Any color outside of these ranges should be evaluated, especially if black, green, yellow, gray or foul-smelling.
Black Specks in Discharge During Pregnancy
Tiny black specks in cervical mucus are usually harmless. Possible causes include:
- Old blood cells picked up by mucus as it exits the cervix
- Microscopic blood clots degrading in mucus
- Skin cells or tissue fragments dislodged from cervix
As long as the mucus itself looks normal and you do not have heavy bleeding, black specks are likely benign. However, unusual discharge colors always warrant a call to your OB.
Can a Yeast Infection Cause Black Discharge?
A yeast infection can sometimes cause black vaginal discharge. When severe, yeast overgrowth can create thick, chunky discharge that appears white, yellow or even black in color.
Other yeast infection symptoms include:
- Thick, white cottage cheese-like discharge
- Vaginal and vulvar itching and burning
- Swelling and redness of the vulva
- Painful urination or intercourse
A simple vaginal culture can confirm if black discharge is due to yeast. Antifungal medications can treat the infection.
Can Trichomoniasis Cause Black Vaginal Discharge?
Trichomoniasis is a common sexually transmitted infection that may cause black vaginal discharge. Symptoms include:
- Thin, fouls-melling black or gray discharge
- Itching, burning and redness of genitals
- Discomfort urinating
- Lower abdominal pain
Microscope exam and lab culture of discharge can confirm trichomoniasis. Antibiotics called metronidazole or tinidazole can treat it.
When to Call the Doctor About Black Discharge
Contact your OB provider right away if you have black discharge along with:
- Bleeding that soaks a pad in an hour or less
- Severe abdominal or pelvic pain
- Fever over 100.4°F (38°C)
- Foul vaginal odor
- Burning with urination
- Green, yellow, or gray discharge
- No known cause like recent exam or intercourse
Medical evaluation is advised whenever black discharge occurs with other abnormal symptoms. Prompt treatment can prevent complications.
Takeaways
- Black vaginal discharge during pregnancy has several possible causes, including old blood mixing with mucus.
- Heavy black bleeding with clots may signal a miscarriage and requires urgent assessment.
- Persistent black discharge or foul odor can indicate an infection needing treatment.
- Contact your OB provider any time unusual discharge occurs alongside other symptoms.
- Most dark brown spotting or after an exam is normal. But unusual colors, textures or smells need evaluation.
While it can be unsettling, black discharge does not always mean something is wrong. Stay in touch with your OB provider and call promptly about any abnormal symptoms.