Appropriate doctor follow up for early miscarriage - would appreciate your experiences — The Bump
Miscarriage/Pregnancy Loss

Appropriate doctor follow up for early miscarriage - would appreciate your experiences

I miscarried between 5 and 6 weeks the middle of October.  We had a few positive HcG tests going up, positive home tests, and then I started spotting.  After two more blood tests it was confirmed my HcG was down.  

My HcG went from 78 to 352 to confirm the pregnancy, but then that number dropped to 170 and then 18.6.  The nurse practitioner at my doctor called me when it dropped the first time to confirm this was a miscarriage.  She was very kind and asked that I have another blood test.  Up to this point, calls were prompt from the office and very appropriate.

I did my last blood test on Saturday, Oct. 18.  I never heard back from the doctor.  During the first few days, I was having some cramping and pain on my right lower side.  It had been confirmed earlier through a vaginal ultrasound that I ovulated on the right, and there was a slight chance of etopic pregnancy.  A past conversation with the nurse practitioner told me that if the pain was incredibly bad I should go to the ER.  (To which I reply...thank you for the common sense.  If I can't breathe, yes, I will go to the ER.)  I was a bit worried, and just wanted to know that my numbers were going down.  Monday, word from the doctor.  I got in touch with the blood lab myself and found out my number was 18.  Since it dropped so much and the pains have gone, I believe I am ok.  I took a home pregnancy test and it was definitely negative.  

I have read many of you discussing your follow up appointments after MC.  I miscarried naturally and early, but my doctor never called to tell me the last blood result (18).  They never asked me to come in for a follow up appointment or get any other blood test.  They never referred me to a social worker or counselor, which I sought out on my own.  I have had positive experiences with the doctors and nurse practitioner from this practice, but the office staff obviously isn't doing their jobs.  Has anyone had an early loss and didn't have a follow up?  Did the doctor see my numbers and feel it was ok, so just dropped it?  The whole thing is just odd to me, and I would appreciate some unbiased insight.  Maybe this is so common and standard to them that it just isn't a big deal, although it was truly a life altering experience for me.

Re: Appropriate doctor follow up for early miscarriage - would appreciate your experiences

  • So sorry you are going through this. You obviously heard my experience on my post. Very similar, but obviously still waiting to see what happens. She told me to come back for another hcg in 2-3 weeks to see if it is at 0. I've had to push to get blood tests done >:|  In fact, if I hadn't made sure I got the blood test done last week, I would probably still think everything was just fine as I never really bled much and first appointment wasn't supposed to be for 3 more weeks. Doctors can be so frustrating. I hope everything turns out fine for both of us. <3
  • I think what you experienced is pretty typical.  It wasn't until my third loss (and even then, I had to push) that I had any sort of follow up.  We did follow my betas down to zero with my first loss, but I always had to call to get my results.  After this m/c, my doctor gave me no plan except to come back in 4 weeks for a follow up at which fertility plans or birth control would be discussed.
    4 early losses 2009, 2010, 2015.  Baby #1 born 2/13/11.  
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  • I had my follow up 10 days after my d&c. He didn't do a pelvic or anything, just asked about my bleeding and how I was feeling. I was already done bleeding and felt ok physically. My hcg was down to 19 and they were supposed to call me in 2 weeks when I needed a repeat. Well they never did. So 3 weeks later I called them said I wanted a repeat, and then I had to call and get my results. I was down to 0 and according to my dr I should be getting AF within 4-6 weeks after d&c. It's now a little over 6 weeks later and I called to speak to the nurse. She had my dr look over my chart and now he ordered an ultrasound for next week to see what's going on. I'm just ready to get back to normal and ttc!
  • IMHO a doctor should monitor until hCG is 0 (<3). Any publication will say that, especially if ectopic is suspected. I was "the ectopic" at my OB and it was handled poorly; I didn't know I need to advocate for myself and it ended badly. So sorry for your pg loss. Make sure you are at 0. I am in beta hell again, but this time I have an RE so hope for a less traumatic outcome. My clinic has counseling brochures around but I don't think my RE (who I love) mentioned it. I sought it out.

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