Early Miscarriage: When to Contact Your Care Provider

I am only one week late but I have had all the symptoms of pregnancy. I started some mild cramping this afternoon and by early evening I was having some light bleeding/spotting. As the night has progressed, the cramps have become worse and the bleeding much heavier. I also have some lower back pain. Should I contact my doctor?

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Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

I often think it is the "unknowing" part that is harder to deal with in the initial stages of loss. About one-third of all pregnancies are lost without any documentation of the pregnancy. In many cases, the woman suspects because, as you indicate, she knows what is normal for her and what is not. If you're still not sure you miscarried you can call your care provider and schedule an ultrasound.

Considering your symptoms, it seems reasonable to think that you experienced an early pregnancy loss. Most of the time, in an uncomplicated miscarriage, the bleeding is like a heavy period for a few days and the embryo passes with no further attention needed.

It's important to contact your care provider immediately if:
-- your bleeding gets heavy
-- if you have intense abdominal pain or cramping
-- if you have signs of blood loss, such as weakness, dizziness or light-headedness
-- if you have a fever
-- if you have discharge with an odor
-- if the bleeding lasts longer than a week.

If you pass any whitish or bluish tissue, save it and bring it to your care provider.

In circumstances such as this, it can be important to rule out an ectopic pregnancy. However, cramping is usually more indicative of an intrauterine pregnancy. If you experience any right or left lower quadrant pain or even diffuse abdominal pain, shoulder pain, fever or dizziness, get medical attention right away.

If you are Rh negative, you may request that you receive RhoGAM to prevent Rh isoimmunization that would affect a subsequent pregnancy.

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