Implantation Bleeding vs. Miscarriage: Know the Difference

  • Written by

    Paige Figueroa

    BSN, RN
  • Verified by

    Dr. Aditi Neelakantan

    Medical Practitioner, MBBS

    Dr. Aditi Neelakantan

    Dr. Aditi Neelakantan, a medical practitioner with a strong inclination for compassion-driven research, believes that “knowledge is a commodity to be shared”. She dedicates her time to simplifying complex medical information so that people can better understand their health and make informed choices.

Implantation Bleeding vs. Miscarriage
  • Written by

    Paige Figueroa

    BSN, RN
  • Verified by

    Dr. Aditi Neelakantan

    Medical Practitioner, MBBS

    Dr. Aditi Neelakantan

    Dr. Aditi Neelakantan, a medical practitioner with a strong inclination for compassion-driven research, believes that “knowledge is a commodity to be shared”. She dedicates her time to simplifying complex medical information so that people can better understand their health and make informed choices.

Stressing over whether you’re experiencing implantation bleeding or a miscarriage? Any amount of bleeding during your pregnancy or fertility journey can feel alarming. And rightly so. 

But bleeding in early pregnancy is actually more common than you think.

In fact, 15-25% of women experience bleeding during the first trimester. In those first few weeks, you develop more blood vessels in the area around your cervix. So this can contribute to bleeding.

But really, there are a variety of reasons you could be experiencing vaginal bleeding in the beginning stages of pregnancy. While some are normal, others require medical attention.

So if you’re pregnant or think you could be pregnant, keep reading. By the end, you’ll be able to confidently differentiate between implantation bleeding, miscarriage, and other causes of vaginal bleeding.

How do you know if it’s a miscarriage or implantation bleeding?

Here are the main differences:
  • Implantation bleeding comes slightly earlier than your expected period. It ranges from spotting to light pink or brown bleeding.
  • Bleeding caused by a miscarriage will occur later than your expected period. This type of bleeding will be dark red and could include tissue and clots.
If you want to be really thorough in your self-assessment, take a closer look at even more differences in the chart below.

Characteristic

Implantation Bleeding

Miscarriage

Flow

Light spotting (appears like an “early light period”)

It may start light but then become heavy bleeding (“late heavy period”)

Duration

1-2 days

As a general rule, the farther along the pregnancy was, the greater the bleeding.

 

Usually in the early stages, it lasts for about a week and is just like a prolonged period. As the weeks of the pregnancy progress, the bleeding becomes heavier and longer 

Color

Pink or brown 

Dark red

Clotting

No clots are present

Tissue or jelly-like clots are usually present

Timeline

Usually 8-10 DPO, but can be anywhere from 6-12 DPO

Can happen anytime before 20 weeks

Still unsure why you’re experiencing bleeding? There are some other signs that can give you more insight. Keep reading!

How do I know if it’s implantation bleeding?

Implantation bleeding appears as spotting or bleeding that is light pink or brown. It can happen anywhere from 6 – 12 days past ovulation (or DPO) (8 – 10 DPO is most common though). 

It’s usually hard to confuse this with miscarriage bleeding. Miscarriage bleeding is heavier and would occur a few days after your missed period.

But if you’re used to having a lighter period, this could make it trickier to tell implantation from menstrual bleeding. The timing of the bleeding can help guide you though since your period typically begins closer to 14 DPO

Does implantation bleeding have clots?

Clotting is a fairly definitive sign that it’s not implantation bleeding. Here’s why. Implantation bleeding occurs when the fetus establishes a connection with the mother’s circulation. It can cause spotting or very light bleeding. This would show as just a few drops of blood on toilet paper or on your underwear.  

Some clotting can occur with your period though. This is normal and happens if you have a heavy flow or if you pass bits of uterine tissue. But clotting can also happen when you’re miscarrying and passing fetal tissue. 

How do I know it’s miscarriage bleeding?

A miscarriage is a spontaneous pregnancy loss that happens before 20 weeks gestation. As sad as it can be to experience this type of loss, it’s not at all uncommon. Especially in the early stages of pregnancy. 

When it comes to bleeding and pregnancy though, knowing the timing matters. A miscarriage beyond 6 weeks gestation would be hard to mistake for implantation bleeding.

But due to the nature of the timeline, it may be tricky to distinguish menstrual period bleeding vs. implantation bleeding vs. a miscarriage that occurs between 5 – 6 weeks gestation.

Read more: Difference Between Miscarriage and Period

If you do experience an early pregnancy loss around the 5 – 6 week mark, it’s likely either a chemical pregnancy or a missed miscarriage. A missed miscarriage wouldn’t involve any obvious signs, but a chemical pregnancy would.

Just to give you all the must-knows here, let’s review what a chemical pregnancy entails.

Chemical pregnancy bleeding

Here’s a quick rundown of what happens during a chemical pregnancy:

  • The egg is fertilized and implantation occurs. You would get a positive pregnancy test if you take one.
  • After implantation, the embryo fails to develop (most commonly due to chromosomal abnormalities), so a miscarriage occurs. This is what causes the bleeding. Your body is passing the pregnancy tissues from your uterus. Typically, this happens before 5 weeks.
  • If you test again, a pregnancy test will come up negative. Even after you initially got a positive. This also means no gestational sac would appear on an ultrasound.

Bleeding that occurs from a chemical pregnancy will be heavier than a normal period. It may even include clots.

But here’s a helpful way to distinguish implantation bleeding from a chemical pregnancy. A chemical pregnancy happens after you would expect your period to come. Bleeding from this type of loss comes about a week after your expected period. Whereas implantation bleeding would come a few days before you expect your period.

Read more: Chemical Pregnancy: Quick Guide and Need to Know

Some women may have a chemical pregnancy and not even know. They would just think it was a delayed period. Especially if they didn’t take a pregnancy test during that early window. 

Now, let’s take a look at what a missed miscarriage is.

Missed miscarriage bleeding

In some cases, you could miscarry but not experience any visible signs. This is called a missed miscarriage or a silent miscarriage.

A few subtle signs you may notice with a missed miscarriage include:

  • Mild cramping
  • No longer experiencing pregnancy symptoms
  • Brownish vaginal discharge

Read more: Silent Loss: Causes and Treatment of Missed Miscarriage

Keep reading the next section to get even more tips on telling the difference between implantation bleeding and miscarriage.

Implantation bleeding or miscarriage? How else you can tell

Bleeding isn’t the only way to distinguish between implantation and miscarriage. Below you’ll find additional symptoms that can give you a fuller picture of what else may be going on with your body.

Symptoms of implantation

For starters, during implantation, your levels of the hormone progesterone rise. When you have increased amounts of progesterone, you may experience any of the symptoms below:

  • Cramping
  • Spotting
  • Fatigue
  • Tender breasts
  • Mood swings
  • Food cravings 
  • Stomach issues
  • Raised basal body temperature

When it comes to implantation, keep in mind that symptom tracking isn’t an exact science. This is because not all women experience symptoms of rising progesterone. And even for the ones who do, the precise symptoms vary from woman to woman.

Additionally, you may have noticed that a lot of the symptoms associated with implantation look quite familiar. That’s because many of these overlap with symptoms of premenstrual syndrome (PMS). So if you’re going off of symptoms alone, it may not be all that easy to decipher the underlying cause of your bleeding.

Miscarriage symptoms

In this, you could experience:

  • Severe cramping in the lower abdomen
  • Pink cervical mucus
  • Back pain
  • Weakness
  • Fever

Pregnancy symptoms that have faded away

Experiencing one or more of these symptoms?  It’s time to call your healthcare provider. They’ll be able to help you get additional testing done to figure out what’s going on.

Other reasons for bleeding in early pregnancy

Is this question still burning in your mind: How do you know if it’s a miscarriage or just bleeding? Then read on carefully because we want to make sure you have all your facts straight.

Implantation and miscarriage are just two reasons you could see bleeding at the onset of pregnancy.

So to help you make the best judgment of your unique situation, here are some additional causes of bleeding you should know about.

Ectopic pregnancy

This happens when the embryo implants outside of your uterus, usually in one of your fallopian tubes. Common symptoms you should look for include severe abdominal and back pain, vomiting, fever, and weakness. If this sounds like what you’re experiencing, our hearts go out to you. But be sure to consult a doctor immediately. 

Molar pregnancy

Molar pregnancies are non-viable, meaning they can’t result in a successful pregnancy. Telltale symptoms include passing grape-like clusters, severe nausea and vomiting, and severe abdominal pain.

Infections

Not surprisingly, infections like urinary tract infections (UTI), bacterial vaginosis (BV), yeast infections, and STIs can also cause vaginal bleeding. Think an infection could be the cause of your bleeding? Then look for other infection symptoms like discomfort during urination, abdominal pain, abnormal odor or discharge, and vomiting or fever.

Subchorionic hemorrhage

This is actually the most common culprit of bleeding when you’re around 10-20 weeks gestation. Subchorionic hemorrhage bleeding comes from below the membranes that enclose the embryo inside the uterus. This may sound a bit technical. But all you need to know is that when the chorion membranes are partially detached from the uterine lining, bleeding occurs.

Having sex

Due to increased blood circulation to your cervix during pregnancy, this area is super sensitive. That’s why it’s not uncommon for pregnant women to experience light spotting after having sex. No fun, right? But this spotting would be temporary and not last for more than a few hours.

faq img

FAQs

No. Remember, pregnancy begins once the embryo implants into your uterus. So failed implantation wouldn’t be considered a pregnancy in the first place.
That said, in some cases, the fertilized egg implants somewhere other than the uterus. This is called an ectopic pregnancy, and it requires immediate medical attention.

It really depends on the timing of when implantation occurred. Usually implantation will happen between 8 – 10 DPO–12 DPO at the most. Once the embryo has implanted, you can miscarry at any point after that. If you do miscarry early on, it’s likely to be a chemical pregnancy which is when the fertilized egg implants but doesn’t continue to develop.

Perhaps it could feel similar to a missed miscarriage, which has very subtle signs like mild cramping. During implantation, in addition to cramping, you could also have stomach issues, mood swings, and tender breasts. Although, other miscarriages include more obvious signs like severe cramping, back pain, weakness, and fever.

No, passing clots is not a characteristic of implantation bleeding. If you have smaller clots, it’s more than likely from your period.
Read more: Implantation Bleeding Vs Periods | What Does Implantation Bleeding Look Like?

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