Chemical pregnancy: What it is and how it feels

Losing a pregnancy, no matter when or how it happens is incredibly difficult. And having a miscarriage before you find out you’re pregnant can be really confusing. It can feel like you’re mourning the loss of something you didn’t even know you had. This can happen if you have a chemical pregnancy — a very early miscarriage that happens before your fifth week of pregnancy. 

Chemical pregnancy can be really difficult to understand due to the fact that it happens so early on. You may not have even missed a period yet, which is one of the first key signs that you’re pregnant. To make it more confusing, many of the symptoms that are linked to chemical pregnancies can feel a little bit like a very heavy period.

To help you spot the differences between a period and a chemical pregnancy and to share information about the other symptoms, we spoke with two Flo experts. Plus, a Flo user shares their experience of chemical pregnancy — because the emotional side of it is just as important to talk about as the physical. 

What is a chemical pregnancy?

Chemical pregnancy (sometimes called biochemical pregnancy) is a pregnancy loss that happens within the first five weeks after conception because the embryo stops developing in the uterus. The name can sound really harsh or detached, so please remember this isn’t your doctor commenting on your loss or how you should feel about it. 

Chemical pregnancy gets its name from the different chemicals or hormones that develop in your body around week five of pregnancy. After you conceive, your embryo will implant into the wall of your uterus. Around one week later, a placenta will start to develop. 

Your placenta produces the hormone human chorionic gonadotropin (or hCG), which supports your body while your baby develops. It’s hCG that at-home urine pregnancy tests and blood tests look for in order to confirm that you’re pregnant because, at this stage, the embryo is far too small to see on an ultrasound scan. 

If you experience a chemical pregnancy, your hCG levels will drop. Dr. Allison Rodgers, obstetrician and gynecologist, Illinois, US, explains that many chemical pregnancies happen between weeks three and five of pregnancy.

Losing your pregnancy so early might leave you with lots of questions, so it’s important to lean on your health care provider for information and support. Remember that a loss like this is never your fault, and you don’t need to have all the answers.

Chemical pregnancy and clinical pregnancy: Is there a difference? 

You might have heard the term clinical pregnancy and wondered how it’s different from a chemical pregnancy. Although the terms sound similar, there’s an important difference between the two. Dr. Barbara Levy, clinical professor of obstetrics and gynecology, Washington, DC, US, explains that a clinical pregnancy is “when an ultrasound can detect a gestational sac or an embryo.” However, “if the pregnancy test is positive, but there is no sign of pregnancy tissue, that’s called a chemical pregnancy.”

It’s estimated that between 8% and 33% of all pregnancies will end as a chemical pregnancy, but it can be really difficult to know how common it actually is. This is because some people will have one and won’t even have known they were pregnant. 

A chemical pregnancy means you won’t end up with a clinical pregnancy, and while this happens early on, the loss that you might feel afterward is completely valid. You should always have the support and space to express your feelings. 

What are the signs and symptoms of chemical pregnancy? 

You might be curious as to how you can experience a chemical pregnancy without knowing that you’re expecting. The earliest time an at-home pregnancy test can detect hCG in your pee is two weeks after conception, but many people won’t find out they’re pregnant for a few more weeks. 

If you don’t track your periods, you have an irregular period, or you have a chemical pregnancy very early on, then you may not know to take a pregnancy test within the first five weeks. And as chemical pregnancies often look like a late, heavy period, it’s easy to confuse the two.

Some signs of chemical pregnancy to look out for include: 

• Bleeding in the days after getting a positive pregnancy test 
• Severe period cramping when you have your period
• Getting a negative pregnancy test a few weeks after a positive one
• Your period being a week or more later than usual

There are so many things that can impact your cycle and might mean your period is late. It isn’t always pregnancy-related. However, if you notice that something isn’t quite right for you or if you experience bleeding after having a positive pregnancy test, then don’t hesitate to reach out to your doctor. 

What causes a chemical pregnancy? 

The most important thing to remember is that no one knows what causes chemical pregnancy — and it isn’t your fault. In many cases, it’s believed that it can happen if the embryo doesn’t implant in your uterus in the way it would have needed to in order to continue growing. 

There might have also been some problems with the embryo’s genetic makeup (or DNA). When you conceive, both the egg and the sperm provide 23 chromosomes each. However, if there are some abnormalities with these chromosomes, it can lead to pregnancy loss. This doesn’t mean there’s anything wrong with you, and it doesn’t mean you can’t go on to have a healthy baby later down the line.

If you’re at all worried about chemical pregnancy and miscarriage, then speak to your doctor. They will be able to advise you on any symptoms you might be experiencing and can serve as a sounding board for all your concerns. 

There are some factors that have been linked to a higher risk of miscarriage. These include: 

• Being over the age of 35
• Being underweight or overweight 
• Having a uterus that is an atypical shape 
• Having conditions like polycystic ovary syndrome (PCOS) or diabetes that isn’t treated 

If you fall into any of the above demographics, please don’t lose hope about your chances of having a healthy pregnancy in the future. Just because you may fit into one or some of these criteria does not mean you will definitely miscarry — far from it. And even if it happens to you once, many people still go on to have a healthy baby later on.

Chemical pregnancy bleeding: What does it look like? 

Bleeding caused by a chemical pregnancy might look a little bit like your period, and Dr. Levy explains that this is because your embryo hasn’t grown a lot. 

However, not everyone displays symptoms of a chemical pregnancy in this way. For example, you might notice that you’re experiencing more severe cramps or that your period is a lot heavier than normal. Dr. Rodgers says it might start as spotting and get progressively heavier, and it can last between a few days and up to a week. If the bleeding saturates more than one pad per hour, she advises that you reach out to your health care provider. 

Seeing blood at any stage of pregnancy can be worrying, but it’s worth remembering that light bleeding in the early weeks doesn’t always mean you’re experiencing a miscarriage. Sometimes it can be a sign of implantation bleeding when the embryo embeds into the wall of your uterus. Alternatively, spotting in the first trimester of pregnancy may be caused by penetrative sex and changes to your cervix. If you notice blood in your underwear in the early stages of pregnancy, try not to panic. Call your doctor and schedule an appointment with them; they’ll be able to help you get to the root cause of it. 

How is a chemical pregnancy diagnosed and treated? 

Having a chemical pregnancy or experiencing any kind of bleeding can be really scary, so the best thing to do is to reach out to your health care provider. They will start a series of investigations, which may include a blood and urine test, to monitor your hCG levels and establish if you’ve experienced a chemical pregnancy. They may also ask you when your last period was and whether it was typical for you. 

There aren’t any treatments for the physical side effects of chemical pregnancy. You may notice that bleeding ends by itself within a week. However, if you’re uncomfortable, bleeding through more than one pad per hour, or the bleeding doesn’t stop within a week, then reach out to your doctor for advice. 

It’s so important to be gentle with yourself at this time and to understand that you did nothing wrong. If you’d like support for the emotional toll that chemical pregnancy can take, then speak to your doctor about accessing loss and mental health services. March of Dimes offers information and support for people who have experienced pregnancy and baby loss. Similarly, the Miscarriage Association is a UK-based charity that has a helpline and organized support groups for families who have experienced miscarriages.  

What does it feel like to have a chemical pregnancy? 

Learning about the potential causes and signs of a chemical pregnancy may help you to understand more fully what it is. But knowing that other people have been in your position and hearing how they navigated it is also powerful. 

Thirty-three-year-old Mya experienced a chemical pregnancy in 2021. She had a son two years earlier and had been trying to conceive again with her partner. “Had we not been trying for a baby, I’m not sure I’d have spotted that I was pregnant so early,” she says. “I was in the routine of taking tests, and we were over the moon. It was exactly what we wanted.” 

A week and a half after taking an at-home pregnancy test, Mya started to experience bleeding. “It was just like my period, really. I thought the pregnancy test might have been wrong and that I’d received a false positive,” she says. “But the bleeding got heavier, and I started to experience really bad pain. I went to see my doctor, and that was the first time I heard the term chemical pregnancy.” 

Mya’s doctor conducted a blood test, confirming that her hCG levels had dropped and that she was no longer pregnant. They also explained that she had likely found out she was pregnant very early, at around week three. 

“The bleeding only lasted a week, about the same amount of time that I knew I was pregnant. But talking about the loss was so painful,” she says. “My partner couldn’t understand, and I had to work out how to tell my family that I was pregnant but that we’d lost the baby. One friend asked if I was really pregnant if it had only been four weeks. 

“I’m still really annoyed that there’s such a lack of understanding surrounding chemical pregnancies. I suffered in silence because I didn’t really understand what I’d gone through,” continues Mya. “I went through the high of finding out I was pregnant and then losing the baby in two weeks.” 

Mya worked closely with her doctor and her therapist to talk through her experience and process what she’d gone through. She started trying for a baby again in the summer of 2022, and in October, she found out she was pregnant. “I realized I had a lot to work through before I could even think about getting pregnant again. The first few weeks after I found out I was pregnant again were scary, but I’m now surrounded by people who know what I went through,” she says. “At my appointments, my doctors know I need all the information, and this pregnancy now feels like a fresh start.”  

Chemical pregnancy and fertility: Getting pregnant after a chemical pregnancy 

Chemical pregnancy can be emotionally challenging. But the good news is that — just like Mya — many people who experience chemical pregnancies will have healthy pregnancies in the future. 

Because chemical pregnancy happens so early on, Dr. Levy explains that it might not impact the timing of when you next ovulate. She adds that your periods after you’ve had a chemical pregnancy should be totally typical for you. However, if they become irregular, heavy, or painful, then make sure you let your doctor know. 

If you decide to try for a baby again, Dr. Levy has some advice. “The chances of having a normal pregnancy after a chemical pregnancy are the same as they would have been without detecting the chemical pregnancy,” she says. Try to remember that if you ever feel you’re losing hope. 

Chemical pregnancy: The takeaway 

A chemical pregnancy can be tough to process. Losing a pregnancy in the first few weeks of conception can leave you with a lot to process within a very short amount of time. However, Mya’s story highlights that you’re never alone, and if you want to, there’s a good chance that you’ll go on to get pregnant again. 

The cause of chemical pregnancy is frustratingly unknown. For some people, it can look like their normal period. So if you’ve experienced bleeding outside of your period or think you may have experienced a chemical pregnancy, then speak to your health care provider. There isn’t any specific treatment for the physical symptoms of a chemical pregnancy, but they will be able to provide you with support for the emotional impact that it can cause.