Can seeking immediate, urgent care for bleeding during pregnancy stop a miscarriage from happening? And if not, why do people say to go to the ER if you have bleeding in early pregnancy?
Some, but not all, doctors advise women to the emergency room if they notice any bleeding in early pregnancy. The reason for this is unfortunately not because immediate care can make a difference in whether the pregnancy miscarries but rather to rule out emergency complications that could threaten the mother. Bleeding doesn't always lead to miscarriage (it can occur for other reasons), but when it is a sign of miscarriage, doctors usually can't stop the process no matter how quickly you seek treatment.
Why bother with an emergency room, then, if nothing can be done? You should certainly be treated ASAP if you are bleeding heavily or if you are concerned about ectopic pregnancy, as those situations can be life-threatening. But if the bleeding isn't really heavy or painful, you may not need to go to the ER. If you have an established relationship with an OB/GYN or primary care provider, try calling that doctor about the bleeding first. Your doctor can see you for hCG blood tests or ultrasound to determine whether you are miscarrying. Your doctor can't stop you from miscarrying if that is what is happening, but your doctor can help you get an answer to what is going on without you necessarily having to wait for hours in an emergency room. Remember that confirming or ruling out a miscarriage diagnosis may take more than one visit in early pregnancy, so you may not get an answer the same day in the ER anyway.
Sometimes, however, it is a good idea to go to the ER. Always go to an emergency room if you have signs of ectopic pregnancy or otherwise suspect you might have an ectopic pregnancy; when in doubt, err on the side of caution and go. Similarly, if you are soaking through menstrual pads in under an hour, you might be hemorrhaging and may need immediate care. Finally, if your doctor has advised you to go to the ER, you should always go.
Bleeding and Spotting from the Vagina. March of Dimes. Accessed: 2 May 2010 http://www.marchofdimes.com/pnhec/188_25620.asp