{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T15:34:48Z","timestamp":1771342488799,"version":"3.50.1"},"reference-count":24,"publisher":"Guttmacher Institute","issue":"3","license":[{"start":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T00:00:00Z","timestamp":1436227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title><jats:styled-content style=\"fixed-case\">CONTEXT<\/jats:styled-content><\/jats:title><jats:p>Miscarriage care can safely and effectively be offered in appropriately equipped offices and emergency departments. However, it is often treated in the operating room, which limits access to timely, cost\u2010effective and high\u2010quality care.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:styled-content style=\"fixed-case\">METHODS<\/jats:styled-content><\/jats:title><jats:p>Between May 2013 and January 2014, in\u2010depth interviews were conducted with 30 staff holding diverse roles at 15 medical offices and emergency departments with the aim of exploring barriers to and facilitators of offering miscarriage care, and identifying methods for expanding care. On\u2010site observations were also conducted at four facilities. All data were transcribed, iteratively coded and analyzed using qualitative techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:styled-content style=\"fixed-case\">RESULTS<\/jats:styled-content><\/jats:title><jats:p>Similar barriers to and facilitators of providing miscarriage care were identified across facility types. Barriers were physician preference for providing care in the operating room, the similarity of miscarriage management and abortion procedures, the limited availability of support staff, difficulties integrating miscarriage management into patient scheduling and flow, and uncertainty about responding to women's emotional needs. Facilitators were a commitment to evidence\u2010based medicine, insurance coverage of miscarriage, offering other procedures of similar complexity and the minimal resources needed for miscarriage care. Resources needed to expand miscarriage services included a medically trained \u201cchampion,\u201d best practices for implementing services, persistence and patience, training, clear protocols, and systems for tracking equipment and supplies.<\/jats:p><\/jats:sec><jats:sec><jats:title><jats:styled-content style=\"fixed-case\">CONCLUSIONS<\/jats:styled-content><\/jats:title><jats:p>Miscarriage care was viewed as neither resource\u2010intensive nor technically complex to provide. Although it may be emotionally and politically challenging to offer, effective strategies are available for expanding the scope of miscarriage care offered in multiple settings.<\/jats:p><\/jats:sec>","DOI":"10.1363\/47e4315","type":"journal-article","created":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T16:36:51Z","timestamp":1436287011000},"page":"141-149","source":"Crossref","is-referenced-by-count":14,"title":["Barriers to and Facilitators of Moving Miscarriage Management Out of the Operating Room"],"prefix":"10.1363","volume":"47","author":[{"given":"Amanda","family":"Dennis","sequence":"first","affiliation":[{"name":"Ibis Reproductive Health Cambridge MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Ibis Reproductive Health Cambridge 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