The case for shared decision-making in miscarriage management

About one in five pregnancies results in a first trimester miscarriage, also known as an early pregnancy loss (EPL). There are multiple safe and effective methods for managing a miscarriage, but providers often only offer the one or two methods they believe are best. A new study reveals, however, that women greatly prefer counseling that covers the full range of care options.

In addition to finding that women want clear, unbiased information about all suitable treatment options, the study also finds women want to feel ownership of their treatment choice. Many women do want provider input, but they want it to be objective, rooted in clinical expertise, and respectful of a woman’s personal priorities and circumstances.

Ultimately, in other words, women want their choice of miscarriage treatment to feel like a decision they shared in with their provider—rather than one that was dictated to them. Prior Bixby Center research on other decisions that involve many options and personal preferences, such as contraceptive choice, also supports the effectiveness of a shared decision-making approach.

In addition to developing shared-decision making guides, such as the one piloted in this study and pictured below, the authors also recommend training providers further in all available care options and how to effectively counsel women on them.

Decision aid for miscarriage treatment counseling