Implantation Cramps, Explained

When you’re trying to conceive — and particularly in the excruciating “two week wait” between ovulation and the day when you can finally take a pregnancy test — it’s normal to be on the hunt for any early signs of pregnancy, like implantation cramping. We asked OB-GYN Dr. Tiffany Wells to explain what implantation cramps really are, what they feel like, and what it means if you don’t notice them at all.

What is implantation and when does it happen?

“Implantation is where the blastocyst has moved down into the uterus and is now attaching to the uterine wall. When that happens, you release what's called prostaglandins, and prostaglandins are actually what make you cramp,” Wells explains. Implantation cramping can happen about a week after ovulation, Wells explains, so it’s understandable that many people who are trying to conceive are on the look-out for these very particular cramps. Unfortunately, even if you think you’ve felt them, you’ll still need to wait about a week — depending on the length of your cycles — to take a pregnancy test.

What do implantation cramps feel like?

I explained to Wells that I thought I felt implantation cramps with my second pregnancy, and they felt like a pinchy cramp. Wells says that it very well could have been an implantation cramp. Implantation cramping happens where period cramping does, she explains, “low down in the pelvis where, if you get menstrual cramps, you typically would feel them.” You shouldn’t feel them more on one side or the other, and Wells says they should be mild in nature.

What’s the difference between implantation cramping and period cramps?

Though implantation cramping is generally more mild than period cramps, it can can be confusing to really tell, Wells says, which may be a reason to try not to be too vigilant during the dreaded two-week wait. “When the implantation cramping occurs, you won't necessarily have a high enough pregnancy hormone level — HCG — to detect on a home pregnancy test. Oftentimes you have to wait it out in that very long two-week wait.” Anyone who has been there knows that those 14 days (give or take) can feel incredibly long, but you’ll make it. And if your period doesn't come, and you’ve had that cramping, then Wells says it would be a good idea to go ahead and do a pregnancy test to see if it’s positive at that point. If so, you’ll know you experienced implantation cramping, not period cramps.

Does it matter if you notice implantation?

Not really, Wells assures, adding that only about 30% of pregnant people notice implantation cramping. “It doesn't really change the course of the pregnancy,” she says, adding that if 30% of people notice these cramps, that leaves a whopping 70% of pregnant people who do not notice them. “Both turn out equally fine,” Wells says.

Other classic signs of implantation

Implantation happens so early in the pregnancy process that it can be easy to miss. Again, the best thing to do is try to focus on other things while you wait until you’re able to take a pregnancy test. “It’s too early to have anything like nausea, vomiting, fatigue, breast tenderness,” Wells says. However, some people might get a little bit of bleeding in conjunction with implantation cramping. If you do, Wells says it should be very light and only last a day or two at the very most.

Hang in there as you wait, and as ever, contact your health care provider if you’re concerned about anything or experiencing unusual discomfort.

Expert:

Dr. Tiffany Wells, M.D., general OB-GYN at Baptist Medical Center in Jacksonville, Florida