PREGNANCY

Implantation bleeding and pregnancy tests: your questions answered

First published on Monday 3 July 2023

Hand holding a magnifying glass to an illustration of the womb

If you’re experiencing spotting or heavy bleeding and you’re confused about implantation bleeding and pregnancy tests, we’ve got your main questions answered.

If you're TCC (trying to conceive) and you've experienced some spot bleeding, you probably have plenty of questions relating to pregnancy test results and how they might be affected. So we've answered the main questions for you!

Further reading:

Can I be pregnant if I didn't have implantation bleeding?

Yes, you could be pregnant, even if you haven't experienced any implantation bleeding. When the egg implants into your uterus lining it can cause some spotting and cramping, but not in all cases.

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First Response says, 'Don’t worry if you don’t experience any implantation bleeding at all.'

They say;

  • 70-75% of women don’t report any implantation spotting
  • 25-30% of women do have some implantation bleeding

This means that you're more likely to be in that 70-75% and be pregnancy without any sign of implantation bleeding.

How do I know if my bleeding is implantation bleeding or something else?

Any kind of bleeding, when you're trying to get pregnant, can put you on high alert. It can be tricky to tell the difference between implantation bleeding and something else, which only adds to the stress.

Implantation bleeding looks different in every case, but generally it shouldn't be as heavy as your normal period or contain any big blood clots.

Healthline says, 'The color of the blood can also help you distinguish between implantation bleeding and your period.'

They say, 'Implantation bleeding is more likely to be a pinky-brown color. Menstrual bleeding, on the other hand, may start off light pink or brown, but it soon changes into crimson red.'

They also say, 'Implantation bleeding is usually super-light spotting. Your period may start off light, but the flow gets stronger.'

No woman's period or implantation bleeding is the same though, which is why this is a difficult question to answer.

Signs you might be experiencing implantation bleeding:

  • You only see blood when you wipe
  • You find spots of blood in your underwear
  • You experience a very light flow of blood (on and off) for a few days (1-3 days)
  • You only need to wear a panty liner, rather than a full period pad
  • The bleeding happens around the time you period is due, but ...
  • The bleeding doesn't look like your normal period
  • You experience some mild cramping that doesn't become more intense

These early pregnancy signs could also indicate implantation bleeding:

  • Mild cramping
  • Tender breasts
  • Headache
  • Fatigue
  • Mood swings
  • Food cravings

PMS symptoms can be very similar to early pregnancy symptoms though, so keep in mind these are not exhaustive lists and that there are always exceptions!

The best way to know if you've experienced implantation bleeding is to wait until you miss your period and then take a home pregnancy test.

We know it's torture having to wait though, so we gathered some implantation bleeding real-life stories with pictures from women in our Forum.

Can heavy implantation bleeding be a sign of pregnancy?

Implantation bleeding isn't normally heavy, but that doesn't mean you're not pregnant, or that heavy implantation bleeding isn't a thing!

Nobody really knows why heavy implantation bleeding occurs. Anecdotal evidence suggests that one theory could be that heavy implantation bleeding may occur if you're carrying twins.

This idea stems from the notion that there may be more trauma to the womb lining during implantation causing heavier bleeding. However, there is no real research to confirm this.

One study tracked the bleeding patterns of over 4,500 women during their first trimester of pregnancy. 

They found that of all bleeding episodes:

  • 75% had spotting
  • 18% had light bleeding
  • 6% had heavy bleeding

The most heavy bleeding episodes happened between the sixth to eighth weeks of pregnancy though – this is far past the typical implantation window.

This suggests that there are other causes of heavy bleeding in the first trimester besides implantation.

Potential causes of heavy bleeding that aren't implantation bleeding:

  • Your period
  • A miscarriage
  • Subchorionic Hematoma
  • Ectopic pregnancy
  • Molar pregnancy
  • Another serious condition

Can you take a pregnancy test during implantation bleeding?

If you see 'spotting' you may feel so hopeful that you want to take a pregnancy test straight away to find out if it's implantation bleeding. But this may only lead to more confusion.

According to Medicine Net, 'If you choose to test as soon as you discover spotting, be aware that the earlier you test, the more likely you are to get a false negative.'

They say, 'A false negative can happen when pregnant, but your hCG levels are not yet high enough to trigger a positive result on a home pregnancy test.'

When to take a pregnancy test after implantation bleeding

Whilst the temptation to take a pregnancy test straight away is strong, you may save money on expensive tests if you wait a little while longer.

Normally you would wait until you have missed a period, but if you are spot bleeding this may be confusing. Calculating the day your period is due isn't always accurate either, as you may have ovulated earlier or later than you though.

Medicine Net says 'The best thing to do is wait a couple of days after seeing implantation spotting before taking a pregnancy test.'

They say, 'This gives your body time to produce detectable levels of hCG.' and advise, 'For the most accurate results, wait until your period is due before taking a home pregnancy test.'

Can heavy implantation bleeding be a sign of miscarriage?

If you have taken a pregnancy test and know you're pregnant, then yes, heavy implantation bleeding could be a sign of miscarriage.

A miscarriage that occurs this early on is called a 'chemical pregnancy'. It usually begins as spotting and then progresses into a heavier flow with visible clots and a dark red colour that may look and feel like your regular menstrual period or be heavier than normal. You'll probably also get some cramping similar to period pains, and for some women these can feel more intense.

Even if you don't know for sure if you're pregnant, heavy flow is not usual for implantation bleeding and suggests that something is either wrong, or you are having your normal period.

Should I be worried if I have heavy implantation bleeding and a positive pregnancy test?

If you've already taken a pregnancy test and got a BFP (big fat positive), heavy bleeding is definitely a concern in most cases.

Implantation bleeding should be light, so if your bleeding is heavier this usually indicates a problem.

According to Medical News Today ...

Potential causes of heavy bleeding in early pregnancy include:

  • Chemical pregnancy – This term describes a pregnancy ending before 24 weeks
  • Subchorionic hematoma – This involves the placenta separating from part of the uterus wall, allowing blood to pool in the space between. This is most common for women who are 10-20 weeks pregnant, but it can also happen earlier.
  • Ectopic pregnancy – occurs when a fertilised egg implants outside of the uterus, most likely in the Fallopian tube. It is high risk as the tube can burst, leading to potentially life threatening internal bleeding.
  • Molar pregnancy – occurs when the placenta does not form correctly and instead develops into a mass of cysts. This is due to an irregularity in the embryo’s chromosomes.

What should I do if I have heavy implantation bleeding with a positive pregnancy test?

If your bleeding is fairly light, with no other symptoms that suggest something is very wrong, there's probably nothing to worry about. However, if you are experiencing heavy bleeding, try not to panic, and following this advice:

Medical News Today says, 'Anyone who experiences heavy bleeding in the first 12 weeks, or first trimester, of pregnancy should speak with their midwife, a doctor, or another healthcare provider as soon as possible.'

How can I reduce my risk of a miscarriage?

The NHS says, 'In many cases, the cause of a miscarriage is not known and you would not have been able to prevent it.;

However, there are ways to lower your risk of miscarriage:

  • Don't smoke during pregnancy
  • Don't drink alcohol or using illegal drugs during pregnancy
  • Eat a healthy, balanced diet with at least 5 portions of fruit and vegetables a day
  • Make attempts to avoid certain infections during pregnancy, such as rubella
  • Avoid certain foods during pregnancy, which could make you ill or harm your baby
  • Being a healthy weight before getting pregnant will reduce the risk of miscarriage or other complications.

Can you have implantation bleeding and a negative pregnancy test?

If you test too early, which many women do because they've seen some spotting and want to know if it's implantation bleeding, you may get a negative pregnancy test result, even if you are in fact pregnant. This is called a 'false negative'

It happens because the hCG levels (pregnancy hormone) in your body are still too low to be detected by the pregnancy test.

Alternatively, a negative test can be the result of you not being pregnant because your spotting or bleeding is your menstrual period, which may be starting off lighter than usual.

Remember, your menstrual cycle can be affected by all kinds of things, including stress, diet and hormonal imbalance.

What does it mean if I get a negative pregnancy test result 2 weeks after implantation bleeding?

Any negative pregnancy test result taken 2 weeks after implantation bleeding could mean a number of different things ...

It could be a false negative because;

  • You tested too early
  • You didn't test correctly
  • The pregnancy test is faulty
  • The pregnancy test has expired
  • You're experiencing a complication

Alternatively it could be negative because;

  • You're not pregnant
  • You've had a chemical pregnancy

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Implantation bleeding and pregnancy tests: your questions answered

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