Finding care for bleeding or miscarriage in early pregnancy

This page has information about miscarriage and pregnancy loss. If you find this distressing, support is available. You can speak with your healthcare provider or find a support service that is right for you.

If you are having, or think you may be having a miscarriage, it can be hard to know where to go for care. This page explains your options, including where you can get help, what may happen when you first seek care and how to receive follow-up care.

Depending on your needs and where you live, you can receive care through:

• a doctor
• an early pregnancy assessment service (EPAS) 
• a hospital emergency department
• a maternity service
• an obstetrician or gynaecologist
• a community health service

Not all these services are available in every area. You may need a referral from a doctor to use some of the early pregnancy services, such as an EPAS. 

You deserve care and support at any stage, whether you think you may be having a miscarriage, are having one or have had a pregnancy loss. If you are worried, you can seek care and support at any time.

You do not need to decide on your own how urgently you need care. Contact your healthcare professional (doctor, midwife, obstetrician), early pregnancy assessment service or other support service for advice.  

An early pregnancy assessment service (EPAS) is a specialised clinic where you can receive care if you have bleeding or pain in early pregnancy. You can find an EPAS in most local hospitals and major cities in Australia.

You will usually need a referral from a doctor or an emergency department to go to an EPAS. How you book an EPAS appointment depends on the service. You may:

• receive a call to arrange an appointment once they have your referral 
• call to book an appointment when you have a referral
• visit without an appointment if the service offers walk-in care

How long your visit takes can vary, so allow plenty of time. 

You may need an ultrasound (Opens in new tab) or blood tests (Opens in new tab) to help work out what is happening. You may have these at the hospital or at another health service. Your healthcare professional will let you know if you need to come back for follow-up care. 

EPAS are usually covered by Medicare. If you don’t have Medicare, ask the EPAS if there are any costs.

If you live in a rural or regional area, an EPAS may not be near you — ask your doctor, midwife, community health service or Aboriginal Community Controlled Health Organisation (ACCHO) where to get care.

Call triple zero (000) or go to your nearest hospital emergency department immediately if you:

• have heavy vaginal bleeding, which is soaking 1 or more sanitary pads in an hour, or if you can’t catch or contain the bleeding
• have severe or worsening abdominal pain
• have shoulder-tip pain
• have smelly vaginal discharge
• have a fever (temperature of 38°C or more)
• feel faint, dizzy or very unwell

These may be signs you need urgent treatment for significant blood loss or an ectopic pregnancy. An ectopic pregnancy is when a fertilised egg grows outside your uterus, usually in a fallopian tube.

Bleeding or pain in early pregnancy can be frightening.  Even if your symptoms are mild, contact your GP, midwife, obstetrician or care provider promptly for advice about when and where to be assessed.

If you have mild symptoms and no urgent care signs, contact your healthcare provider promptly for advice. Mild symptoms are: 

• spotting or light vaginal bleeding that is not soaking pads
• mild abdominal pain 

Bleeding in early pregnancy does not always mean you are having a miscarriage. However, it is important to receive medical advice to find out what is happening.

You may choose to see your doctor, midwife, obstetrician or go to an EPAS, rather than an emergency department. They can assess your symptoms and arrange blood tests, an ultrasound or referral if needed. 

If your symptoms change or worsen before your appointment, seek urgent medical care.

What to consider

If you feel comfortable doing so, tell the receptionist that you are pregnant and have bleeding or pain when you book your appointment. This may help you get an earlier appointment.

If you already have a referral to an EPAS, you may also be able to contact them directly. 

You may prefer to go to an emergency department for care, especially if the timing is after hours or if you can’t see your usual doctor, midwife, obstetrician or go to your community health service. You have the right to decide where you receive care. 

Read about having conversations with healthcare professionals after miscarriage. 

A healthcare professional (doctor, midwife or obstetrician) will ask about your pregnancy, what’s happening with your body and medical history. 

Depending on your circumstances, the healthcare professional may offer an examination, blood tests, an ultrasound or refer you to another service. They should explain why they recommend each test and what it involves so you can decide whether to have it or not.

You may not receive a definite answer about what is happening with your pregnancy at your first appointment, especially in very early pregnancy. You may need to have more blood tests or another ultrasound before the healthcare professional can confirm what is happening and discuss your care options.

What tests might I be offered?

You may be offered a vaginal ultrasound and blood tests to help understand what is happening with your pregnancy. The results may not give a clear answer very early in pregnancy, and you may need to have more tests.

Before each test, your healthcare professional should explain:

• why they recommend it
• what it involves
• its benefits and risks
• if there are any alternatives
• what the results may mean

You can ask questions and decide whether to have the tests or not, including discussing what it could mean for your care if you decide not to have them. 

You may have an ultrasound over your abdomen (tummy) or through your vagina. An ultrasound through your vagina is called a vaginal or transvaginal ultrasound. It can provide clearer images in early pregnancy than one over your tummy. Having an ultrasound does not increase your chance of miscarriage. 

If you are offered an ultrasound through your vagina, you can ask for a chaperone or support person to be with you, choose not to have the ultrasound or ask for it to stop at any time. You can also talk to your healthcare professional about concerns or support you need. Your comfort, dignity and privacy should always be respected. 

You have the right to decide whether to have any tests and investigations you are offered. 

A healthcare professional (midwife, nurse or obstetrician) will assess what’s happening to your body and whether you need immediate treatment. An ultrasound may not be available straight away.  Most emergency departments do not have ultrasounds, so you may need to go to another part of the hospital or service to have one. Depending on your needs, you may also need to see your doctor or an early pregnancy assessment service (EPAS) for further tests or follow-up care.

Emergency departments can be busy, shared clinical environments, and you may need to wait to see a healthcare professional. Tell the staff if what’s happening with your body changes while you are waiting. They also may not provide the privacy or emotional support you need at the time.

Before leaving any appointment or the hospital, ask what happens next and who to contact if you have concerns. It may help to have them write this down for you. 

Where you seek care is your decision. This may depend on what’s happening with your body, how worried you are, which services are available and how soon you can see a healthcare professional. If you are unsure at any time, contact your healthcare professional or support service for advice.

You may be referred to an EPAS, hospital, obstetrician or gynaecologist if you need tests, treatment or specialist care that your current service doesn’t have.

You may also be offered specialist care if you have had 2 or more miscarriages before 20 weeks of pregnancy. A specialist may discuss what tests you should have to look for possible reasons for the miscarriages and help plan your future care. Sometimes, no clear reason is found.

You may also need urgent specialist care if there is concern about another condition, such as an ectopic pregnancy.

Ask your healthcare professional why they recommend that you see a specialist, what the specialist may be able to offer and if you need to organise the appointment yourself. You can also ask about waiting times and costs.
You have the right to ask questions and be involved in the decisions about your care.

If services are not available near you, ask your healthcare professional about telehealth or receiving care through your nearest health service.

You can find more information about rural health services in Australia, including how to find healthcare and support if you live outside a major city.

Can I use telehealth?

Some of your follow-up appointments may be available to you by phone or video. You need to have tests, such as an ultrasound or blood test, and emergency treatment in person.

How can I make a care plan if I live in a rural or remote area?

In some rural and remote areas, you can receive healthcare from the Royal Flying Doctor Service (Opens in new tab) (RFDS) through their local clinics, and phone and video consultations. Ask your local healthcare provider whether these services are available to you.

If you need to travel for specialist care, patient assisted travel schemes (PATS) may help you with some travel and accommodation costs. Eligibility and available support vary between states and territories, so ask your healthcare provider about the scheme where you live.

Ask your healthcare provider where you should go if your symptoms change and where you can access tests, treatment and follow-up.

The healthcare professional or service caring for you should explain what follow-up care you need and who will arrange it. This may include receiving test results, having more blood tests or an ultrasound, checking your physical recovery or discussing emotional support.

Before leaving an appointment with a healthcare professional or the hospital, you may want to ask:

• what happens next and who will contact you
• when and how you will receive your results
• if you need another appointment, test or referral
• who to contact if you have questions or your symptoms change

Tell your healthcare professional about any cultural, communication, accessibility or other support you need that may affect your follow-up care. If you leave without a clear plan or no one contacts you when expected, contact the service directly or your healthcare professional.

What if I am not happy with my care?

You have the right to raise concerns or make a complaint about your healthcare without it affecting how you are treated. You can speak with your healthcare professional or ask to contact the service’s complaints manager or consumer representative. Read about making a healthcare complaint, including what to do if you still have concerns.

If you need emotional support after a miscarriage, our miscarriage support page has information about services and other ways to get help.