Resources

These materials are free to use. They include materials we have developed as part of our training work as well as external resources, and are open to anyone caring for patients with early pregnancy loss, whether or not you've worked with us.

TEAMM material
External link

Clinical guidance

ACOG Practice Bulletin — Early Pregnancy LossAmerican College of Obstetricians and Gynecologists SOGC Guideline — Early Pregnancy LossSociety of Obstetricians and Gynaecologists of Canada ACEP Policy Statement on Miscarriage Management, 2024American College of Emergency Physicians UpToDate — early pregnancy loss modulesSubscription required Managing Complications of MUA for EPL in the ClinicBleeding, cervical laceration, perforation, vagal reaction, infection Steps for Performing MVA Using the Ipas MVA Plus and EasyGrip CannulaeIpas · illustrated ten-step procedural reference

Protocols and setting up a service

Office Manual Uterine Aspiration for EPL — Sample ProtocolIndications, contraindications, equipment list, procedure steps, documentation Clinical Protocol for ED Management of EPL - also applicable outside the EDAccess Bridge Nursing Sample Protocol for MUA Management in the Outpatient SettingRoom setup, patient support, tissue handling, recovery Medication Management for EPL — Sample ProtocolReproductive Health Access Project Prescribing Mifeprex — Danco (branded)Prescriber requirements, including the Prescriber Agreement Form Prescribing Mifepristone — GenBioPro (generic)Prescriber requirements, including the Prescriber Agreement Form Coding for Miscarriage ManagementICD-10, HCPCS, procedure codes, and modifiers

Counseling and communication

Frequently Asked Questions by EPL PatientsSuggested guidance on answers to what patients commonly ask Counseling Practice Points for EPLSuggested phrasing, open-ended questions, neutral phrasing Shared Decision-Making Tool: Patient Treatment PrioritiesA checklist patients complete to help surface what matters most to them Emotional Support Resources for EPLBereavement support, comfort kits, and a vetted list of patient support organizations

For patients

What to Expect: Aspiration Management of MiscarriagePatient education handout What to Expect: Medication Management of Early Pregnancy LossPatient education handout Early Pregnancy Loss Treatment Options Fact SheetReproductive Health Access Project

Literature

Darney BG, Weaver MR, VanDerhei D, Stevens NG, Prager SW. "One of those areas that people avoid": a qualitative study of implementation in miscarriage management. BMC Health Serv Res. 2013;13:123. PubMed →

Darney BG, VanDerhei D, Weaver MR, Stevens NG, Prager SW. "We have to what?": lessons learned about engaging support staff in an interprofessional intervention to implement MVA for management of spontaneous abortion. Contraception. 2013;88(2):221-5. PubMed →

Darney BG, Weaver MR, Stevens N, Kimball J, Prager SW. The family medicine residency training initiative in miscarriage management: impact on practice in Washington State. Fam Med. 2013;45(2):102-8. PubMed →

McCoy EE, Weidner AKH, Benson LS, Darney BG, Prager SW. Practice change following an interdepartmental training on early pregnancy loss management in the emergency department. Cogent Public Health. 2022;9(1):2052402. Article →

Benson LS, Magnusson SL, Gray KE, Quinley K, Kessler L, Callegari LS. Early pregnancy loss in the emergency department, 2006–2016. J Am Coll Emerg Physicians Open. 2021;2(6):e12549. PubMed →

Baird S, Gagnon MD, deFiebre G, Briglia E, Crowder R, Prine L. Women's experiences with early pregnancy loss in the emergency room: a qualitative study. Sex Reprod Healthc. 2018;16:113-117. PubMed →

Quinley KE, Chong D, Prager S, Wills CP, Nagdev A, Kennedy S. Manual uterine aspiration: adding to the emergency physician stabilization toolkit. Ann Emerg Med. 2018;72(1):86-92. PubMed →

Dennis A, Fuentes L, Douglas-Durham E, Grossman D. Barriers to and facilitators of moving miscarriage management out of the operating room. Perspect Sex Reprod Health. 2015;47(3):141-9. PubMed →

Kinariwala M, Quinley KE, Datner EM, Schreiber CA. Manual vacuum aspiration in the emergency department for management of early pregnancy failure. Am J Emerg Med. 2013;31(1):244-7. PubMed →

Wittels KA, Pelletier AJ, Brown DFM, Camargo CA Jr. United States emergency department visits for vaginal bleeding during early pregnancy, 1993-2003. Am J Obstet Gynecol. 2008;198(5):523.e1-6. PubMed →

Talks and media coverage

Many ERs offer minimal care for miscarriage. One group wants that to changeNPR · TEAMM feature · January 2023 KUOW's Soundside: In a post-Roe world, miscarriage treatment becomes more difficultRadio segment featuring TEAMM co-founder Sarah Prager · January 2023 Emergency Medicine: Reviews and Perspectives: Miscarriage Care in the EDPodcast episode featuring Kelly Quinley · November 2024