A little bit of bleeding without cramping
should be okay, but call a doctor. Small darting cramps, even if they hurt, are also okay,
usually they just signal the body stretching and pulling to accommodate the
growing baby. Lie down and the cramps will usually go away within the hour.
These symptoms can be other things rather than a loss of pregnancy,
however, if you are not sure you are pregnant. Check the "I'm
not sure I was pregnant" section.
What should you do?
If it is during doctor's regular working hours, call your regular
doctor first. They will give you instructions.
If it a night or weekend, first call your regular doctor's after-hours
number. Usually this will be on their answering machine or with their answering
service. The nurse or doctor on call who calls you back will help you decide if
you need immediate attention or not. Don't feel like you are bothering them
needlessly; this is a natural and expected part of any OB practice.
If you can't get through, don't have a doctor, and you are afraid, then go to
an emergency room. Be prepared for some possibly insensitive treatment. While
some hospitals are well equipped for handling this situation and do a good job,
often you are left alone in a room for hours, or told to sit on a toilet and
catch tissue, or just sent back home because "there is nothing they can
do." It may be worth the trip, though, if they draw blood for an hCG test
or give you a sonogram.
When I began bleeding heavily on an airplane on a Friday afternoon, I still
waited until Monday to see my doctor. I did not want some total stranger telling
me the baby had died, or to have a sonogram in an emergency room and be told to
"call my doctor for the results." While I was sad about the possible
loss of the pregnancy (turns out I lost one of a set of twins), I was
resolved to wait for a comforting, familiar doctor's office.
There is not really a risk to waiting until Monday or the next morning if you
are in your first trimester. There is no magic way to stop an early miscarriage
at the hospital. What is going to happen will happen. If you are farther along
than 12 weeks, though, and you are merely in labor and not bleeding, then you
should take quick action to see if labor can be stopped.
If you are passing tissue at home, and it is your first miscarriage,
it is not necessary to catch the tissue and take it in. You may do this if you
choose, however, and you can store it in a sealed plastic bag in the
refrigerator until you get to a doctor. However, it is rare that tissue caught
this way will be usable. Tissue from first miscarriages is rarely tested, since
it is assumed your miscarriage was due to a genetic defect. The best way to
ensure testable tissue is to have a D&C.