Lower back pain and brown discharge in early pregnancy

If you're pregnant, you're likely paying extra close attention to your body. If you feel a cramp, you may worry that it is a sign of a miscarriage, especially if it is early in your pregnancy.

While the first trimester is the most common time for miscarriages, there are other reasons for cramps. Whether cramping signals a miscarriage depends on when it occurs, severity, and whether you're experiencing other symptoms with it.

Cramping in Early Pregnancy

Having cramps in your lower abdominal area or lower back in early pregnancy (the first trimester) most likely signals one of three things:

• Ectopic pregnancy: Faintness and/or severe abdominal cramping may be a symptom of ectopic pregnancy. This occurs when the egg implants outside of the uterus, usually in a fallopian tube. While rare, ectopic pregnancies are not viable and can put your life in danger. If you suspect this issue, go to the emergency room right away.
• Miscarriage: When cramping is accompanied by spotting or vaginal bleeding, it can be a sign of miscarriage. Call your doctor for advice; they may suggest testing to determine whether you are having a miscarriage. A miscarriage can occur within the first 20 weeks of gestation, but the risk is higher in the first trimester.
• Normal pains: Cramping without bleeding is usually not a sign of miscarriage. Cramps or short-lived pains in your lower abdomen can happen early in normal pregnancy as your uterus adjusts to the implanted embryo, or even if you have a urinary tract infection. These pains are likely mild and brief. If you feel anything severe and/or prolonged, always call your doctor to be safe.

Symptoms of Miscarriage

Look out for these signs and symptoms of miscarriage in the first trimester.

• Bleeding that is brown or bright red
• Clots of tissue passing from the vagina
• Mild to severe back pain that's worse than normal menstrual cramps
• A sudden decrease in the signs of pregnancy, such as breast tenderness or morning sickness
• Very painful contractions every five to 20 minutes
• Weight loss
• White-pink mucus-like vaginal discharge

Contact your doctor if you notice any of these symptoms. Miscarriage is the most common cause of early bleeding in pregnancy.

However, it's important to note that early bleeding could actually be a threatened miscarriage. This is diagnosed when there's uterine bleeding but the cervix is closed and an ultrasound shows that the baby's heart is beating.

Fortunately, threatened miscarriages don't always result in pregnancy loss, even when there's a lot of blood on more than one occasion. If you experience spotting or bleeding that's concerning, your doctor may perform an ultrasound to check on the baby's status.

Cramping in Late Pregnancy

Cramping in the second or third trimester could be harmless or concerning—it depends on the situation.

• Preterm labor: Cramps occurring at regular intervals (try timing them) may indicate preterm labor. More than six cramps or contractions in 1 hour, a change in vaginal discharge such as bright red vaginal bleeding, a sudden gush of clear fluid, a low, dull backache, or intense pelvic pressure are all possible signs. For any of these symptoms, call your doctor immediately.
• Round ligament pain: You may experience shooting pains in the lower abdomen or around your hips due to a phenomenon called round ligament pain, which occurs as your body accommodates your growing uterus. These types of pains are normal and will pass, but you should discuss them with your doctor.

A Word From Verywell

A little bit of anxiety is totally normal in early pregnancy. After all, your life is about to change with the addition of this tiny bundle of joy. Your instinct is to protect your little one and make sure that he or she is as healthy and as safe as possible.

Talk to your doctor whenever you are concerned about any level of cramping during pregnancy. It can be a stressful time, and talking to your doctor about your symptoms can be very reassuring.

By Krissi Danielsson
Krissi Danielsson, MD is a doctor of family medicine and an advocate for those who have experienced miscarriage. 

Thanks for your feedback!

Experiencing bleeding at any point during pregnancy can be scary. But keep in mind: There are times when finding discharge that resembles blood is a typical part of pregnancy.

But what about pinkish-brown discharge? Is this dangerous for you or your fetus?

Here are six possible reasons you might be experiencing pinkish-brown discharge during pregnancy.

Implantation bleeding

If you’re very early on in your pregnancy and actively looking for symptoms, you may notice some light spotting around week 4.

This can be implantation bleeding, or the bleeding that occurs when the fertilized embryo burrows into the highly vascular lining of your uterus.

Cervical irritation

During pregnancy, your cervix, which is the bottom of your uterus and the part that opens and stretches during labor, is highly vascular. This means it has a lot of blood vessels, so it can bleed easily.

If your cervix is irritated during pregnancy, it may cause some brownish-pink discharge. This can happen at any point during your pregnancy. It may be caused by sex, a cervical check by your doctor, or an infection.

Ectopic pregnancy

In rare cases, brownish-pink discharge can be caused by an ectopic pregnancy. This is when a pregnancy occurs outside of the uterus, most commonly in the fallopian tube.

The brownish color occurs because the bleeding is older blood, not bright red (new) blood. An ectopic pregnancy is a life-threatening emergency.

Go to the emergency room if you notice bleeding along with any of these symptoms:

• extreme dizziness
• shoulder pain
• fainting
• lightheadedness
• abdominal or pelvic pain that comes and goes, especially on one side

Miscarriage

Any bleeding during pregnancy can be an early sign of miscarriage. In general, bleeding that results in a miscarriage is also accompanied by other symptoms.

If you notice brownish-pink discharge, be on the lookout for other symptoms, including:

• cramping
• increased bright red bleeding
• gush of fluid or watery discharge
• abdominal pain
• lower back pain

Unknown reasons

Many times, there’s no obvious reason for bleeding during pregnancy, especially during the first trimester. A 2019 study found that as many as one-fourth of women reported some kind of bleeding during the first few months of pregnancy. Although researchers speculated that the bleeding was an early sign of the placenta not developing properly, they aren’t sure of all of the reasons bleeding can happen.

Call your doctor if you experience other symptoms, or if you’re concerned.

Mucus plug

You may be losing your mucus plug if you’re further along in your pregnancy, (anywhere from 36 to 40 weeks) and notice an increase in discharge that’s brownish, pink, or even slightly green-tinged.

As your body gets ready to go into labor, it’s common for your cervix to soften and release the mucus plug. This plug helps protect any bacteria from getting into your uterus.

The mucus plug can look like, well, mucous. But it may also be tinged with brown-colored discharge when it dislodges. You may notice the mucus plug come out all at once. Or it may dislodge in smaller, less noticeable “chunks” over the course of a few days or weeks.

If you notice a small amount of pinkish-brown discharge during your pregnancy, don’t panic. In most cases, a small amount of blood-tinged discharge is typical.

Consider if there could be any possible reasons for the discharge:

• Were you checked by your doctor recently?
• Did you have sex in the last 24 hours?
• Are you nearing the end of your pregnancy and might be losing your mucus plug?

If the discharge increases, or if you experience any bleeding with other symptoms, call your doctor or head to the hospital.

Why I am having brown discharge and back pain?

Should I be worried about brown discharge in early pregnancy?

Is it normal for your lower back to hurt in early pregnancy?

Does a miscarriage start with brown spotting?