While treatments for miscarriage are safe, providers do not always offer them all to their patients
Research Activities, December 2010, No. 364
Treatments for miscarriage can include letting it progress naturally, treating it medically with the drug misoprostol, or surgical evacuation. All three options are safe and acceptable to women, studies show. However, health care providers vary in which services they offer, a new study finds.
Vanessa K. Dalton, M.D., M.P.H., of the University of Michigan Medical School, and colleagues surveyed 976 obstetrician/gynecologists (OB/GYNs), midwives, and family medicine practitioners (FPs) to determine their treatment patterns for miscarriage. Midwives (55.2 percent) and FPs (64.5 percent) most often preferred to let the miscarriage progress naturally compared with OB/GYNs (24.4 percent). OB/GYNs (45.7 percent) commonly preferred to have women undergo surgical evacuation in an operating room. The three provider groups ranked treatment with misoprostol as the second preferred option. Surgical evacuation in an office setting was the least preferred option for OB/GYNs (37.2 percent) and midwives (43.9 percent), and surgical evacuation in an operating room was the least preferred option for FPs (41.8 percent).
Lower-than-expected rates for misoprostol use and office-based surgical evacuations may be the result of misinformation on the safety of these options, the authors suggest. Alternatively, because these two options are also associated with induced abortions, providers may shy away from receiving training on how to perform these procedures. In fact, just one-fifth of the OB/GYNs reported having formal training in induced abortions. Nonetheless, because miscarriage is one of the most common problems that women face, this type of training will broaden the treatment options for women experiencing miscarriages. This study was funded in part by the Agency for Healthcare Research and Quality (HS15491).
See "Provider knowledge, attitudes, and treatment preferences for early pregnancy failure," by Dr. Dalton, Lisa H. Harris, M.D., Ph.D., Katherine J. Gold, M.D., and others in the June 2010 American Journal of Obstetrics & Gynecology 202(6), pp. 531.e1-531.e8.