Because of its political and clinical connections to elective abortion care, outpatient uterine evacuation management of early miscarriage has not been taught to the majority of physicians. Decades of research on uterine evacuation, generated through experience with elective abortion, has been excluded from clinical instruction on miscarriage management because of stigma associated with elective abortion. Given that approximately 12 to 24 percent of pregnancies end in miscarriage before the first 20 weeks of gestation, this omission affects many women's ability to receive timely and appropriate care from their primary care providers. This gap in the healthcare delivery system also affects abortion care: it limits the system's ability to respond to both self-induced and incomplete abortion.

But what if the research on and experience in early abortion care could be used to improve miscarriage management? What if clinicians were trained to manage early pregnancy loss in an outpatient setting?

Training clinicians in modern methods of miscarriage management will result in more accessible, patient-centered care for women experiencing early pregnancy loss and a stronger system of back-up for early elective abortion. AAP is working with clinicians in a variety of settings to help them competently and compassionately manage early pregnancy loss in an outpatient setting, enhancing the reproductive healthcare for all women. We train staff at all levels to integrate the evidence-based standard of care.