Unexpected vaginal bleeding could indicate the beginning of a new life (or lives) or it could mean that you’re not pregnant and you’ve just started your period.
If it’s the former, then you’ve just had some implantation bleeding, which is perfectly normal. But women can sometimes confuse heavy implantation bleeding with twins with the onset of their period and even with a miscarriage.
While the first two normally aren’t dangerous, the third one is a serious and life-threatening medical emergency that requires intervention. To help you figure out which of the three is causing your spotting, we’ll take a look at implantation bleeding, why it happens, when it’s normal, and what to look out for.
What is implantation bleeding?
About 6 to 12 days after the sperm joins the egg, the embryo attaches itself to the uterus. As it implants itself into the uterine lining, its burrowing movements can break down blood vessels. The light bleeding or spotting that results is what we call “implantation bleeding.”
This type of vaginal bleeding is completely normal and does not need to be treated. It doesn’t happen during every pregnancy but is quite common. According to the American Pregnancy Association, about a third of all pregnant moms will experience some implantation bleeding.
Women who are pregnant for the first time are more likely to experience implantation bleeding or will bleed a bit more than women who have already been pregnant. This is because their uterine walls are not used to the embryo attachment.
Implantation bleeding usually happens before a woman even discovers that she is pregnant, which is why it’s often thought to be menstrual bleeding. The timing typically coincides with the expected start of a woman’s next period, making things even more confusing.
These signs usually accompany implantation bleeding:
- Mild cramping
- Low back pain
- Breast tenderness
To make things even more puzzling, these are all also symptoms of ovulation. So if you experience any of these with spotting, you could easily mistake it for your period.
Implantation bleeding vs. normal period
Whether you’re trying to get pregnant or don’t want to get pregnant, finding blood in your underwear can bring on some intense emotions. It’s easy to confuse implantation bleeding with the onset of your period, not to mention other types of vaginal bleeding.
Instead of panicking over some blood, you should learn how to tell when it’s implantation bleeding and when it’s your period.
Here are some of the main differences between implantation bleeding and menstrual bleeding:
- Colour — Most women are well acquainted with the colors of their menstrual blood, from the dark red of the first few days to the brighter reds at the middle and end of their period. Meanwhile, implantation bleeding can be as light as a pinkish red or as dark as a deep brown.
- Thickness and clotting — While menstrual blood can be quite viscous and include a good amount of clots, implantation bleeding does not include any clots at all.
- Amount — Menstrual blood is usually enough to fill tampons and pads, especially during the second or third days of a period. With implantation bleeding, there’s not actually much blood. The flow is very light compared with that of period blood and is hardly enough to fill a panty liner.
Implantation bleeding is actually more like spotting than actual bleeding. It can also be intermittent instead of a continuous flow like a period. But because implantation bleeding usually begins near the expected start of a woman’s period, it’s often mistaken as an early flow.
- Duration — Regular menstrual periods typically last three to seven days. Women who are on birth control normally have shorter periods while those who aren’t on birth control have longer periods. Implantation bleeding can last anywhere from just a couple of hours to a couple of days.
If you’re still unsure if the bleeding is from implantation or just an early period, it may be time to take a pregnancy test. To get accurate results, it’s best to wait at least three days or even a week after the onset of the bleeding before you get tested.
Implantation bleeding, like menstrual bleeding, will go away on its own without you having to do anything about it. Unfortunately, there may be another reason behind the bleeding or spotting: a miscarriage.
Implantation bleeding vs. miscarriage
Implantation bleeding, especially if it’s the heavy kind, can sometimes be confused with bleeding from a miscarriage.
Most miscarriages take place within the first trimester of pregnancy. Usually, bleeding from a miscarriage begins as spotting and then becomes heavier. The blood is usually dark red with visible clots.
These signs and symptoms may accompany bleeding from a miscarriage:
- Pelvic and abdominal cramps
- Pain in the lower abdomen
- Passing tissue along with the blood
- Symptoms of pregnancy, such as nausea and breast tenderness, cease
Heavy implantation bleeding with twins: normal or not?
Implantation bleeding is frequently associated with conceiving twins. There are some who theorize that implantation bleeding is more common during a twin pregnancy than in a singleton pregnancy. This has not been backed by scientific studies.
While some implantation bleeding is normal at the beginning of a twin pregnancy, be wary of mistaking a miscarriage with heavy implantation bleeding. Pregnancy loss is more common in moms carrying twins or multiples, so you should always be on the lookout for any signs or symptoms of an impending miscarriage.
If heavy bleeding is accompanied by cramping and the passing of tissue, it’s best to call your doctor or head to the hospital immediately.
Whether or not you are trying to get pregnant, knowing the signs of implantation bleeding can help you and your doctor figure out what you’re dealing with. Implantation bleeding in itself shouldn’t be cause for concern, but there are other reasons behind vaginal bleeding, including miscarriage, an ectopic pregnancy, cysts, and vaginal infections.
If you’re experiencing heavy implantation bleeding with twins, it’s best to let your doctor know right away. For more about symptoms to watch out for during pregnancy, check out this post. Good luck!