Last updated date: 12-Feb-2023

    Originally Written in English

    Implantation bleeding - should you be concerned?

      Implantation Bleeding

      Implantation bleeding is also known as a small load of light bleeding from the vagina, which typically occurs 10 to 14 days after conceiving a baby. Not all women experience this, it isn’t dangerous, and you don’t need a specific treatment.


      When does implantation bleeding happen?

      Implantation bleeding is the result of the attachment between the fertilized egg and the lining of the uterus. It usually happens around the time you would normally have your menstrual period. The difference between these two is that implantation bleeding is lighter than menstrual bleeding. So if your menstrual flow is not usually abundant, you might not notice it. In this case, you should also be aware of the common signs of pregnancy such as nausea or vomiting, missed periods, breast tenderness, food cravings or aversions, frequent urination, constipation, irritability, fatigue, and dizziness.


      Implantation Bleeding Symptoms

      Implantation Bleeding Symptoms

      Implantation bleeding tends to make its appearance before morning sickness, and you might notice the following:

      • Brown or pinkish blood
      • Lighter flow that doesn’t last as long as a usual period (1 or 2 days)
      • Mild or non-existing cramps
      • No sign of blood clots or any kind of tissue in the blood

      If you are not sure whether you are on your period or you are having implantation bleeding, consider taking a pregnancy test or talking to your doctor.


      Implantation bleeding treatment

      Implantation bleeding stops on its own, without any type of treatment.


      When you should see a doctor?

      Doctor consultation

      If you bleed more than usual and you also notice significant abdominal cramping, you should call your doctor. Other signs that can lead to the existence of a more serious issue are dizziness, weakness, inability to keep down liquids and fever.

      You should seek immediate medical attention for the following:

      • Bright red vaginal bleeding
      • Rectal pressure
      • Heavy flow with clotting
      • Waves of pain located in the lower black, shoulder or pelvis
      • Severe pain in your abdomen or cramps

      All of the above could be signs that you are having a miscarriage or an ectopic pregnancy.


      How will your doctor determine what’s going on?

      Your doctor might need information about quantity, color, and consistency. They will also look very carefully into your symptoms and medical history to figure out the best treatment for you.

      They may recommend blood tests, such as blood type identification and Rhesus (Rh) factor, to discover if you need Rho(D) immune globulin.

      Rho(D) immune globulin is an injection administered to individuals who are Rh-negative regularly between 27 and 28 weeks. It is usually provided again within the course of 3 days after delivery. It is also given to women who struggle with bleeding during pregnancy.

      Other recommended tests include a vaginal ultrasound to firstly confirm that you are pregnant and secondly to make sure the fertilized egg has been implanted in the uterus and that it is not ectopic.


      Other causes of bleeding during pregnancy

      Many things can lead to bleeding during pregnancy. Some of these causes are harmless, and some are serious.

      If you are pregnant and you notice the appearance of blood in your underwear, it may be caused by:

      • Sex: hormonal and physical changes may determine this; in this case, the bleeding should stop on its own.
      • Fibroids and polyps: you need to run some tests such as an ultrasound to check for these growths in your uterus.
      • Cervical problems: infections or growths on your cervix can also cause bleeding.
      • Infections: sexually transmitted diseases like trichomoniasis can lead to bleeding as well as more serious problems; the immediate start of special treatment will keep you and your baby in good condition.
      • Ectopic pregnancy: embryo implants outside the uterus; the bleeding can be associated with pain and cramps and it requires urgent medical care.
      • Miscarriage: Approximately 15% of women experience a miscarriage during the first few months of pregnancy. Most of them bleed and cramp afterward.

      There is no specific treatment for trying to prevent a miscarriage, but there are some things you can do that may help: getting plenty of rest, avoiding tampons while you are bleeding (use pads instead), avoiding sex, taking mild pain relief medication like paracetamol and keep in touch with your doctor if any changes occur.


      How long after implantation bleeding can you take a pregnancy test?

      You can take a pregnancy test right away, especially since this usually takes place around the same time your period would normally start. Some kinds of pregnancy tests are able to detect the hCG hormone in your urine six days before you have missed your period. If you take a test too early, it might give a false negative result since the amount of hCG hormone would be too low to detect, even if you were pregnant. If you have a negative result but you are unsure whether you are pregnant or not, you can retake a test after three days. The quantity of hCG rises very fast during early pregnancy, so there is a higher chance of getting a more precise result.


      Types of pregnancy tests

      Pregnancy tests

      Since the beginning of pregnancy, your body starts to change to support growth in the grouping of cells that will, later on, turn into your baby.

      Each type of pregnancy test looks for a specific hormone – human chorionic gonadotropin, also known as the hCG hormone, which only appears in a woman’s body during pregnancy.

      These tests can determine the level of hCG in your body by using either your urine or your blood.

      You can find at-home urine pregnancy tests in pharmacies or at supermarkets, available in a variety of price ranges, some of them having very affordable prices. There is no need for a prescription from your healthcare provider to buy them. At-home pregnancy tests can be very accurate (about 99% effective) if you are using them correctly.

      In an urine test, the reactive paper detects the presence of the hCG hormone. After processing, you will notice a plus sign, double vertical lines or even the word „pregnant” in case it is positive. Not all tests are the same, but you will find all the information you need in the box, so read the directions that come with it to figure out what a positive result looks like. Each test takes a different amount of time to process.

      If you choose to take a blood test, your doctor will collect a sample of your blood and send it to the laboratory, where your level of hCG will be determined, telling you if you are pregnant or not. This type of test will not only detect if the pregnancy hormone is in your body but will also determine the exact quantity. Blood tests are a little more sensitive than urine tests because they can even detect very small levels of hCG, within 9 to 12 days after conception. However, they are rarely chosen since they are usually expensive and tend to give you the same result as the urine test. Results may take from a few hours to more than 24 hours to be ready.

      Your doctor may also recommend blood tests to compare your levels of hCG during the course of your pregnancy to make sure everything is going well. Your hCG levels should normally double about every two days in the first few weeks. If they rise very much or not at all, there might be a problem with the pregnancy.

      Extremely high levels of hCG might also reveal the fact that you are carrying twins.

      Pregnancy can also be confirmed by your doctor through an ultrasound, which later is used not only to see your baby but also to make sure that its evolution is normal.


      How to use a pregnancy test correctly?

      At-home pregnancy tests come with a very specific list of directions. Not all of them are the same so you should follow every single step mentioned in the list.

      If you choose an at-home pregnancy test, you typically place one to several drops of urine on a chemical strip or you can place the strip directly in the urine stream. The strip is the one that detects thethe hCG hormone, about 10 days after conception. Taking a test right after you have missed your period reduces the chance of getting a false-negative result.

      Here are something to keep in sight when taking a home pregnancy test:

      • Take the test in the morning using your first urine if possible. In the morning, your level of hCG is the most concentrated, so it makes it easy to detect. If you take the test at any other time of the day, try to keep your urine in your bladder for at least a few hours.
      • Do not drink excessive amounts of liquids before taking a pregnancy test. Even though liquids can increase the volume of urine, they can also dilute your hCG level, decreasing the accuracy of the result.
      • Read and follow the directions that come within the patient information leaflet with the test very carefully before starting.


      Types of birth control

      Birth control

      Birth control helps you prevent an unwanted pregnancy. There are many types of birth control options:

      • The birth control implant: it is a tiny, thin rod that you can compare to the size of a matchstick. It is inserted by a nurse or a doctor under the skin of your upper arm, and it can protect you from pregnancy for up to 5 years. It releases the hormone called progestin to stop you from getting pregnant. Progestin can either thicken the mucus on your cervix, stopping sperm from getting to your egg, or it can stop eggs from leaving your ovaries (ovulation), which means there is no egg to fertilize. If at some moment you decide you want to get pregnant or you just don’t need it anymore, your doctor will remove the implant. It doesn’t affect fertility and you can get pregnant quickly after the removal. However, bear in mind that the implant does not prevent STDs (sexually transmitted disease). To protect yourself, condoms or internal condoms are the best way to stay clear of STDs. The implant is known to be 99% effective and it can cost up to 1300 dollars.
      • IUD: the IUD stands for „Intrauterine Device” and is a small piece of flexible plastic shaped in the form of a „T”, that is placed into your uterus to prevent pregnancy. It is long-term, reversible and also one of the most effective birth control method (99% effective). They are divided into 2 types: hormonal IUDs and copper IUDs. Both hormonal and copper IUDs prevent the pregnancy by changing the way of the sperm cells so they can’t reach the egg. It lasts for years, but it is not permanent. In case you want to get pregnant or you decide you don’t need it anymore, your doctor will remove it for you. It does not affect your fertility and it can cost up to 1300 dollars.
      • Birth control shot: the birth control shot is an injection you get once every three months. The shot contains the hormone progestin, which stops you from getting pregnant by stopping ovulation. It also makes your cervical mucus thicker so the sperm can’t get through. It’s about 94% effective, can cost up to 150 dollars and it does not protect you from STDs.
      • The birth control vaginal ring: a very convenient birth control method that works very well if used correctly. You insert a small, flexible ring inside your vagina, and it protects you 24/7 by releasing hormones into your body. You must change the ring once a month. It is 91% effective, costs up to 200 dollars and it does not protect you from STDs.
      • The birth control pill: birth control pills come in a pack of either 21 or 28 pills, and you take 1 pill a day. Taking your pill every day, at the same time of the day can increase its effectiveness. The pill contains hormones that safely stop your ovulation and it also thickens your cervical mucus. Besides preventing pregnancy , the pill also has other benefits, including the following: it helps reduce period cramps, acne and it also regulates your menstrual cycle. It is 91% effective, costs up to 50 dollars but it does not protect you from STDs.


      Infertility treatment

      Unfortunately, some women are battling infertility issues. Infertility evaluation can be expensive, and it may include some uncomfortable procedures. Finally, there is no guarantee you’ll get pregnant, despite all the testing and counseling.

      Fertility in women consists in the release of healthy eggs by the ovaries. The egg has to pass into the fallopian tubes and join the sperm for fertilization. Afterward, the fertilized egg must reach the uterus and implant in the lining. Female infertility tests reveal if any of these processes are affected.

      Besides a general physical exam and a gynecological exam, there are other specific tests:

      • Ovulation testing: an ovulation test measures your hormone levels to reveal whether you are ovulating or not.
      • Hysterosalpingography: this analyzes the condition of the uterus and the fallopian tubes. An X-ray contrast injection is administered into your uterus to help the doctor see if the cavity is normal and if there is any fluid spill through an X-ray.
      • Ovarian hormone testing: other hormone tests also check the level of pituitary hormones that are responsible for reproductive processes.
      • Imaging tests: a pelvic ultrasound looks for uterine or ovarian problems. Sometimes doctors use a sonohysterogram (saline infusion sonogram) to observe in depth details in your uterus, that can not be seen on a regular ultrasound.


      Some women improve their fertility with only one or two therapies. Others need several different types of treatment to get pregnant.

      Stimulating ovulation with special fertility drugs: This is the main option for a woman whose infertility is caused by an ovulation disorder. This type of medication regulates or induces ovulation.

      IUI – Intrauterine insemination: In this process, healthy sperm is introduced directly into the uterus around the exact time of your ovulation. The timing of IUI can change along with your normal cycle or with your fertility medication.

      Surgery: Endometrial polyps, a uterine septum, intrauterine scar tissue and some smaller types of fibroids are all uterine problems that can be fixed with hysteroscopic surgery. More serious problems like endometriosis, pelvic adhesions, and larger fibroids require laparoscopic surgery or a surgery with a bigger incision in the abdomen.

      Complications of infertility treatment include: multiple pregnancy (the most common) – twins, triplets or more, ovarian hyperstimulation syndrome – OHSS or bleeding and infection in case of an invasive procedure.


      How to take care of yourself and your baby at the beginning of the pregnancy?

      Pregnancy and doctor

      Good prenatal care is a great start for a healthy pregnancy, so try to find a doctor or a midwife you feel comfortable with. During your pregnancy, you should at all costs, avoid alcohol, smoking or drugs. You should cut down on your caffeine intake, start eating healthy meals and snacks and you should also consider taking prenatal vitamins. Exercising, reducing stress and taking plenty of rest should also be taken into consideration.

      Right after you get a positive result on your pregnancy test, you should call your healthcare provider to schedule your first prenatal visit, where you will be screened, to eliminate any concerns that could lead to complications. The doctor will also review any medication you are taking and might as well make the decision to stop some of them, since many can harm the baby.

      The doctor will then give you a list with future appointments. Visits can take place every 4 weeks for the first two trimesters. In the third trimester, you may visit every two weeks, from 28 to 36 weeks and after this, weekly until the delivery. Even if you feel perfectly fine, you should go to all your doctor appointments since monitoring your pregnancy is very important in preventing any kind of problem. Prenatal appointments can also turn into unique experiences, for example when you hear your baby’s heartbeat for the very first time.

      During the course of your pregnancy, also focus on eating well. Since you currently have to feed for two, make sure you get enough protein, which is the building block of cells. You also need the following:

      • Folic acid: about 600 mcg daily, to help prevent NTDs – neural tube defects.
      • Iron: 27 mg daily, to make sure red blood cells deliver oxygen to your baby and also prevent anemia.
      • Calcium: 1000 mg, for healthy bones, teeth, heart, nerves and muscles.
      • Iodine: 220 mcg daily, for brain and nervous system development.
      • Choline: 450 mg, for brain and spinal cord development.
      • Vitamin A: for the baby’s eyesight, organs and bone growth.
      • Vitamin C: helps absorb more iron and build strong bones and muscles.
      • Vitamin D: for the baby’s bones and teeth.
      • Vitamin B6 and B12: for the baby’s brain and nervous system.
      • DHA: DHA is an omega-3 fatty acid that helps your baby’s brain and eyes.

      Eat plenty of healthy snacks, include whole grains, fresh fruits and vegetables into your daily meals, and limit calories from saturated fats and added sugars. If you need a special diet (in case of diabetes, allergies, or intolerances) you may consult a dietitian to ensure you get everything you need for a balanced diet.

      Even though you can get many of your nutrient requirements with a healthy diet, you may need to consider supplements to keep you and your baby in good condition. Prenatal vitamins usually fill in any blanks in your organism.

      There are also certain foods you should avoid while pregnant. Stay clear of undercooked eggs and meat, unpasteurized dairy products and juices, raw seafood and fish that contains a high level of mercury.

      Staying hydrated is also very important. Make sure you increase your water intake during pregnancy. Water can help reduce swelling and prevent constipation, urinary tract infections and even hemorrhoids. Other liquids count too but try to avoid beverages that are high in sugar and empty calories like sodas, and reduce caffeine consumption.



      Implantation bleeding is a normal part of pregnancy, but it's very easy to mistake it for a much more serious issue, so it's important to know what this common symptom looks like. Fortunately, implantation bleeding really has no serious risks and will clear up on its own. In most cases, spotting or light bleeding happens because fertilization was unsuccessful. It may be that the egg wasn't fertilized or that the fertilized egg didn't become implanted in the uterus. If this is the case, you'll likely have some spotting around the time when your period would have started if you weren't pregnant. In more serious cases of implantation bleeding lasting more than a few days, it could mean that the egg had been implanted but broke off before it began growing—it's called an ectopic pregnancy. This can cause a tubal (ectopic) pregnancy and will require immediate treatment.