The early stages of pregnancy can be a really anxious time, especially if you have a history of miscarriage. But many of the things people worry about in early pregnancy are not conclusive signs that anything is wrong with the pregnancy.
In early pregnancy, doctors may test levels of the hormone hCG (human chorionic gonadotropin) over a period of days to try to determine whether the levels are rising as they should. In most normal pregnancies, the level of hCG should double every two to three days during the early part of the first trimester. But a single hCG level rarely tells you anything, and even two hCG levels may not be conclusive for miscarriage unless the second test showed that the level was dropping.
Knowing that hCG levels are supposed to double every two days in early pregnancy, it's tempting to try to track your hCG levels at home by taking multiple home pregnancy tests to see if the color of the test line is getting darker, or to worry if the test line is faint. But urine-based home pregnancy tests are not a reliable method for judging true hCG levels. The shade of the test line has more to do with how much water you drank and the type of test you're using than the actual hCG level in your blood.
It's natural to be concerned about spotting, and it's smart to call your doctor when you're having early pregnancy bleeding of any kind. Yet spotting does not always mean miscarriage, and a significant number of women who go on to carry their babies to term report having had spotting in early pregnancy.
As with spotting, cramping can happen in normal pregnancies as well as in pregnancies that will miscarry. If cramping is ever severe, however, it's wise to immediately contact doctor to rule out ectopic pregnancy (and go to the emergency room whenever in doubt over severe lower abdominal or back pain in early pregnancy).
It is quite normal for pregnancy symptoms to fluctuate from day to day in early pregnancy, and sometimes they may even disappear. It is not a sign of miscarriage.
If you have heard that morning sickness is a good sign for having a viable pregnancy, you might worry if you don't have any morning sickness. But not having any nausea does not mean that your pregnancy is doomed. About a third of women never have any nausea at all.
It is not uncommon that an early pregnancy ultrasound will raise concern but without a solid verdict that anything is wrong. The ultrasound might show no fetal heartbeat, no fetal pole, or simply measurements that don't match the original estimated due date. You might feel like you're being left in limbo when your doctor tells you that you'll just have to come back in a week for another scan.
It's scary to hear, but a threatened miscarriage is not the same thing as a definite miscarriage. The term refers to a pregnancy in which there is some level of bleeding, but the cervix is still closed and the ultrasound is not conclusive for miscarriage. Sometimes threatened miscarriage does go on to be an actual miscarriage, but a lot of the time, the bleeding stops and the pregnancy continues without further problems.