Can you not have implantation bleeding and be pregnant

During pregnancy, your body goes through all kinds of changes. Some are obvious and expected, like a growing belly or the stoppage of your menstrual cycle. But did you know that very early on, you may experience some bleeding that could be mistaken for your period? This is called implantation bleeding, and we sat down with Heather Reed, MD, an obstetrics and gynecology physician and medical director of labor and delivery at Banner – University Medical Center Tucson, to learn what it is and when you should be concerned.

Q: What is implantation bleeding? Is it normal?

A: Pregnancy starts when an egg is fertilized in the fallopian tube and then makes its way to the uterus. When the fertilized egg reaches the uterus, it attaches to the uterine wall. When this attachment happens, you may experience a small amount of bleeding. This is called implantation bleeding and it is completely normal.

Q: How much bleeding is normal?

A: The amount of bleeding at implantation can vary between women. Some women may not experience any bleeding with implantation, while other women may have bleeding that compares to a light period and lasts two or three days. Anything on that continuum – from no bleeding to bleeding resembling a light period – can be considered normal.

Q: I’m experiencing bleeding that is heavier than a light period. Should I be worried?

A: Because implantation can be the same time as you might be expecting your period, it can be hard to tell the difference between implantation bleeding and your regular menstrual bleeding. It’s tough to know when you should be worried because every woman’s circumstance is different. However, any time bleeding saturates a pad in less than two hours it should be considered too much vaginal bleeding, and you should consult a physician.

Q: Are there other symptoms associated with implantation bleeding?

A: Some women experience slight cramping or nausea during implantation, in addition to light bleeding. Because implantation occurs so early in pregnancy it can be difficult to tell if the symptoms are from implantation or your regular monthly menstrual cycle.

Q: How do I know the difference between implantation bleeding, my menstrual period, and a miscarriage?

A: Unfortunately, there’s no way to tell the difference between implantation bleeding and menstrual bleeding. Implantation occurs 6-12 days after conception, which is around the same time you may be expecting your monthly period, and both can produce the same amount of bleeding.

If you think you may be pregnant, your best bet is to take a home pregnancy test. The level of human chorionic gonadotropin (hCG), a pregnancy hormone, can vary between women but most home pregnancy tests can detect pregnancy. However, it’s important to know that a home pregnancy test can produce a false negative because everyone’s hormone level is slightly different. While it’s possible to become pregnant and lose the pregnancy this early on – resulting in light bleeding that could be confused with implantation bleeding – a pregnancy loss this early isn’t considered a miscarriage.

If you think you’re pregnant, it’s best to make an appointment with an OBGYN. An OBGYN can provide a pregnancy blood test and if you are pregnant, start important prenatal care right away.

For additional information, check out these related articles: Is My Period Normal? — 7 Signs You Might Be Pregnant — Things You Should Know About Well-Women Visits. And for other helpful advice regarding pregnancy, visit the Banner Health blog. 

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What Is Implantation Bleeding?

Implantation bleeding is light bleeding from the vagina that happens in some women 10 to 14 days after conceiving a baby.

You may think it’s just a light period, but it’s an early sign of pregnancy. It’s not dangerous, and you don’t need treatment.

But heavy bleeding (more than you’d have with a typical period) can be a sign of a problem. Call your doctor if you bleed a lot, with or without fever, chills, or have cramps that get worse. 

When Does Implantation Bleeding Happen?

After a sperm fertilizes your egg, the combination becomes an embryo. It travels to your uterus, where it implants itself into the lining.

Sometimes, as the embryo attaches, it causes a little bleeding.  This usually happens about the time you would have your period. You may even confuse it with your period and not realize you’re pregnant. Implantation bleeding is normal and doesn’t mean you or your baby will have problems.

Implantation Bleeding Symptoms

Implantation bleeding tends to happen before you notice morning sickness. You might have:

  • Blood that’s brown or pinkish
  • Blood that’s lighter in flow and doesn’t last as long  as your period
  • Mild or no cramping
  • Unlike your period, you won’t see any blood clots or tissue in the blood

It’s probably implantation bleeding if you have some of the other signs of early pregnancy, including:

  • Tender, swollen breasts or nipples
  •  Fatigue
  •  Headache
  •  Upset stomach
  • Vomiting (morning sickness)
  • Food cravings or aversions
  • Mood swings
  • Peeing more than usual

If you’re not sure whether you’re having implantation bleeding or your period, take a pregnancy test or talk to your doctor.

How Long Does Implantation Bleeding Last?

Unlike most periods, it usually stops after 1 or 2 days.

Implantation Bleeding Treatment

It will stop on its own. If you're worried that you've bled a lot, call your doctor. They may want to know how much blood you saw and what color it was.

Other Causes of Bleeding During Pregnancy

Many things can cause bleeding in pregnant women, some of them harmless and some serious. If you’re bleeding a lot, with or without pain or cramping at any time, call your doctor.

If you’re pregnant and see blood in your underwear, it may be caused by:

Sex. Hormonal and physical changes may be to blame for this. It should stop on its own.

Fibroids and polyps. Your doctor might do some tests to check for these growths on your uterus.

Cervical problems. Conditions like infection or growths on your cervix can also cause bleeding.

Infection. Sexually transmitted diseases like trichomoniasis can cause light bleeding as well as more serious problems. Starting treatment as soon as possible will keep your baby healthy.

Ectopic pregnancy. This is when an embryo implants outside your uterus. You may have bleeding with pain and cramps. It’s dangerous and needs medical care right away.

Miscarriage. About 15% of known pregnancies end during the first few months. Most women bleed and cramp afterward. Call your doctor right away if you know that you're pregnant and you have these symptoms.

When to See a Doctor

Call your doctor if the bleeding doesn’t stop after a few days or if you’re worried about how much you are bleeding. 

Can there be implantation without bleeding?

Some women may not experience any bleeding with implantation, while other women may have bleeding that compares to a light period and lasts two or three days. Anything on that continuum – from no bleeding to bleeding resembling a light period – can be considered normal.

Does every pregnancy have implantation bleeding?

Does every woman get implantation bleeding? No. Bleeding only happens in 15-25% of early pregnancies1. In most cases, spotting is a normal sign of implantation, but any bleeding should be checked out if you're worried, because it could still be a symptom of a miscarriage or an ectopic pregnancy.

Can you be pregnant without implantation symptoms?

Keep in mind that most women experience no signs at all of conception or implantation — and are still pregnant! — though some women do experience signs of implantation.