Implantation bleeding

Many women confuse implantation bleeding with a period. Instead interpreting it as a sign of a light period or old blood loss. But in fact, implantation bleeding is relatively common – around 10-15% of pregnant women will experience some degree of bleeding in their pregnancy. Most progress to having a healthy baby 9 months later.

What is implantation bleeding?

In the earliest days of conception, the blastocyst – or ball of cells that is soon to become an embryo and eventually becomes the baby, needs to nestle down to grow. The blastocyst has already been multiplying since it left the fallopian tube and now has to find the ideal spot in the womb to bed down for the next 9 months.

Because the womb is so full of blood and nourishment for the blastocyst, there can be a minor disruption to the lining of the womb, creating light bleeding. Sometimes this is obvious and can be seen on underwear, or it may be only slight. Some women only become aware they are bleeding when they have been to the toilet and see blood on the toilet paper.

Blood loss during an implantation bleed tends to be light, or described as “spotting”. It is mostly pinkish and watery in appearance, though it may also be a brighter red colour. After lying down for a while or first thing in the morning, the blood may be more of a brown colour. This is because it may have been sitting in the cervix or vagina for a few hours.

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It is also common to have some light cramping during an implantation bleed. Not to the same degree as period pain but a vague, heavy, dull feeling in the location of the womb. If possible, rest is recommended and beneficial. It’s also useful to avoid doing anything too strenuous. This won’t prevent the implantation bleeding from occurring, but it may help you feel you’re doing something positive by not exerting yourself.

When does implantation bleeding happen?

It normally occurs at around the same time as the period is due, around 6-12 days after ovulation and fertilisation. Which is why implantation bleeding can be both confusing and disappointing. It’s often confusing and disappointing, because it can be interpreted as a light period and a sign of not being pregnant. Women who are keen to conceive can become very upset at the sight of any blood loss and interpret this as a negative sign.

An implantation bleed occurs even before the pregnancy has been confirmed. Human chorionic gonadotrophin (hCG) hormone is the hormone detected in the pregnant mother’s urine. This is not produced until after the embryo has embedded in the womb and there has been some very early development of the placenta. Which is why an implantation bleed occurs too early for even the most perceptive of couples to know with any certainty that they have created a baby.

One of the symptoms of pregnancy can be having a period which is considered lighter than normal. An implantation bleed can certainly be mistaken for a period and many times it’s only with the benefit of hindsight that a woman reflects back on what she thought was an early period, and was in fact an implantation bleed.

What can I do to prevent implantation bleeding from happening?

Unless you have pain as well, or the bleeding is continuous and heavy, there really is nothing you can or have to do. If you have already had your pregnancy confirmed and it has been longer than 2 weeks since fertilisation, then an implantation bleed is unlikely.

An implantation bleed is not necessarily a bad thing. It can be a sign that fertilisation has occurred and the pregnancy is progressing as it needs to. But of course, when it happens you won’t know you’re pregnant, it’s too early to say. Some women believe that breast tenderness, nausea and other early pregnancy symptoms are also present at around the time of implantation bleeding. But this is unlikely. It is too early for the hormones that cause these symptoms to have been released by the placenta already.

But the mind works in mysterious ways and some women actually “know” they are pregnant and feel very different from the moment of conception.

What can I do if I have an implantation bleed?

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Sit tight and don’t become anxious. Just monitor the amount that you bleed and seek the advice of your healthcare professional if you experience any pain or other symptoms. For the majority of women, implantation bleeding settles and stops within a day or two, and doesn’t return. It is unlikely to be to heavy that you need to wear a pad, but for comfort’s sake many women find they prefer to use a panty liner just to be on the safe side.

If considered necessary by a healthcare professional, it is possible to have an ultrasound to determine if the pregnancy sac and foetus are developing as they need to. This can provide immediate reassurance that the bleeding was due to the embryo implanting, rather than indicating a miscarriage.

The foetal heartbeat can be detected from around 5 ½ to 6 weeks of gestation, by which stage the embryo is well embedded in the wall of the womb.

When to be concerned about implantation bleeding

If you start bleeding heavily, pass clots or your blood loss becomes bright red, then you need to be medically assessed. Any bleeding which is accompanied by backache, abdominal cramping, pain, nausea and/ or shoulder tip pain also needs to be checked out. These can all be symptoms of an ectopic pregnancy or miscarriage.

Generally implantation bleeding settles after a couple of hours or days. It does not continue for long and does not require any specific treatment. It is worthwhile to make a note of the date/s it occurred and then trace back to the first day of the last normal menstrual period.

Then it is possible to “connect the dots” between when fertilisation is likely to have occurred and when the embryo nestled its way into the vascular lining of the womb.

What else could it be?

There are a range of possibilities, but some of the more common include:

  • Normal menstruation, just a little early
  • A change in the pattern of menstruation – perhaps a break-through bleed
  • Due to hormonal-based contraceptives such as “the pill”, more commonly in the early days of starting hormonal contraception
  • An infection of the womb or vagina, which has caused the bleeding
  • Rough intercourse which has resulted in abrasion
  • Bleeding from the urethra or anus, rather than the vagina

Remember

  • If you are in any doubt then have a check with your health care professional.
  • Implantation bleeding occurs in around 10-15% of women – you are not alone.
  • It can be useful to visualise the embryo “nestling” into the bloody lining of the womb.
  • Take it easy for a day or two if it makes you feel better.
  • Mark the dates on a calendar when you had the spotting; in the next week or so it may all make perfect sense.
  • Sometimes a normal period follows an implantation bleed. The pregnancy did not develop past the very early weeks and for some reason, there was an interruption to it embedding or developing as it needed to.
 
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