What It Is, What It’s Not, And What To Look For

 

 

When couples start trying to conceive, we can be like hound dogs looking for an early clue that we’re pregnant. The “two week wait” can seem longer than the wait for the next Star Wars sequel! ? But for some lucky women, they get a sign before they even get that BFP on that home pregnancy test. It’s called implantation bleeding and the process can look different for each woman and each pregnancy.

For this reason, it can be tricky to identify a true implantation bleed versus some other kind of spotting. In this post, we’ll unpack implantation bleeding so that you’ll know if you may be pregnant, or may have something else going on.

 

What came first? The implantation or the egg?

 

To explain the biology of implantation, we need to rewind the tape.

When two people love each other…

Just kidding. We don’t need to rewind that far. At a conception, a male sperm swims to meet a female egg, or ovum, in the fallopian tube where one lucky swimmer enters the egg and fertilizes it. The parents’ genetic material fuses together to create an embryo with its own unique DNA, which is mindblowing, but let’s continue.

The embryo divides into two cells to become a zygote. The zygote continues to grow and subdivide to become what we’ve been waiting for: a blastocyst. At the blastocyst stage, baby is ready to implant. Throughout this time of subdivision and cell growth, baby has been multitasking. Not only is baby growing, but he or she is journeying down the fallopian tube toward the “mothership,” or uterus.

And the uterus can’t wait. After each and every monthly ovulation, the uterus has been hoping for this by preparing the uterine wall. To prepare, the uterine lining gets thick, spongy, and vascular to make it an ideal cushion for a potential, burrowing blastocyst.

Finally the long-awaited day arrives and the uterus receives chemical signals that its monthly project was not in vain again and it is time to fluff the pillows.

The blastocyst reaches the cushy uterine destination, is accepted by it, and attaches to it. Boom. Implantation.

The baby implants in the uterus by way of blood vessels and a stalk what will become, you guessed it, the umbilical cord.

The implantation process can be accompanied with vaginal bleeding or spotting, and maybe a little cramping. Implantation bleeding isn’t necessarily the exact day of implantation. Bleeding can occur anytime within a week after implantation. Think of it as the afterparty, or even the after-after party.

When does implantation occur?

Implantation typically occurs 6-12 days after ovulation/fertilization, although some sources give it a wider range of 5-14 days.

The average is 8 or 9 days after ovulation/fertilization. This puts implantation bleeding window just a day or so before a woman would otherwise expect her period.

For some women, it may overlap. For this reason, it is important to differentiate implantation bleeding from a typical first day menstrual cycle by color, consistency, and intensity.

The difference between implantation bleeding and menstrual bleeding

Since implantation bleeding can occur around the same time as menstruation, here are some key differences to look for:

• Implantation bleeding is pinkish/brownish in color. Period blood is redder. Wearing a white pantyliner or white underwear can help accurately determine the shade.
• Implantation bleeding has a thinner, “waterier” consistency and does not contain clots.
• Implantation bleeding is more like spotting or discharge. It does not turn into a heavy, bloody flow like periods do.
• Implantation bleeding can be accompanied by light cramping, which many women find less painful and/or different from their typical period cramps.
• Implantation bleeding typically lasts only 1-2 days, versus 5-7 days of bleeding with a normal menstrual cycle.

Stress or a change in medication can cause changes in menstrual patterns, it’s true, but those changes are generally foreseeable and recognizable. A woman with a fairly regular cycle will be quick to notice a seemingly unexplained pinker/lighter/milder period when a pregnancy is possible.

How long does implantation bleeding last?

It varies. Implantation bleeding can last anywhere from from a couple hours to a couple days. It could be something you see once while wiping with a square of toilet paper, a few times on a pantyliner, or it could be a light flow for one, two, and even three days. It is likely to be longer for first time mothers and shorter for mothers whose bodies have had children before and are “used to” implanting.

What if I don’t have implantation bleeding?

According to the American Pregnancy Association, only one third of women experience the “phenomenon” of implantation bleeding. I haven’t had it with any of my pregnancies. If you don’t notice any spotting, you’re in the majority. Be sure to look out for other early signs of pregnancy such as breast tenderness, nausea, bloating, and fatigue.

If it is too early for implantation bleeding, why am I bleeding?

When trying to piece together a pregnancy timeline, it is important to remember that a fertilized egg isn’t capable of implanting till at least Day 5 after fertilization. It simply isn’t developed enough before than. Early bleeding within 4-5 days after intercourse likely has a different origin. What could too-early bleeding indicate?

• Women can experience a hormonal withdrawal bleed after a failed ovulation attempt due to a confirmed ovarian cyst rupture.
• Breastfeeding and irregular postpartum cycles could also result in pinkish discharge.
• Other times, mid-cycle spotting occurs prior to ovulation due to extra high estrogen levels.
• Unexplained spotting could be leftover blood from your last period that was knocked out by sex.
• Unexplained spotting could also be from cervical irritation from sex or a pelvic exam.

I am confused on whether this is implantation bleeding or the beginning of my period?

 

You wouldn’t be alone. In some cases, women have mistaken their implantation bleeding for a period, resulting in an inaccurate due date estimate.

In other cases, women have mistaken their spotting for implantation bleeding, only to get their period a day or so later. These mix-ups are common and since the evidence is not conclusive until you take an actual pregnancy test, there’s no practical way to guarantee it.

Over the counter pregnancy tests detect the pregnancy hormone Human Chorionic Gonadotropin (hCG), which the placenta produces after the fertilized egg implants into the lining of the uterus. Implantation bleeding occurs before or at the time of the very first positive pregnancy hCG test reading, so if you aren’t sure yet, you will be soon. You’re just going to have a wait a couple extra days. (Darn it!)

When to call a healthcare provider:

Implantation bleeding poses no risk to the mother or baby. There is no need to call a healthcare provider for light spotting and mild cramping before or at the time of the woman’s normal period. Bleeding after a women’s missed period is concerning, however. You should call a healthcare provider if:

• there is substantial bleeding after a positive pregnancy test or after a missed period. Such could be a sign of miscarriage, molar pregnancy, or ectopic pregnancy.
• there is noticeable clotting.
• in the case of a suspected ectopic pregnancy (when a fertilized egg implants in the fallopian tube instead of the uterus), bleeding is accompanied by pelvic, abdominal, and/or shoulder pain. An ectopic pregnancy is a medical emergency.
• if your bleeding is heavier than a period and is accompanied by fever, chills, and cramps increasing in severity.

Keep in mind that many women experience light spotting throughout the first trimester to no negative effect. Your healthcare provider should be able to run the appropriate blood, urine, and ultrasound tests to safely monitor mother and child’s development.

Does your spotting or bleeding concern you?

If you ever you are ever concerned with any kind of vaginal bleeding before, during, or after pregnancy, never hesitate to reach out to your healthcare provider. They are very useful at sorting things out, dispelling fears, and reading the signs.

Causes of Bleeding

Pregnant women can bleed for reasons other than implantation. If it’s heavy plus with or without pain or cramping at any time, call your doctor.

If you’re pregnant and you see blood, it may be caused by:

• Sex. Sometimes this happens early on, although it can happen at any time during pregnancy. Hormone changes in your body may be to blame. It should stop on its own.
• Ectopic pregnancy. This is when an embryo implants outside of the uterus. You may have bleeding with pain and cramps. It’s dangerous, and you need to see a doctor right away.
• Miscarriage. About 15% of known pregnancies end during the first few months. Most women bleed and cramp afterward. Call your doctor right away if you know you're pregnant and you have these symptoms.

How do you tell the difference between implantation bleeding and a period?

There are several key differences between implantation bleeding and menstruation which can help you work out whether you’ve conceived or not.

• Colour:  for implantation bleeding the discharge or spotting will usually be pinkish or dark brown, whereas period blood tends to be bright, vibrant red.
• Duration: as implantation bleeding only happens while the egg is fixing itself to the uterus, it may last as little as a few hours or up to 1-2 days. It will remain light and possibly stop and start during this time. There are normally no clots. If bleeding starts off light, but gets heavier, has a constant flow and lasts 4-7 days it is almost certainly your period.
• Timing: implantation bleeding usually happens about 10 days after ovulation, while menstruation normally occurs after 14. So pinkish spotting on day 22-25 is more likely to be implantation bleeding than first signs of menstruation (usually around day 26-27).
• Cramping: it is possible to experience light cramping when the egg is attaching itself to the womb, but it would be very faint and not increase in strength. That’s compared to cramps caused by menstruation which are usually more intense and get stronger.

Are there any times when I should be worried by implantation bleeding?

This very early sign of pregnancy is not usually a reason to be concerned; it is perfectly normal and no risk to the developing baby. However, if you are also experiencing symptoms such as, lower abdominal pain, nausea, dizziness or vomiting you should see your doctor as is may be an indication of an ectopic pregnancy.

Still not sure?

 

As with a lot of early signs of pregnancy, the only real proof that you’re on the path to parenthood is that all-important line on the pregnancy test.  If you think you’ve experienced implantation bleeding, the advice is that you need to wait at least 3 days before taking a home pregnancy test. Before that, there’s unlikely to be enough of the pregnancy hormone hCG to give a positive result.  If you can bear to wait 5 days, there’s even more chance it will be accurate. In the meantime keep looking out for other early signs.

“I’d never heard of implantation bleeding. I just assumed I had had a slightly lighter period than normal and got back to the job of trying to make a baby. I couldn’t believe it when I got a ‘3weeks+’ reading on a pregnancy test a fortnight later!”