I'm still waiting for the nurse to call and officially confirm that my hCG levels are now normal, and I can happily move on with my pregnancy, but that has not stopped me from mostly freaking out about a little bit of spotting I've been getting.
First, the good news: according to everything I've read, there are a lot of reasons women bleed during the first trimester, most are benign, and although this will not stop any pregnant woman from worrying, chances are your worry is baseless. Around 20-30% of women bleed during early pregnancy. Bleeding can be caused by implantation, sex, hormonal changes that affect the uterus, or a benign cyst that bleeds as your total blood supply increases.
Now for the bad news: by definition, any bleeding that occurs before 20 weeks means a threatened abortion (a medical name for a possible miscarriage) though roughly 50% of women do go on to have healthy pregnancies. If you are bleeding (not just spotting, more on that later) during your first trimester and you do have a miscarriage, there is not much they can do at this point. However, bleeding can be a sign of an ectopic pregnancy (egg implants outside the uterus) or a molar pregnancy (egg does not develop into a baby), so definitely see your doctor if you are bleeding.
Should you be going to the emergency room? Well (and I am not a doctor, so please take everything said here with a grain of salt) this is where the bleeding vs. spotting comes in. If you are spotting (think pinkish or brownish discharge, not enough to soak a pad), stay home, try to relax, and let your doctor know that you have spotting. If you are bleeding (bright red, soaks a pad in two hours or less, possibly passing blood clots), get yourself to an emergency room. That kind of bleeding could be dangerous to you, and not just your baby. The nurse at my hospital confirmed that "a pad soaked in two hours" is the amount of blood that my hospital thinks warrants an emergency room visit. Also, this information is only valid in the first trimester. Different rules apply in the second and third trimesters.
So what do you do now? Monitor the amount of bleeding you are getting (a panty liner is a good idea), as well as the color. Call your doctor if anything feels wrong or if you are also getting cramping. Trust yourself and your body. If something feels wrong, don't ever be afraid to call your doctor (or midwife). Unfortunately, the story will not end well, for some of us, we will miscarry because this baby to be was just not viable. And we will grieve because no matter how early we lost a baby, we'll still know we lost that baby. And that's OK too.