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Clinical Guides: ED Management of Early Pregnancy Loss and Contraception Care

These resources from PHI’s Access Bridge are designed for Emergency Department (ED) physicians who are engaged in the diagnosis and treatment of early pregnancy loss within the ED setting.

  • Access Bridge
Doctor with patient in an ER room

Across the country, millions of women live in contraception and reproductive healthcare deserts. Lower-income patients and patients of color are disproportionately impacted, especially in states where there are primary care and OB-GYN provider shortages.

Emergency departments are uniquely positioned to be a safety net for sexual and reproductive health services: EDs are open 24/7, available in most communities and staffed by clinicians trained to manage multiple specialties. Many sexual and reproductive health needs can be met quickly and easily in these settings. And, in light of the alarming restrictions on reproductive rights, healthcare providers have a moral imperative to make legal reproductive health services widely available.

Access Bridge, a project of PHI’s Bridge, works to improve access to sexual and reproductive health services by integrating them into EDs. Access Bridge has developed clinical resources for emergency department providers, including:

These protocols were developed by a team of specialists in emergency medicine, family medicine, obstetrics-gynecology, midwifery and nursing. They are being tested in multiple states and will be updated periodically. They should never be used as a substitute for clinical judgment. Providers are responsible for assessing the unique circumstances and needs of each case. Adherence to these guidelines will not ensure successful treatment in every situation.

Emergency Department Protocols for Management of Early Pregnancy Loss

Access Bridge’s guidance on diagnosing and treating early pregnancy loss is the first of its kind for emergency providers. The variations in these protocols reflect how different political landscapes affect access to mifepristone—a drug that blocks a hormone called progesterone that is needed for a pregnancy to continue.

ED Management of Early Pregnancy Loss

Chart: ED MANAGEMENT OF EARLY PREGNANCY LOSS

Last updated: March 2024

A clinical guide and chart for diagnosing and managing early pregnancy loss in the Emergency Department. Includes EPL diagnosis, expectant management, medication management, procedure management and more. See the guide.


ED Management of Early Pregnancy Loss (Misoprostol Protocol)

Chart: ED MANAGEMENT OF EARLY PREGNANCY LOSS (MISOPROSTOL PROTOCOL)

Last updated: March 2024

A clinical guide and chart for diagnosing and managing early pregnancy loss in the ED for sites without access to mifepristone. Includes EPL diagnosis, expectant management, medication management, procedure management and more. See the guide.


Emergency Department Protocols and Resources for Contraception and Emergency Contraceptive Care

These clinical resources from PHI’s Access Bridge are designed for Emergency Department (ED) physicians, providing guidance on contraception and emergency contraceptive care in the ED setting.

Quick-Start Contraception and Emergency Contraceptive Care

Updated 2023

A clinical guide for ED and urgent care clinicians, without immediate access to IUDs or implants. See the guide.

 


Oral Emergency Contraception Fact Sheet

Screenshot: Oral Emergency Contraception Fact SheetUpdated 2023

This fact sheet includes clinical comparison information for Ella, Plan B and One Step, as well as FAQs for medical providers and their patients. See the fact sheet.

 


 

Originally published by Bridge


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