What Is Implantation Bleeding?

Getting Pregnant

When the 6-12 days-old fertilized egg attaches to the interior lining of the uterus, something known as implantation bleeding may occur. This movement of the egg can result in light bleeding or spotting, which is completely normal and should not require any kind of medical attention.

In general, around a third of pregnant women will experience this. While similar in timing to a woman’s menstrual period, the two should not be confused as there are differences.

Signs of Implantation Bleeding

Implantation bleeding is considered one of the early symptoms of pregnancy (at least one of the first easily identifiable signs for a mother).

Typically, it begins around a few days before the next menstruation cycle. However, as implantation bleeding occurs at a similar time to that of a period, many women are confused whether it is a possible pregnancy or a period. How can someone clearly tell the difference between a period and implantation bleeding? There are several additional signs to keep in mind.

Common Signs Accompanying Implantation Bleeding:

(These can also be PMS symptoms or ovulation symptoms, so having these along with pinkish/brownish spotting does not guarantee that it has to do with pregnancy.)

What Does Implantation Bleeding Look Like?

Implantation bleeding does look a bit different from that of the average woman’s period. Now, it is important to remember that not all women have the same kind of blood flow during their menstrual period. Some will have a heavier flow during their period while others may experience a bit more unpredictability.

Even with that in mind, there are several differences separating menstruation bleeding and that of implantation bleeding.

Key Differences:

  1. Color.  Whether heavy or light, most women are familiar with the color of their period (usually a bright to dark red). Implantation bleeding, however, is typically light pink to dark brown (rust-colored) in color.

  2. Clotting.  Some women experience a great deal of clotting during their menstruation, while some do not see much at all. Implantation bleeding, however, should not present any clots.

  3. Length of time.  The length of women’s periods can range from about 3 to 7 days. Women not on birth control tend to bleed longer, while women on birth control often bleed for a shorter time or do not bleed at all. Implantation bleeding should last anywhere from a couple of hours to 3 full days.

  4. Amount.  Most women are able to fill pads and tampons during their periods, but with implantation bleeding, it is different. The descriptor “bleeding” can be misleading – implantation bleeding is usually only spotting or a light flow rather than a full flow. Typically, implantation bleeding is a little pink or brown discharge only when a woman wipes or just enough to get on a pantyliner. It may be either intermittent or a more constant light flow.

So, if what you experience right around the time you expect your period is bright or dark red blood, lasts more than 3 days, and is a full flow in that you are filling up pads and/or tampons, it is very unlikely that what you are experiencing is implantation bleeding.

However, if your menstruation is shorter than normal (< 3 days), you did not fill up pads or tampons, it was more pinkish/brownish than red, and you had less cramping than normal, it is possible that you are having implantation bleeding.

When Does Implantation Bleeding Occur?

About 6-12 days after conception (when the sperm joins with the egg), the embryo will implant itself into the wall of the uterus. This movement may break down some blood vessels within the uterus wall and cause some bleeding.

Menstruation occurs around 11-14 days after ovulation (when an egg is released & conception is possible), which is another reason why the two are often confused with one another. Some women may simply believe their period is a few days early. Implantation bleeding typically happens within the week before the expected period.

For example, if you are sexually active and expect your period on January 25th, then you might question any spotting you have between Jan. 18th – Jan. 25th as possible implantation bleeding. It is not common that implantation bleeding would occur before this time or after a period is expected or missed. However, if one experiences ovulation early in the fertility window and the implantation process is quick, or one experiences ovulation late in the fertility window and the implantation process is slow, it is possible.

Women know what their normal menstrual flow looks like, and as long as they are not on any kind of new medication (including birth control and emergency contraceptives) or have a change in stress level, then their menstrual blood flow, color, and consistency are usually the same. So, when this lighter, pinker spotting occurs, it will appear a bit out of place.

How Long Does It Last?

In most cases, implantation bleeding may last as little as a few hours up to three days. Women who are going through their first pregnancy will likely spot or bleed a little bit more than women who are used to the egg attachment. (It is similar to dental flossing of the gums as the first time the gum line is aggravated, it will bleed more, while subsequent times bleeding is lessened.)

Implantation Bleeding Concerns

Implantation bleeding should not be a cause for concern and should pose no real risk to the developing baby. If you experience bleeding or spotting more than a few days after your missed period, it is not likely to be implantation bleeding. True pregnancy concerns rarely come from implantation and usually occur after the missed period.

Though this post-implantation light bleeding during pregnancy is not considered normal, there are a few main reasons it may occur:

At least 50% of women that experience spotting/bleeding (other than implantation bleeding) will go on to have a normal, healthy pregnancy.

Extended bleeding can be a sign of something more serious, especially further on during the pregnancy. Molar pregnancy or miscarriage are two concerns, which is why whenever visiting the OBGYN or other doctors, it is necessary to inform them of current or recent bleeding (especially if it is heavy), as well as any other symptoms you are experiencing.

In your first trimester, be sure to let your healthcare provider know about any spotting.

Let your healthcare provider know immediately about any spotting in your second or third trimesters.

If at any point during your pregnancy you experience heavy bleeding, contact your healthcare provider immediately or consider seeking emergency care.

For women going through nausea/vomiting, dizziness, abdominal pain (especially one-sided pain), it is possible you are experiencing an ectopic pregnancy, so inform your doctor right away. Cramping is normal during pregnancy, yet if the level of pain during cramping increases, it is recommended to contact a doctor.

Still Not Sure?

If you are not sure which type of bleeding you are having, we recommend waiting three days after the bleeding/spotting stops before taking a pregnancy test.  You are welcome to contact our toll-free helpline at 1-800-672-2296 to speak with a pregnancy educator.

Often, taking a pregnancy test before the missed period or during implantation bleeding is just too soon for tests to offer conclusive results. Ideally, waiting a week after the spotting or missed period is most desirable as the results should prove more accurate.

Next Steps

Implantation bleeding is a sign of a potential pregnancy. If you have waited until after your period was due and taken a pregnancy test that delivered a negative result, there is a good chance you are not pregnant. Watching for implantation bleeding while trying to get pregnant is fine, but many women do not experience nor notice implantation spotting even when it does occur.

Last updated: July 9, 2019 at 10:41 am


Compiled using information from the following Medical sources:

1. March of Dimes: “Pregnancy Complications.”

2. National Institute of Child Health and Human Development: “What Are Some Common Signs of Pregnancy?”

3. American College of Obstetricians and Gynecologists: “Abnormal Uterine Bleeding,” “Early Pregnancy Loss.”

4. Norwitz ER, et al. Overview of the etiology and evaluation of vaginal bleeding in pregnant women.

5. Moore KL, et al. Answers to clinically oriented questions. In: Before We Are Born: Essentials of Embryology and Birth Defects. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2013.

6. Frequently asked questions. Pregnancy FAQ038. Bleeding during pregnancy. American College of Obstetricians and Gynecologists.

https://www.acog.org/Patients/FAQs/Bleeding-During-Pregnancy

7. American College of Obstetricians and Gynecologists. Months 1 and 2. In: Your Pregnancy and Childbirth Month to Month. 6th ed. Washington, D.C.: American College of Obstetricians and Gynecologists; 2015.

Source: American Pregnancy Association


Content from the ACOG

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FAQs on Bleeding During Pregnancy

Does bleeding during pregnancy always mean that there is a problem?

Vaginal bleeding during pregnancy has many causes. Some are serious, whereas others are not. Bleeding can occur early or later in pregnancy. Bleeding in early pregnancy is common. In many cases, it does not signal a major problem. Bleeding later in pregnancy can be more serious. It is best to contact your obstetrician–gynecologist (ob-gyn) or other health care professional if you have any bleeding at any time during pregnancy.

How common is bleeding during early pregnancy?

Bleeding in the first trimester happens to about 15–25% of pregnant women. Light bleeding or spotting can occur 1–2 weeks after fertilization when the fertilized egg implants in the lining of the uterus. The cervix may bleed more easily during pregnancy because more blood vessels are developing in this area. It is not uncommon to have spotting or light bleeding after sexual intercourse or after a Pap test or pelvic exam.

What problems can cause bleeding during early pregnancy?

Problems that can cause bleeding in early pregnancy include infection, early pregnancy loss, and ectopic pregnancy.

What is early pregnancy loss?

Loss of a pregnancy during the first 13 weeks of pregnancy is called early pregnancy loss or miscarriage. It happens in about 10% of known pregnancies. Bleeding and cramping are signs of early pregnancy loss. However, about one half of women who have a miscarriage do not have any bleeding beforehand.

If you have had an early pregnancy loss, some of the pregnancy tissue may be left in the uterus. This tissue needs to be removed. You can allow the tissue to pass naturally, or it can be removed with medication or surgery (see FAQ090 “Early Pregnancy Loss”).

What is an ectopic pregnancy?

An ectopic pregnancy occurs when the fertilized egg does not implant in the uterus but instead implants somewhere else, usually in one of the fallopian tubes. If the fallopian tube ruptures, internal bleeding can occur. Blood loss may cause weakness, fainting, pain, shock, or even death.

Sometimes vaginal bleeding is the only sign of an ectopic pregnancy. Other symptoms may include abdominal, pelvic, or shoulder pain. These symptoms can occur before you even know you are pregnant. If you have these symptoms, call your ob-gyn or other health care professional. The pregnancy will not survive, and it must be removed with medication or surgery (see FAQ155 “Ectopic Pregnancy”).

What can cause bleeding later in pregnancy?

Common problems that may cause light bleeding later in pregnancy include inflammation of or growths on the cervix. Heavy bleeding is a more serious sign. Heavy bleeding may be caused by a problem with the placenta. Any amount of bleeding also may signal preterm labor. If you have any bleeding late in pregnancy, contact your ob-gyn right away or go immediately to the hospital.

What problems with the placenta can cause bleeding during pregnancy?

Several problems with the placenta later in pregnancy can cause bleeding:

Can bleeding be a sign of preterm labor?

Late in pregnancy, vaginal bleeding may be a sign of labor. If labor starts before 37 completed weeks of pregnancy, it is called preterm labor. Other signs of preterm labor include the following:

How preterm labor is managed is based on what is thought to be best for your health and your baby’s health. In some cases, medications may be given. When preterm labor is too far along to be stopped or there are reasons that the baby should be born early, it may be necessary to deliver the baby.

Glossary

Cervix: The lower, narrow end of the uterus at the top of the vagina.

Cesarean Delivery: Delivery of a baby through surgical incisions made in the woman’s abdomen and uterus.

Early Pregnancy Loss: Loss of a pregnancy that occurs in the first 13 weeks of pregnancy; also called a miscarriage.

Ectopic Pregnancy: A pregnancy in which the fertilized egg begins to grow in a place other than inside the uterus, usually in one of the fallopian tubes.

Fallopian Tubes: Tubes through which an egg travels from the ovary to the uterus.

Fertilization: Joining of the egg and sperm.

Hysterectomy: Removal of the uterus.

Inflammation: Pain, swelling, redness, and irritation of tissues in the body.

Miscarriage: Loss of a pregnancy that occurs in the first 13 weeks of pregnancy.

Obstetrician–Gynecologist (Ob-Gyn): A physician with special skills, training, and education in women’s health.

Oxygen: A gas that is necessary to sustain life.

Pelvic Exam: A physical examination of a woman’s reproductive organs.

Placenta: Tissue that provides nourishment to and takes waste away from the fetus.

Placenta Accreta: A condition in which part or all of the placenta attaches abnormally to and is inseparable from the uterine wall.

Placental Abruption: A condition in which the placenta has begun to separate from the inner wall of the uterus before the baby is born.

Placenta Previa: A condition in which the placenta partially or completely covers the opening of the uterus.

Preterm: Born before 37 completed weeks of pregnancy.

Trimester: Any of the three 3-month periods into which pregnancy is divided.

Ultrasound Exam: A test in which sound waves are used to examine internal structures. During pregnancy, it can be used to examine the fetus.

Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.

If you have further questions, contact your obstetrician–gynecologist.

FAQ038: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice, may be appropriate.

Copyright July 2016 by the American College of Obstetricians and Gynecologists