No help from NHS services

[Akemi]

I had my period last week starting on Tuesday with 1.5 days of medium to heavy bleeding after 2 days of heavy spottting on Sunday and Monday. Bleeding stopped on Wednesday night and I've been light spotting brown since then.

I though last cycle was unsuccessful so on Saturday I took an LH test to start tracking ovulation again and it came back super positive which was weird for my "CD 5" so I took an hcg and came back positive. Not as dark as I thought it would be at "20 dpo" but clearly positive.

I knew straight away that this will not end well because I'm very sure of my dates given I'm tracking with LH and BBT but nobody will do anything! I called 111 and my GP and they both said that because I'm not in pain they can't refer me anywhere but to go to A&E if I develop pain ir heavy bleeding. But I know that by that point is usually too late in case of an ectopic.

The reason I'm so worried with an ectopic is because I know that bleeding before a positive hpt + erratic hcg is a classic pattern, and my tests have been varying in intensity since the first positive on Saturday but all of them are too light for "20-25 dpo"

I really don't know what to do anymore and I'm at the verge of a breakdown. Why is the system so horrible with pregnant women? I just want to know if this is a "safe" miscarriage or get the help I need if an ectopic.

Agree with this
stop with the tests in the meantime

Just to add incase it hasn't been mentioned already, you can still get implantation bleeding around 5 weeks, so there is still a chance that is the cause of the brown discharge.
If you are going to do repeated tests (lots of us have been there), try to stick to the same brand as they are not that reliable to start with, and all a bit more/less sensitive than each other.

Have you phoned your EPU directly and asked if they do a walk in? (Some do, some don't).

Some of these responses are really unnecessarily harsh! Have a little bit of sympathy people!!!

OP you are right to feel concerned given how many people are let down my the NHS in these types of situations. I don't have any experience or what the 'correct' protocol is but don't let these people make you feel bad for wanting to advocate for yourself!

Sending you support. Whatever you are going through sounds tough and I hope you get some answers soon x

Try a different NHS GP. You’re allowed to get a second opinion. Be very clear what you’re asking for and why (EPU referral to monitor HCG due to classic signs of ectopic pregnancy).

My EPU doesn't do walk ins or self referrals.

The good news (for me) is that my nhs GP finally saw me and my partner after I sent them an email with the details of my situation: bleeding with clots followed by light hpt. The email was a suggestion of my private insurance midwife.

I want to add here that both the midwife and GP from my private insurance advice service said I should be seen face to face given the bleeding before a positive test, and that I should push for the NHS GP appointment or go to A&E anyways. I didn't want to go to A&E because I'm not in pain and I don't feel comfortable taking space from real emergencies, but I did want someone to see and hear me.

My local NHS GP agreed that I should have been offered an appointment for triage as there was bleeding and that the tests are not strong enough for 5 weeks. He also agreed that now I am being monitored so if I develop new symptoms I can be booked in with the EPU straight away.

Anyways, thanks everyone for their suggestions! Including those who think this is a pavalova and not a real thing to worry about. This is/was my very first pregnancy and I don't have friends nearby and sadly never had a mum, so no one to reach out for advice other than the health care providers.

Early pregnancy is an anxiety riddled time and I'm sorry your GP made you feel dismissed and alone. Unfortunately like all services, demand outstrips supply and so there is a criteria for referrals they have to follow. You have bleeding at a time they expect there to be bleeding and they cannot go by urine hcg tests showing no progression as they are not qualititative and were not designed to measure hcg concentration, just to detect its presence. This is why women are advised not to repeatedly take tests as it just causes anxiety when most often everything is progressing normally.

If bleeding persists or you develop pain, you need to ask again about an EPU referral but unfortunately there is nothing that can be done but to wait. If it was an ectopic at this stage it wouldn't be visible. A private scan at 6 weeks gestation may provide you some answers and if they have concerns then they can refer to EPU for bloods/further monitoring and management.

Really hoping for a healthy pregnancy for you.

It may well be a successful pregnancy. The home testing you have done up to now cannot allow you to “know straight away that it will not end well”.

Early pregnancy is a time of waiting and feeling anxious and many, many trips to the loo (to check). Unless you have a history of miscarriage or ectopic it really isn’t a good use of NHS resources to try and work out what’s going to happen when a woman is in very, very early pregnancy.

I wish you all the best

nb only just read that you’ve been passing clots, I thought it was just spotting brown.

That’s obviously more worrying.

I'm glad you got an appointment OP but agree, you made absolutely NO mention of passing clots in any post you made! All you said was spotting, so replies might have been different with this new info!

I have no intentions to argue but while not specifically clots, I did say in my original post medium to heavy bleeding that looked like a period. Heavy bleeding is usually not compatible with life in early pregnancy.

I had my period last week starting on Tuesday with 1.5 days of medium to heavy bleeding after 2 days of heavy spottting

Apologies if I misunderstood but when I read period, I thought you meant your last period! I did ask in my first post if you've had bleeding since getting a positive preg test and you said 'brown spotting'. Wishing you all the best.

Many women continue to have “periods” throughout pregnancy. It’s not unusual.

a friend of mine didn’t realise she was pregnant until she felt the baby kicking at 5m- she’d had monthly bleeds as normal so no reason to think she was pregnant.

OP has had 'real' symptoms of heavy bleeding. Her faint positives only appeared after this.

I agree with this. I’ve been pregnant 3 times. First pregnancy no bleeding, all fine, healthy baby. Second pregnancy had an early scan due to pain, all fine at that point with a heartbeat, no bleeding until 12 weeks then I miscarried. Third pregnancy had bleeding on/off for several weeks, sometimes heavy, had early scans, healthy baby. It really is just a watch and wait. There’s very little that can be done at this stage and any referrals to EPU are based on strict protocol.

I get that there are successful cases with bleeding, trust me, I scoured the Internet with these words. But what is concerning in my case, and yesterday the gp said so as well, is that my tests lines are not consistent with how far along I am based on my last "true" menstrual cycle. What worries me is that the lines are not getting fainter which would be the pattern in a chemical or miscarriage, but they are also not getting consistently darker as you would expect in a normal progressing pregnancy.

I tried to look this at every possible angle. I really really want to have a baby of my own but now I'm not only having to come to terms that this is unlikely to be time, but also I'm scared of a more dangerous situation based on dozens of similar cases that ended in ectopic.

Just for your reference, these are my tests at "20 dpo, 22 dpo and 23 dpo". They seem to be getting darker but not enough for being in the 20ish days post ovulation.

And I am pretty sure of my ovulation as 1. I'm pretty text book regular. 2. I'm tracking with LH strips, clearblue advanced digital and BBT.

Rn I'm just waiting for next week when I would be 6 weeks to book a private ultrasound.

I got the vibe in some of these comments that in my situation is best to figure it out by myself than reaching out to nhs for help. My problems are not real enough it seems.

Just to clarify, the vast majority of people kn the thread who have said the GP won't do anything is because your tests ARE GETTING DARKER.

You have just now again uploaded tests with a very clear progression, and pretty dark lines tbh.

We are more concerned about how stressed out you are getting and trying to ease your mind that despite saying your HCG is erratic, there's no evidence of that in all the tests you uploaded.

We wish you all the best obviously.

My problems are not real enough it seems.

No one is denying you are worried and that any bleeding in early pregnancy is a concern. What most people are saying is that in the absence of very, very heavy blood lost and/or pain, there is very little the health services can do.
If you had experienced multiple miscarriages or had had a previous ectopic then very early monitoring would be advisable.
Early miscarriages are very, very common.

Testing, scans and what have you will not change the outcome.

Early pregnancy support services are crap on the NHS @Akemi and conflicting area to area - many areas will allow a self referral others only via a GP and that’s if you can get a bloody appointment these days. Private healthcare insurance very rarely covers pregnancy so are useless also.

Looks like your tests are getting darker which is positive - word of warning on those cheap test strips is that the darkness level can be misleading ….. I had twins and my tests never really got that dark. I’ll be told off for saying it but I’d use the clearblue digital with weeks indicators - I used them alongside blood testing so can say in my case that they are very accurate - you’d be wanting to see the 2-3 weeks come up at least maybe 3+ but then I didn’t get that until 20 DPO twins

you can have private scans earlier than 6 weeks - that would at least potentially rule out an ectopic as the sac should be visible at this point in your uterus - viability would just be inconclusive if you do do it earlier as you may not see a heartbeat

Hey thank you for the suggestions! I took two of these clearblue tests with weeks displaying, one the day I go the positive so "20 DPO" and one yesterday which would've been "23 DPO". Unfortunately both came with 1-2 weeks. Congratulations on your twins though! What a surprise I'd imagine haha

I think we are leaning more and more towards the private scan. They are quite expensive in my area, at £100+ so we will try to time it towards the end of this week/beginning of next to get a more definite answer.

I'm way more comfortable now that I know my GP has me on a watch list. He said that as soon as I develop more concerning signs he will refer me straight away to the EPU. Up until that point yesterday I was feeling lost because my only option seemed to be going to A&E which is obviously not appropriate yet.

Hey, I get that it looks is getting darker, but even the gp says yesterday that they are not dark enough for a 20-24 DPO or 5 weeks pregnancy. And I'm really really sure of my ovulation. Even if we wanted to stretch it and say, ok I had a weird cycle and ovulated later, my intercourse dates also don't add up. And I'm really really sure of that too as I was present during the act haha.

Anyway, thanks for the good wishes. I will update this post when I get my answers one way or another.

When I had my chemical I had very light tests before my period, almost couldn't see them light, then what seemed like a normal period. Then 1-2 weeks after that I was testing very strongly positive, so you can still test with high HCG even after a chemical depends on how your body works. My EPU doesn't do walk ins or Dr referrals, I rang the Drs and they told me I needed to go to A&E so I did. I'm not sure why you wouldn't if you're so worried and that's what they advised, that's the support available. They sent me to the EPU, who then did a scan and I got a "pregnancy of unknown location" diagnosis, and they monitored my HCG for 3 more weeks until it came down from 95 to under 10 so they can be sure the pregnancy had passed in case it was ectopic as they couldn't rule that out. They also said next time I'm pregnant I can ring them directly to arrange an early scan, as I'd had a PUL so they want to monitor closely. I know it was a chemical now, but it was good to get the reassurance of the monitoring and I was also scared about an ectopic so I get the concern.

The GP can't do anything, and the only way to EPU for the first time in my area is through A&E, which sounds the same for you. It's also perfectly possible you could have a sub chronic haematoma that then cleared up, and this could have caused the bleeding and you are still pregnant. Many cases of this.

This is really really helpful! Sounds that you were cared really well.

Would you mind sharing what did you tell them when you got to A&E?

I just told them the Dr had told me I needed to come to be referred to the EPU, and then the facts about the bleeding and the positive pregnancy tests. I also had some on and off pain still in my ovaries, but that's also not totally abnormal for me as I had that when I was pregnant with my daughter and I get ovulation pain. They got me to wee in a cup but didn't actually do a pregnancy test in the end, or ask to see my positive tests. They just triaged and rung up the EPU, who then gave me an appointment spot that day. Probably took a couple of hours in A&E in the middle of the day, and then the appointment was an hour after that. It does feel silly you can't go straight to the EPU, but that's their process.

This is honestly really helpful! Thank you so much for sharing. I will show your comments to my husband and see what we do next. :) also sorry, one last question. How many weeks were you when you went?

Between 5 and 6 weeks I think. My "period" was only 1 day late, but it was heavier and a bit more painful than normal. So I assumed that was a chemical and did a test a few days after it ended to check the positives I'd seen had gone and we were ready to try again. I'd just follow the Drs advice, if they've told you to go then go.