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Infections and Black Discharge During Pregnancy: What You Need to Know

July 14, 2025

Typically, menstrual blood is red, but during pregnancy, many women may experience various shades of red colour, and sometimes black. When pregnant and there is blood or black discharge, it is an indication to visit your doctor to ensure the baby is healthy. Do not take it lightly, as it can be a sign of some issue or a missed miscarriage. If you are starting a family, understanding why it happens can help you make the right decisions. Below you will learn about the causes of black discharge in pregnancy, symptoms and more.

Causes of Black Discharge or Blood During Pregnancy

During your menstrual cycle, when you shed black blood, it is not a major cause for concern as it is considered a normal part of a healthy cycle. Black or dark blood indicates heavy blood flow or that the uterine tissues have taken time to shed and exit the uterus. The blood gets oxidised due to the iron in the old blood.

The same could have happened during pregnancy, and blood may appear dark-hued. However, some dark discharge can be normal in healthy pregnancies. During pregnancy, if you notice bleeding, it may indicate some underlying health issues or problems with the baby’s development. Here are some causes of blood or black discharge during pregnancy.

Implantation Bleeding

Implantation bleeding may occur when the fertilised egg implants in the uterine lining. It is very light spotting and appears in colours: brown, pink, red and black. Note that not everyone experiences it. If you experience implantation bleeding, monitoring your symptoms is a must. Usually, the bleeding subsides after a day or two, the flow is light, and there is no cramping or abdominal pain. The difference between early pregnancy vs period cramps is crucial in this context as it offers clues about what your body is signalling.

Infection

Vaginal and uterine infections are unpleasant but they happen. Like your skin, digestive system, and other areas, the reproductive system has a microecology that can become imbalanced. Vaginal infections in particular cause darker blood or menstrual discharge. This can be due to bacterial infections or a foreign object like a tampon getting stuck in the vagina. The bacterial vaginosis pregnancy symptoms include:

● A foul smell

● Painful urination

● Pain in the pelvis

● Vaginal discomfort, swelling and itching

● Fever

Consult your healthcare provider if you experience the above symptoms and seek treatment promptly. More care and monitoring are needed to ensure the baby’s health.

PID (Pelvic Inflammatory Disease)

This is a bacterial infection that causes the female reproductive organs to become inflamed. Having an STI (sexually transmitted infection) before, douching, etc., may make you prone to this infection. People with PID have pelvic or lower abdominal pain and symptoms like foul smelling discharge, painful intercourse, frequent urination, difficulty urinating, vaginal bleeding, chills and fever. If you have PID, seek treatment as left untreated, it can lead to lasting effects like female fertility issues. Additionally, expectant women with PID are more prone to ectopic pregnancy, reproductive abscesses and other fertility issues.

Endometriosis

This is a female reproductive health issue where the uterine tissues grow outside the uterus. During your menstrual cycle, these tissues shed and appear as dark brown or black discharge. Endometriosis is very painful, especially during periods, mainly because of the scar tissue created during abnormal bleeding. It can also cause pain during intercourse, abnormally heavy periods, and trouble with conception. Women with this condition experience pregnancy difficulties and are also at high risk of pregnancy complications like:

● Gestational diabetes

● Hypertension

● Preeclampsia

● Preterm birth

● Placental abruption

If you are pregnant and have endometriosis, consult your doctor as soon as possible, as they can create a personalised treatment plan for your pregnancy and after.

Uterine Fibroids

These are growths that alter the uterine structure and, in a few cases, disturb the menstrual blood flow. This may cause blood retention, which shows as black blood and discharge. Fibroids are benign but may affect the menstrual symptoms and patterns. Apart from altering the menstrual blood colour, women may also have heavy bleeding, longer periods and pelvic pain. However, not all women with fibroids have these symptoms or have pregnancy complications. Expectant mothers cannot remove uterine fibroids during pregnancy; medications and surgery are available to treat them after childbirth.

Miscarriage

If you are several weeks pregnant and have persistent bleeding, brown, red or black, it may be a sign of miscarriage. It is called a silent miscarriage or missed miscarriage and is a pregnancy loss that is associated with black discharge or blood. This can happen in the first trimester, and if you have one, you may have the following miscarriage black discharge symptoms:

● Cramping

● Lower back and abdominal pain

● Reduced pregnancy symptoms like morning sickness, headaches and frequent urination

Silent miscarriages are similar to a period with breast tenderness, fatigue and cramping. Some women do not have any symptoms when having a missed miscarriage. Many are unaware they are pregnant.

Book an online appointment with Dr. Manjeet Arora for Pregnancy & Gynecology related issues.

Treatment

Treatment for black blood or discharge during pregnancy is based on the underlying conditions. However, self-treatment and self-diagnosis should be avoided as it is ineffective and unsafe. Here are some treatment options based on the likely causes.

● Implantation bleeding: If the black blood is due to implantation bleeding or old blood, no specific treatment is recommended.

● Infections: If the condition is caused by an infection, the doctor may prescribe antifungal medications or antibiotics tailored to the specific infection.

● PID: If you have PID during pregnancy, the recommended treatment is IV antibiotics and hospitalisation. That is because pregnant women are at a higher risk of complications and preterm delivery.

● Uterine fibroids: The treatment for fibroids during pregnancy focuses more on managing symptoms than removing them. Rest, hydration and pain relief are recommended.

● Miscarriage: Women who have had a miscarriage may not require any treatment. However, in some cases, excess tissue removal may be needed.

Conclusion

If you experience any abnormal discharge while you are pregnant, it is best that you discuss it with your healthcare provider. The doctor will consider medical history, perform a thorough physical examination and recommend necessary tests to determine the cause. If you experience black discharge with symptoms of pain, itching, and a foul odour, do not delay; immediately consult a doctor

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FAQ

What does black discharge during pregnancy indicate?

Black discharge may indicate implantation bleeding, infection or a serious issue like miscarriage.

Is black discharge normal in early pregnancy?

Yes. Black discharge is normal during pregnancy because of blood from a prior period or implantation bleeding.

Can black discharge be a sign of miscarriage?

Yes. Black discharge may be a sign of miscarriage.

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