This is a difficult question to answer because I do not have the test results. If the first ultrasound saw a collapsing pregnancy then the hormone level should not be going up. Sometimes levels do not go up normally if the pregnancy is not inside the womb but is in the fallopian tube. It is still growing but it is not growing normally. Please do not undergo a D and C unless someone can explain to your satisfaction where the pregnancy is and why HCG levels are continuing to increase. The midwife cannot practice without the supervision of a physician. You can ask to see the supervising physician or go somewhere for a second opinion. I know this is a difficult and frightening time. It can make it hard to stick up for yourself when you are dealing with a rather intimidating medical professional. Nonetheless you must be your own advocate. You will never regret getting answers. I hope that you find someone kind understanding and knowledgeable to explain things to your satisfaction.