I must admit that while I would rather be an expert on today's fashions, quality photography, or financial investing, it appears that I am the go-to person when it comes to miscarriage. Believe it or not, I don't mind getting the phone calls from friends who find themselves in that horrible state of limbo where they know they are pregnant, are having spotting or bleeding, and just don't know what to do. My heart breaks for them and, to be honest, it makes me sad for myself that I know as much as I do. But, since I have gotten these phone calls more than once and I don't have very many friends, I know that there must be thousands of women who are looking for advice on what to do. Since they (or you) don't have my phone number, I will write my best advice here.

• Do not consult with Dr. Google!

I know I am probably already too late on that one since that is probably how you found this article. But really, stop surfing the net looking for hope or truth. You won't find the answer as to what is happening to you. Many people have bleeding and do not go on to lose the pregnancy. Many have the exact same bleeding and do miscarry. Reading everyone else's story of their bleeding in pregnancy will not tell you anything. It will only get you hopeful one minute and leave you crushed at your next click. No one can tell you how your story will turn out.

• Try to remain calm.

With as much as we want to know immediately if everything is going to be okay, there is nothing in early pregnancy that can be done immediately to determine if you are going to miscarry or not. If you are fairly certain of your dates of conception/ovulation and you should be beyond 6 1/2 weeks pregnant then you may be able to have an ultrasound that can determine if there is a heart beat. But, even if you do or do not see a heartbeat doesn't mean 100% that you are okay or not. So... most likely it is going to be a hurry up and wait process. Especially if you are between a missed period and 6 1/2 weeks. Click here to calculate how far along you are in your pregnancy.

• Call your OB (or GP if you do not already have an OB)

Depending on the practice and their standard procedure they will likely tell you one of two things. They might have you come in for a blood test. If they only order a Qualitatative test it will only give you a "yes or no" answer. This will not be helpful. Ensure that they order a Quantitative test. If they do this, they will be checking to see where your beta HCG is. This one number will not tell you anything significant at this point. They will likely have you come in for a second blood draw 48-72 hours later. It will be the the second blood draw that will be more helpful in determining viability of the pregnancy. There are several beta calculators that can be found online but my personal favorite it this one. Beta HCG Calculator.

If your doctor's office tells you there is nothing they can do (which ultimately is true) and to go to the ER or do nothing then my advice is this. Call them back. Be your own advocate. Of course, if you are miscarrying there is nothing really to do to "save" a pregnancy but they work for you. They can be more proactive if you push for it. Ask them for a beta series (as described above) to see if your numbers are rising or falling.

Again, in either scenario you have to sit tight and wait for the results of the blood tests. Some offices can get them back for you in the same day. Some won't receive them until the following day.

• Choosing whether or not to go to the ER is a tough call.

You may think that the ER is going to be the fast route to getting answers. This is not always the case. In the ER they will do the same blood test that can be done at a clinic or doctor's office. Which, as I explained, doesn't tell you anything until you have the results of the second draw 48-72 hours later. They may offer you an ultrasound but at least in my experience they clearly stated before even starting the ultrasound that they would not be showing me the screen. It was an uncomfortable silence for close to 20 minutes. Plus, like I said earlier, an ultrasound may or may not tell you anything. So, if you chose to go to the ER in hopes of being reassured just know that you may leave with very little additional info and a big bill for an ER visit. There is a chance that you will learn that everything is on track and baby is measuring well.

• While you are waiting do NOT consult Dr. Google!

I know I already said this but I really can't emphasize this enough. Stress is not good for you regardless of if you are pregnant or not. You will never walk away from the computer feeling great about what you have read. Checking your symptoms is not good either. For some people having a backache is early pregnancy is totally normal. For some it is a sign of miscarriage. The same can be said about just about every pregnancy symptom. Bottom line, as if I have not made it clear, Dr. Google is not a friend to you right now.

• Do not use tampons even if your bleeding is heavy like a period.
  

Tampons can introduce bacteria into your open cervix and result in an infection. Always use pads when bleeding during a pregnancy. This will also enable you to better describe the rate of bleeding should you be asked. The general rule for bleeding is that you should go to the ER if you are filling more than a pad per hour.

• Prayer is a wonderful thing!

Pray for God's will. Pray for patience, understanding, peace. He will hear you and answer your prayers.