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March 2025 Babies
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ER vs Urgent Care vs OB vs Waiting?

sonjanaesonjanae member
edited August 2024 in March 2025 Babies
Potential TW: bleeding, not sure where it’s headed. 

I apologize in advance for being long winded. It’s my notorious flaw. 

I’m at the point where I’m pretty sure my continued spotting is either a SCH or early MC and I don’t know what to do about it. Ectopic has crossed my mind as well, but I don’t have one sided pain and I know the chances are slim in the first place. 

I know the straightforward advice is get checked out, and I agree! My question is how? 😭 I’ll talk about the options and why I’m confused after I explain what’s been going on. 

I’m 9+1. I have cramped and spotted intermittently throughout the entire pregnancy, so initially I wasn’t worried at all. I cramped pretty much every day, sometimes badly, from 5dpo to 6 weeks. Became less frequent after that, up until about 8+3, when it ramped up again after a hike. Spotting (brown) started around 6w, which I attributed to the luteal placental shift since everything else tracked fine and I keep hearing that it’s common enough to not be too worried with it being so minimal. 

Last Tuesday, at I think 8+2, I went on a long, hard hike (7 miles, half of it was super steep), and I don’t know if it’s coincidence, but I’ve been cramping and bleeding significantly more following the hike. The spotting never reached my underwear before (would notice it only when wiping), but as of this week there have been several days I’ve had to wear a panty liner and there’s been intermittent streaking. Wearing a liner a day and not filling it at all, but there has been bright red blood when wiping this week, and there have been a few times I feel pretty damp down there, which wasn’t happening before. Also, 2 days ago I soaked through my underwear with brown blood in one “gush.” My cramps are no longer intermittent— I’ve had them for about 2.5 days straight now. They’re mild but I haven’t had nonstop cramping since like 4wks so I’m beginning to feel a little freaked out. That being said, it’s been almost a week since the hike without the ordeal “ramping up”’ further and I feel like if a miscarriage had started with the increased spotting and cramping 4-5 days ago, there’d have been some progression by now? I’m still having periodic stretches of time without bleeding, including this evening. 

I will say, what makes me suspect SCH is that I have absolutely noticed a correlation between the bleeding and exercise. It all started with a strenuous hike. I rested up and the bleeding did stop for like an entire day. I then ran a lot of errands at once and bam, bled again. Rested again and bleeding stopped but I continued to spot, though more of what my “normal” was before… took the dog for a walk, and then again, bleeding in one “gush”. Somehow that makes me feel better, even though it’s not ideal overall and there’s truly no way to know without just getting checked out. 

As for ectopic, I don’t have reason to believe that’s the issue other than I know endometriosis increases the chances of it happening, and I have suspected for a long time that I have endo based on severrreeeeeee periods and some of the worst PMDD my doctor said she’d seen. I’ve heard the consistent spotting can be a symptom of an ectopic as well, but I also keep hearing about many women who spotted a lot without issue. So this is more of a paranoid afterthought for me that I don’t really believe. But you pregnant ladies know how it is. There’s always that, “but! What if…?” 


Now, that’s the whole backstory, if it helps. I’m so sorry for all the TMI, but I don’t know what all is exactly necessary to mention that might slide the “to panic or not panic” scale one way or the other 😭

My question as a hopefully soon to be FTM is what the heck do I do? I don’t have an OB that can get me in sooner yet (did not have a preexisting relationship with an OB/GYN prior to this pregnancy and my first appointment is scheduled for 8/26 and everywhere else my husband called is booked up). 
It doesn’t look like ER is a good option because the cost seems too high to risk if everything is fine… and even if it’s not, they can’t/won’t do much unless it is an ectopic, right? We’re not getting a clear answer from the insurance on whether it would be an emergency visit (30% of total agreed cost) or be considered maternal care (pay up to $1500 out of pocket) to go to the ER. It sounds so deranged and superficial to be worried about money under these circumstances but we JUST shelled out a large amount to pay for nonnegotiable life stuff and it’s just like urrggg :/ I also worry that I’m just being dramatic and I’d hate to take up their time for something that doesn’t really require the ER. If I were to go the ER route, I should wait for intense bleeding and cramping, right? 
Urgent Care doesn’t have an ultrasound machine and I’ve honestly never heard of them handling maternity issues. 
Considered contacting my PCP to request staggering HcG tests to potentially catch a MC but with being 9w I don’t want to take the chance that the HcG levels are already starting to fluctuate and unnecessarily freak myself out with potentially misleading tests that wouldn’t even give an answer until close to my 8/26 appointment anyway. 

I saw in a few forums posts that some people got a referral for an ultrasound from their PCP, or that they went to urgent care and the UC referred them out? Are there any other alternatives? Have I missed an option? Might my appointment be moved up due to the bleeding & cramping even though the receptionist emphasized that they are packed full up for at least a month? I am hesitant to do that even if it’s an option because my husband has a major major work commitment this week, so he couldn’t attend with me and we’ve had our hearts set on him attending the first appointment (though if I gotta do what I gotta do then so be it). Or do I just suck it up and endure the excruciating wait until the 26th? Does anyone else have experience or insight or any wisdom at all to share? I’ve never done this and I have crippling social anxiety so all the calling around is already really stressing me out and I’m just plain worried. And now I’m worried I sound absolutely crazy and over the top to everyone lol. 

Thank you so much for any advice at all! 
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Re: ER vs Urgent Care vs OB vs Waiting?

  • fininevermorefininevermore member
    First option, call the OB and tell them your symptoms. They always have emergency appts, either for same day or next day, specifically for stuff like this. If they absolutely will not, tell your PCP your symptoms. They may refer you to ultrasound, another OBGYN office, bloodwork or to come in if it’s a family practice physician. The last thing I would do is ignore it. And the best thing urgent care will do is send you to the ER. I understand worrying about a bill you can’t afford; the joys of living in the USA. I can only offer 2 sides of the coin from what I’ve seen; I did everything right when I noticed bleeding last year and it turned out to be a miscarriage, but I wasn’t as far along as you. On the other hand, a friend of mine noticed bleeding and a bit of cramping, and she got it checked out and was fine, delivering a healthy baby boy 2 weeks ago. Keep us posted, from another person with moderate social anxiety.
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  • sonjanaesonjanae member
    @fininevermore Thank you so much for such an insightful and compassionate response! I'm so sorry to hear about your previous loss. Unfortunately my bleeding increased a little over the last two days, but it thankfully did earn me an earlier appointment for Thursday... still feels like such a wait, but I'll take what I can get. I'll be sure to update. 
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  • 23Shelby23Shelby member
    Unfortunately you don’t always experience pain with an ectopic. I’ve had a bit of experience with that sadly. Felt no pain with any of them including the one that was on the verge of rupture before surgery. I completely understand the dilemma of what to do. It’s always good to trust your instinct, going to the er would have been my first thought. It’s so sad that urgent access to healthcare isn’t available. I will say it’s important to find a practice that takes you seriously, the fact that they are still making you wait a bit doesn’t sound promising. I was with a practice like that and made the best decision ever to switch. 
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  • sonjanaesonjanae member
    Unfortunately the ultrasound today did not come with good news. There was an empty gestational sac, and the OB said it was either a blighted ovum or a miscarriage in which the baby and sac are exiting separately, which he said he has seen happen before. If it’s not a blighted ovum I can expect the bleeding and cramps to increase significantly and it will be undeniable, otherwise I’ll briefly have heavier bleeding when the sac is passed, but it should not be as bad as a ~9w miscarriage.

    As it was my first visit, he did suggest perhaps it’s simply a very early pregnancy, but given that I tested a strong positive on a hpt the first week of July and my hcg was 60 on July 12th, that does not sound likely and my gut is telling me it’s over for now for us. They drew blood today and will again Saturday to compare, but I already know what the outcome will be and have begun grieving.

    I have really appreciated this birth month group. Thank you, guys. 
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  • 23Shelby23Shelby member
    i am incredibly sorry for your loss! 
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  • dunder_mifflindunder_mifflin member
    @sonjanae I’m so absolutely sorry for your loss. Truly sending all my love during this time 
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  • fininevermorefininevermore member
    @sonjanae I am so sorry. You are in my prayers.
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  • sonjanaesonjanae member
    Thank you all. I appreciate it more than you know. 
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  • amusiafuschiaamusiafuschia member
    When in doubt, call OB. They’d rather have you call and have it be nothing than not call and have it be something. And they will tell you if you need to go to the ER or if it can wait for their next available. All doctor offices keep a couple of open slots for urgent cases each day too, so if it is urgent they will get you in sooner. They will also tell you what symptoms mean it’s an emergency, or if there’s anything else you can do at home. 
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