Wrongly Diagnosed Miscarriage?

QUESTION

Dear Midwife,
I tested positive on 2 hpts on October 13th. On October 16th I experienced heavy cramping and bleeding for about 2 hours. The ER doctor said that my HCG was 10 so I most likely miscarried. He didn't order an ultrasound and by the time I left the ER I was simply spotting. Since I had no health insurance or cash for a follow up doctors visit I was advised to come back if I had any further symptoms or if another hpt came positive 2 days later. I was advised that if hpt was negative and there were no complications that I didn't have to come back and wouldn't have to wait to TTC

3 days and 5 days after the ER visit I had negative hpts . During the rest of the month I still felt pregnant but thought it was just my imagination. My husband kept commenting about how my body was still changing and that I should test again but I told him that I would wait until I had a missed period.

Now a month later I tested positive again 1 day before my first expected period. My symptoms have been constant since early October and have progressed to the state of what books say is to be expected for 9-13 weeks so I don't know if this is a new pregnancy or if I never miscarried. I haven't had a normal period since August unless I count 2 days of spotting in September.

I fired my OB due to previous bad experience and wanted to wait until I get insurance on Jan. 1st to hire a midwife but I don't know if that's waiting too long to find out how far along I actually am.

Thanks in advance for any advice.

ANSWER

It's probably ok to wait until the first of the year, but of course we'd prefer that you be seen sooner, especially since there is a dating issue, and the best way to solve that is to do an u/s at about 7 weeks or so. The longer you wait, the less accurate they are, but they can almost always tell you which *month* you conceived in, even at 20 weeks!

My best guess from what you say (since you still had a negative test on 10/5) is that this is a new conception. But there is really no way to tell for sure without an u/s.

Congratulations!
-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.