Guest Author - Krissi Danielsson

When I was watching the miscarriage headlines in Google this week, I stumbled across a disturbing story of a woman suing a hospital because she had to wait six hours for treatment when she went in for vaginal bleeding.

I wanted to post some thoughts on this story. Again, I am not a medical doctor so do not interpret anything on this site as being actual medical advice.

I have lurked on many a pregnancy discussion forum online and read many pregnancy books, and it's fairly frequent that pregnant women will go to the ER if they have vaginal bleeding. This is not always a good idea. It's scary to have vaginal bleeding when you're pregnant. It's heartwrenching to be worried you're about to miscarry, especially if you've miscarried before, but there is absolutely nothing the ER doctor can do to stop a miscarriage.

In the case of the woman from the article above, who was only five to six weeks pregnant, it's most likely that she had already lost her baby by the time the bleeding started, and even if she hadn't, the only thing the doctors could have done was to put her in a bed and wait to see what happened. They were most certainly guilty of incredible insensitivity and cloddishness, but the loss of the baby was most likely not the doctors' fault.

It's not right. It's not fair. And it's devastating. There should be something that can be done to save a baby when you're about to miscarry. But in the first trimester, when the majority of miscarriages take place, nothing can be done.

Which leads to the question. Why do so many doctors tell women to go to the emergency room if they have vaginal bleeding in the first trimester?

Obviously sometimes bleeding is a true emergency. In rare cases women can suffer a hemorrhage during a miscarriage and need immediate treatment. The usual advice is that if you're soaking a menstrual pad in under an hour, it's a good idea to be seen. In some cases it might be an ectopic pregnancy, which could also be life threatening and would usually be accompanied by severe pain on one or both sides of your lower abdomen.

But if you're not bleeding heavily or in terrible physical pain, you're probably best off waiting for an appointment with your OB/GYN than going to the ER.

ER doctors are often rushed. They're also seeing a wide variety of patients rather than focusing on pregnant women. In most cases ER doctors will not be as familiar with the symptoms of miscarriage and the proper diagnosis of miscarriage as an OB/GYN would be. Thus, the odds are in favor of a bad experience with the ER. You may be able to get confirmation of a miscarriage or an emergency ultrasound, but you will probably have to wait for a long time, which can add to your stress. To top it off, single ultrasounds can sometimes be inaccurate in the first few weeks of a pregnancy. In order to properly diagnose a miscarriage in the first trimester, the baby would need to be visible and far enough developed to be 100% sure that the heartbeat should be visible. Or the woman would have to have two consecutive ultrasounds a few days apart in order to check for proper growth. Or the hCG level would need to be checked twice in a row for the appropriate rising.

While ER doctors are good for emergencies, for a woman with vaginal bleeding whose physical health is not in danger, the OB/GYN is better trained to check for definitive miscarriage signs than the ER doctor. Some OB/GYNs are also clods, but the odds of intensifying the already traumatic experience of vaginal bleeding in pregnancy is probably higher in the ER.

Anyway...I just wanted to comment on that. These are just some thoughts. If you want to share your experiences with the ER, please visit the forum. I am interested to hear your thoughts.