Implantation bleeding or period: what it looks like and how to tell

Implantation bleeding is light pink or brown spotting that can appear when the embryo implants in the uterus, usually a few days before your period is due or around the same date. It differs from a period in that it is much lighter (it doesn't soak a pad), paler or darker than the red of a period, without clots and shorter: from a few hours to a couple of days. It isn't dangerous, but it doesn't confirm a pregnancy either: to find out, do a test from the first day of your missed period.

If you're trying for a baby or want to know whether you're pregnant, bleeding always raises a lot of questions. That's why our team of midwives has put together this guide, with photos, so you know what implantation bleeding looks like, when it happens, how long it lasts and how to tell it apart from your period.

Implantation bleeding or period: the differences

	Implantation bleeding	Period
When	A few days before your period or on the date it's due	On the expected date according to your cycle
Amount	Light, on-and-off spotting; doesn't soak a pad	Gets heavier, usually needs a pad or tampon
Colour	Pink, brown or dark brown	Red, more intense in the first few days
Texture	Lighter and thinner, no clots	May have clots
Duration	From a few hours to a couple of days	Usually 2 to 7 days
Pain	None or mild discomfort	Often cramping pain

I'm spotting – is it normal?

To get your bearings, look first at how heavy the spotting is, because implantation bleeding is usually much lighter than a period, and then at how long it lasts. Implantation bleeding can last a few hours or carry on for several days as light, on-and-off spotting, unlike menstrual bleeding, which follows a more regular pattern.

Also, with implantation bleeding you usually notice afterwards that your period is late, sometimes with period-like pains, swollen breasts, or even nausea and tiredness. Bear in mind that these signs don't always mean you're pregnant: they are very common in other situations, so they aren't the most reliable way to tell period spotting from implantation spotting.

What does implantation bleeding look like? Photos and features

To work out whether the bleeding you have is implantation bleeding, look at these points:

• Texture: lighter than a period, with no clots.
• Colour: pink, brown or a dark red that is almost brown.
• Duration: variable, from a few hours to a couple of days.
• Intensity: lower than a period.
• Amount: light and on-and-off. Often you only see it when you wipe or on your panty liner.

What colour is implantation bleeding?

Implantation bleeding is usually lighter, thinner in texture and less intense in colour than a period. Most often it is pink or brown.

Brown implantation bleeding

Brown implantation bleeding is caused by "old" blood: because there is little of it and it comes out slowly, it takes longer to leave the body and oxidises, which gives it that brown tone. It is completely normal. If you notice light brown spotting around the date you expect your period, it could be an early sign of pregnancy.

Even so, not every pregnant woman has it, and brown spotting can also be caused by hormonal changes, infections or irritation of the cervix. So don't assume that brown bleeding is always a sign of pregnancy.

Bright red implantation bleeding

Implantation bleeding can range from light pink to red. How intense the colour is depends on the amount of blood and how quickly it comes out: faster bleeding looks redder, and slower bleeding looks darker or brown.

Light red spotting can be normal. But if it is bright red, heavy or with clots, it is most likely your period or another cause, not implantation. If you already have a positive test, or if you also have pain, get it checked (we explain below).

When does implantation bleeding happen?

After the egg is fertilised by the sperm, which usually happens in the fallopian tube, the embryo starts to divide and travels to the uterus, where it implants. This journey takes six to ten days after fertilisation; most often it implants about 8–10 days after ovulation. That's why implantation spotting usually appears about 10–14 days after ovulation, in other words a few days before your period or on the date it's due.

When the fertilised egg arrives, the endometrium is fully ready for implantation, full of veins and arteries that will feed the embryo during pregnancy.

Sometimes the spotting coincides with the luteal phase (the time between ovulation and your period) and is caused by a hormonal change, not by implantation, although it can be mistaken for it.

How long does implantation bleeding last?

From a few hours to a couple of days; sometimes it carries on for up to three days as light spotting that comes and goes. It doesn't get heavier like a period, it doesn't have the heavy flow of the first days of menstruation, and it isn't usually accompanied by the strong cramps typical of a period.

Why does implantation bleeding happen?

It happens in the first weeks of pregnancy, when the fertilised egg, the embryo that will become your baby, attaches to the wall of the uterus. To connect properly with you and secure the nutrients it needs to develop, it "anchors" itself in the endometrium (the inner lining of the uterus) and breaks small surface capillaries, forming new ones that will be the basis of the future placenta. Because the uterus has a very rich blood supply, it can bleed easily.

That is what we know as implantation bleeding, and that's why it is different from period bleeding. Because the endometrium always has a very rich blood supply, this kind of spotting can also happen for other reasons that are just as normal.

Does everyone who is pregnant get implantation bleeding?

No. Although it is considered one of the first signs of pregnancy, it happens in roughly three in ten women. It's just as normal to have it as not to have it.

If I had implantation bleeding in my last pregnancy, will I have it every time?

Not necessarily. Every pregnancy can be different, in this as in everything else, such as vomiting or nausea. Implantation bleeding doesn't follow a fixed pattern: it may appear in one pregnancy and not in others, or in all of them.

Is implantation bleeding bad?

No. Implantation bleeding poses no risk to you or your baby. There is no evidence linking it to pregnancy problems or miscarriage.

What can be linked to bleeding is a problem with the pregnancy, such as a miscarriage, but that bleeding is more like a period: it is heavier and usually comes with pain and other symptoms. And many miscarriages and ectopic pregnancies happen without any bleeding at all, so there is no reason to link implantation bleeding with miscarriage.

What should I do if I have implantation bleeding?

If it's light spotting that doesn't last long, all you need to do is wait: do a pregnancy test from the first day of your missed period. We explain how in when to take a pregnancy test. If it's positive, the next step is your first appointment with your midwife.

When should I get checked?

• Speak to your midwife, GP or gynaecologist if you already have a positive test and you're bleeding, if the bleeding lasts more than a couple of days or if you're not sure what kind of bleeding it is.
• Go to A&E or call 112 (999 in the UK) or your local emergency number if the bleeding is heavy (like a period or more) or has clots, if you have severe pain low in your tummy, especially on one side, pain in the tip of your shoulder, or if you feel dizzy or faint.

What is embryo implantation?

Embryo implantation is the process in which the fertilised egg implants in the endometrium, attaching itself to it. If all goes normally, this is the moment your pregnancy begins.

It usually happens six to ten days after fertilisation. After implantation, your body starts to produce the pregnancy hormone (beta-hCG), which is what pregnancy tests detect.

If the test is positive, write down the first day of your last period: with that date, our pregnancy calculator tells you how many weeks pregnant you are and your estimated due date.

And if you're pregnant: for when your baby arrives

If the test confirms you're pregnant, you have months ahead to get everything ready calmly. Many mums-to-be buy a bottle before the birth, including those who plan to breastfeed, in case they need it for mixed feeding or to give their own milk. Our advice as midwives is that the teat should be as similar as possible to your breast: that's why the Happymami bottle is designed from the shape of your breast.

Frequently asked questions

How many days does implantation bleeding last?

From a few hours to a couple of days. If it lasts longer or gets heavier, it is most likely your period.

Is it normal to have spotting only when I wipe, plus cramps?

Light spotting with mild discomfort can be implantation bleeding, but it also happens before a period. If the cramps are strong or the bleeding gets heavier, get it checked.

How can I tell if it's pregnancy or my period?

By the amount, the colour and how long it lasts (see the table above). The only way to know for sure is a pregnancy test from the first day of your missed period.

Can I take a pregnancy test during implantation bleeding?

You can, but it's probably still too early and it may come out negative. Wait until the first day of your missed period for a reliable result.

Conclusion: implantation bleeding or period?

So how do I know if it's implantation bleeding or my period? By the amount, the colour and how long it lasts, although only a pregnancy test will confirm it. As we always say, every case is unique and every pregnancy is a personal experience. If you have bleeding that worries you, speak to your midwife, GP or gynaecologist: they can assess the cause and tell you what to do. At Happymami we're here to support you throughout the whole process.

Sources

• NHS. Signs and symptoms of pregnancy.
• NHS. Doing a pregnancy test.
• NHS. Ectopic pregnancy: symptoms.
• Cleveland Clinic. Implantation bleeding.