The low down on implantation bleeding...
HOW LONG DOES IMPLANTATION BLEEDING LAST?
Before we get into how long implantation bleeding lasts, let’s start from the beginning. Implantation bleeding is the bleeding that happens when a fertilized egg makes its way to the uterus. Once an egg has been fertilized, it then travels from the fallopian tube to its new home, the uterus (1). In order for this embryo to get into the uterus after conception, it must burrow into the uterine lining, which can cause light spotting because of the changes in the blood vessels of the uterus (3).
How Common is Implantation Bleeding?
If you’ve experienced implantation bleeding, you’re not alone—about a third of pregnant people experience bleeding during implantation. It’s nothing to worry about, though, as it’s generally considered a normal sign of early pregnancy. However, if the bleeding is heavier than your typical menstrual cycle (3) and is accompanied by fever, chills, and cramping that increases in intensity, call your doctor or midwife ASAP (4).
HOW LONG DOES IT LAST?
Not very long. It could just be for one day, or for a few. No more than that.
WHAT DOES IT LOOK LIKE?
Implantation bleeding can look a few different ways, depending on when the blood exits the body. It may be a pinkish/orange color or dark brown and can be mixed in with cervical fluid (3), which some people notice when they wipe. It can also be a more bright or dark red, similar to menstrual blood, and may require a light pad or liner. Sometimes it can be mistaken as the beginning of a period, since it can occur around the same time you’d normally be getting your period, but it shouldn’t be as heavy and won’t last as long—maybe only a day or two.
It may be helpful to write down the color, consistency, and amount of spotting as it can provide additional insight into when conception occurred and may be good info to share with your doctor or midwife.
WHAT ARE THE SIGNS OF IMPLANTATION BLEEDING?
The timing may be a hint, as about 10-14 days following conception implantation occurs (5), which is when you would notice this bleeding. If you notice this light spotting, which may also be accompanied by mild cramping, it could be a sign of implantation.
WHAT ARE OTHER SYMPTOMS OF EARLY PREGNANCY?
The tricky thing about early pregnancy symptoms is that they often overlap with typical period symptoms. Breast/chest soreness or sensitivity, low energy, sensitivity to smell, nausea, constipation, moodiness, and cramping can all be signs of early pregnancy (5) so it can be difficult to tell the difference. It is also possible to experience food aversions, increased urination, and nasal congestion (5) so if you have a few of these symptoms combined with spotting, it may be a good idea to take a pregnancy test.
WHEN SHOULD I TAKE A PREGNANCY TEST?
Depending on the brand, some home pregnancy tests can give you results as early as a week before your missed period, but many sources say to wait until one day after your missed period for the best accuracy (6). Home pregnancy tests work by testing for the presence of the hormone, HCG. If you are pregnant, your body starts producing this hormone rapidly through the cells of the placenta (before the placenta is even fully formed!) and the levels increase rapidly over the first few weeks.
If you take a test too early, it is possible to get a false negative because you may not yet have enough HCG for the test to pick up. Pro tip: It’s best to take the test first thing in the morning, when your urine concentration is highest (6). HCG levels double every 48-72 hours (6) so if you get a negative result and you still feel unsure, wait a day or two and re-test. If you were tracking your basal body temperature (and read more about that right this way) prior to conceiving, you may be able to confirm pregnancy earlier than a home pregnancy test would be able to.
If you aren’t pregnant, progesterone levels will decrease prior to your period, resulting in decreasing temperatures (7). If you continue temping after ovulation and see consistently rising temperatures in the second half of your cycle, you may be pregnant. Learn more here.
WHEN TO SEE A DOC?
Once you’ve gotten a positive pregnancy test, it’s important to find support. You can check out our Ultimate Guide to Abortions here.
If you’ve decided to carry on with the pregnancy, it’s time to start thinking about who you’d like to have support you throughout your pregnancy, whether that be an OB/GYN or a midwife. Note that if you are low-risk, countries that utilize midwifery care, have the best mortality rates. Confused about midwives? Read this! Regardless, it’s important to date around when finding a provider. See our guide here!
We can’t stress enough the importance of finding a provider that is on board with your birth preferences from the very beginning. Do some research, ask like-minded people for recommendations, and call around to set up consultations with potential providers so you can ask questions and get a feel for each person’s approach. Just because you loved them as your GYN doesn’t mean they will be the best fit for your birth experience.
Try not to put this off too long as it can take some time for appointment openings and having prenatal care from the start is important in supporting a healthy pregnancy and birth.
And remember: You can always switch providers if you aren’t happy with your care, just be careful not to wait until too late in your pregnancy because many providers don’t take late transfers.
Are there other times I may bleed in pregnancy?
Bleeding during pregnancy can be a scary thing, especially if you’ve experienced loss or trouble getting pregnant. It’s common for people to experience light spotting throughout the first trimester (4). Outside of this, there is certainly some bleeding that is cause for concern during pregnancy, but there are also instances of bleeding that are perfectly normal. Here are some examples. If at any point you feel nervous or unsure, or are bleeding enough that you are soaking through a pad and/or passing tissue (4), check in with your provider. That’s what they’re there for!
Cervical exams. Sometimes, particularly in the last few weeks of pregnancy, your doctor or midwife may perform a cervical exam to see how thin and open your cervix is. You may experience some light spotting for a day or two after these exams (9).
Intercourse/insertion. Noticing a bit of blood after intercourse or insertion can be concerning, but thanks to all those hormonal changes during pregnancy, can be totally normal (9).
Labor. There are a whole slew of labor surprises that people are often unaware of until the big day. One of these is called “bloody show” and it’s actually a good sign that labor is progressing and your cervix is starting to open or dilate.
Miscarriage & ectopic pregnancies. Probably the most common concern with pregnancy bleeding, miscarriage occurs in about 10% of pregnancies and is most common in the first trimester (9). Ectopic pregnancy occurs when the embryo never makes it to the uterus and implants in the fallopian tubes, resulting in an unviable pregnancy (9). If you notice bright-red bleeding, especially during the first trimester, contact your provider to be checked out.
Written by: Paige Green, @pagpaggy, reproductive health educator and full spectrum doula
All content found on this Website, including: text, images, audio, or other formats, was created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
(1) Mayo Clinic. July 12, 2017. “Fetal development: The 1st trimester.” https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/prenatal-care/art-20045302
(3) Barton-Schuster, Dalene. 2018. “Mid-Cycle Spotting — Should You Be Concerned?” Last modified December 10, 2018. https://natural-fertility-info.com/mid-cycle-spotting.html
(4) Mayo Clinic. January 15, 2019. “Bleeding during pregnancy: When to see a doctor.” https://www.mayoclinic.org/symptoms/bleeding-during-pregnancy/basics/when-to-see-doctor/sym-20050636
(5) Mayo Clinic. January 05, 2017. “Symptoms of pregnancy: What happens first.” https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853
(6) Mayo Clinic, January 12, 2019. “Home pregnancy tests: Can you trust the results?” https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/home-pregnancy-tests/art-20047940
(7) Weschler, Toni. 2015. Taking Charge of Your Fertility: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health. New York: William Morrow, an Imprint of HarperCollins.
(9) American College of Obstetricians and Gynecologists. July 2016. “Frequently Asked Questions.” https://www.acog.org/~/media/For%20Patients/faq038.pdf