Q: I just found out I'm pregnant. According to my period tracking app, I'm about five weeks along. But I can't get a first prenatal appointment until I'm nine weeks in. I'm super stressed out. Why can't I see a doctor sooner? And is it really OK to wait that long?
First of all, congratulations!
And don't worry. It's normal to want to see a doctor right away when you see those two side-by-side lines on a positive pregnancy test. But it's also pretty typical to have trouble getting an appointment to confirm you're pregnant.
A physician friend of mine also recently went through this. Even with insider connections at her hospital, she couldn't see a doctor for another month. So she texted one of the OB/GYNs in her office and asked her to do an ultrasound between her scheduled appointments!
My friend was lucky she could access this workaround. But I've always wondered why early pregnancy care isn't available to those of us who don't have an OB/GYN on speed dial.
Many prenatal providers won't schedule patients until eight or nine weeks of pregnancy — at the earliest. Waiting a month to see a doctor isn't necessarily a bad thing, since most pregnancies will go on to be healthy.
But it can feel like a long time, since most high-sensitivity home pregnancy tests can confirm a pregnancy on the first day of your missed period, which is usually around four weeks along.
So if you're eager for an earlier appointment, here's what you should know.
Do you have a medical question you’d like an honest answer on? Write us at thrive@npr.org, and we’ll consider your question for the column.
A lot of people want earlier prenatal care
In one 2016 study, about 15% of participants said they couldn't get a first prenatal appointment as quickly as they wanted.
Dr. Kavita Vinekar, an OB/GYN whose work focuses on early pregnancy, thinks that number might be even higher.
Vinekar got interested in caring for patients in the earliest stages of pregnancy because it's such a vulnerable period.
She surveyed patients at Jefferson Health in Philadelphia and learned that people were doing whatever they could to confirm the pregnancy, even if prenatal practices were turning them away.
Close to 50% of patients had gotten an ultrasound somewhere else before their first prenatal appointment, while 25% had visited an emergency room.
Almost 15% of those who had gotten an ultrasound had been to what's known as a crisis pregnancy center, which offers anti-abortion counseling without licensed medical care.
Why it's hard to get these appointments
Seeing patients in the first weeks of pregnancy, Vinekar says, is a radical departure from what many doctors learn during training.
In the earliest stages, it's hard to give patients definitive answers about the health of the pregnancy. That's because it can be difficult to visualize an early pregnancy on an ultrasound.
"We have been told: 'Do not see people in early pregnancy,'" Vinekar said. '"You're just going to open up a whole can of worms. You're going to be creating stress when they don't need to be stressed.'"
But some patients are stressed when they can't see a doctor, especially if they're worried they might be having a miscarriage.
Unfortunately, Vinekar says that miscarriage risk is actually a major reason why prenatal practices won't schedule patients early on. They aren't set up to take care of the estimated 15% of pregnancies that will end in the first trimester, so they try to delay taking on patients until eight or nine weeks, when miscarriage is less likely.
Early pregnancy loss can be tricky to diagnose and may require multiple urgent follow-up appointments. Also, practices may not want to leave those appointment slots open, because if nobody schedules, they could lose money.
Here's what you can do while you wait
If you're waiting on a first prenatal appointment but want medical advice sooner, your best option may be trying to see your primary care provider. If you have an OB/GYN, you could make an appointment with them, too.
In my primary care practice, I often talk to patients who have just found out that they're pregnant. They have questions about everything from miscarriage risk to whether or not they can eat sushi.
Many of my pregnant patients start feeling nauseous weeks before their first prenatal appointment is scheduled. They're frustrated they can't see an OB/GYN to get some relief.
So instead, they call me — and I'm happy to help out.
If you're experiencing nausea, heartburn, or breast tenderness but don't yet have an OB/GYN appointment, don't hesitate to call your family doctor or visit an urgent care. Even if we aren't experts in pregnancy, we can usually offer treatment for these common — and unpleasant — symptoms.
What to do if you are worried about miscarriage
As a family doctor, I sometimes get calls from pregnant patients who are bleeding and cramping and are worried they're having a miscarriage.
First, don't panic. Light spotting in pregnancy can be normal.
I usually do my best to get my patient in for an urgent ultrasound in a radiology practice with experience diagnosing early pregnancy and miscarriage. Unfortunately, that can also sometimes take several weeks.
If you already have an OB/GYN, you can also make an urgent appointment with that doctor. If you don't see anyone for routine reproductive health care, a Planned Parenthood or a community health center may also be able to get you in.
Since only an estimated 4% of miscarriages require ER-level care, I try to reassure my patients that what they're experiencing usually isn't life-threatening. Unless they're having severe bleeding, it can be safe to wait it out.
And, of course, I always tell my patients that if they've had a miscarriage, it isn't their fault. Most miscarriages are due to abnormalities in the developing fetus. It's almost never due to something they've done wrong.
Still, most patients want to confirm if they're having a miscarriage right away. In that case, the ER is always an option. Doctors there can usually do an ultrasound and help get pain under control. But because miscarriage is a high-stakes diagnosis and not all doctors are trained in early pregnancy ultrasound, the ER may not be able to answer all your questions.
Future solutions for early care
I hate having to tell my patients all this, but our health care system doesn't do a great job of caring for patients who are having miscarriages — or have anxiety about early pregnancy.
Take the story of Asha Spacek-Hobbs, who had a pregnancy loss before her youngest was born. The Philadelphia mom couldn't get an urgent appointment with an OB/GYN. She said it was "like trying to book a flight to Antarctica."
But the ER experience, she says, wasn't definitive either.
"I left the hospital, believe it or not, not totally knowing if I actually had a miscarriage," Spacek-Hobbs said. "No one would actually say it."
Vinekar has seen this all too many times.
"We've historically shied away and abandoned them," she said. "Maybe that's actually the time they need us the most."
That's why Vinekar and her team have started a clinic they call the Jefferson Early Pregnancy Program, which is almost like an urgent care for people who have just found out they're pregnant. When patients call in, they're offered appointments within a few days.
Vinekar hopes these early pregnancy appointments can help patients get evidence-based miscarriage care right away — without waiting for hours in an emergency room. And she hopes her model will spread so it's easier for people around the country to get early pregnancy care.
Copyright 2025 NPR