Reproductive Access/ Abortion Care Information
The TEAMM Project: The Training, Education, & Advocacy in Miscarriage Management is an option to either attend an in-person training or have them come to your facility. TEAMM supports the integration of all three forms of early pregnancy loss management. TEAMM project funding covers nearly all training expenses: TEAMM brings a team of 4-5 people to sites and covers all training supplies and materials at no cost. Sites are expected to cover costs related to room reservations and A/V support.
“Why are the integration of early pregnancy loss (EPL) services important? EPL is common; in people with a known pregnancy, it is estimated that 1 in 4 will miscarry before the 12th week. It affects 960,000 people annually, most EPL occur before 13 weeks of gestation. While many people can miscarry at home, it is important for providers to be available to assist when patients prefer to manage their miscarriage with medication or an aspiration procedure. APCs have the skills and follow-up capacity and can provide improved patient experience from a primary care office or emergency department. By allowing APCs to provide comprehensive EPL services, we expect to improve patient safety due to early diagnosis and management and patient and clinician satisfaction by integrating EPL care into existing practice, thereby reducing delays and unnecessary referrals.”
POC Ultrasound Training:
Organizations of Note:
Get Politically Involved
- Battistelli M et al. Expanding the Abortion Provider Workforce: A Qualitative Study of Organizations Implementing a New California Policy. February 2018. Perspectives on Sexual and Reproductive Health; 50(1):33-39.
When Abortion is Not Available: Innovating-Education.org
There are six modules that review:
Evaluation and Diagnosis of EPL
Counseling for EPL Management Options
Expectant and Medication Management for EPL
Uterine Aspiration for EPL
Practice Integration of EPL Management Services
EPL Management in Low Resource Settings
The Plan C website (https://www.plancpills.org/) provides reliable, up-to-date information on obtaining abortion pills online for those in the U.S. They list groups that provide medications and clinical services outside the formal healthcare system as online pharmacies without clinical support.
Aid Access (https://aidaccess.org/en/) is a global service that aims to support all people seeking safe and effective medication management for an abortion or miscarriage. Aid Access consists of a team of doctors, activists, and advocates working outside the formal healthcare system who provide information and send medications to those in need of a safe abortion after evaluating people for eligibility.
Self-managed abortion (https://abortionpillinfo.org)
Doctors without Borders Self-Managed abortion video series
Miscarriage & Abortion Hotline:
For Legal Questions:
U.S. Food and Drug Administration (FDA)-approved label for mifepristone includes a regimen for medication abortion that is a combination of mifepristone 200 mg orally followed by misoprostol 800 µg buccally 24 to 48 hours later.
WHO recommends the same dose and administration of mifepristone with misoprostol 800 µg either vaginally, sublingually, or buccally 24 to 48 hours later.
The effectiveness of a combined mifepristone and misoprostol regimen is approximately 98% at ≤49 days gestation and slightly decreases with advancing gestational duration to approximately 93-95% at 6470 days. Addition of a second dose of misoprostol 800 µg four hours after the first increases effectiveness of medication abortion to 97-99% in gestations between 64-77 days .
Oral misoprostol should be avoided since it is less effective than the alternate routes
An alternative regimen for medication abortion if mifepristone is not available involves misoprostol 800 µg used vaginally, sublingually, or buccally with repeated doses every 3 hours up to 3 doses or until expulsion occurs [6, 20].
Self-assess completeness: Symptoms checklist: cramping, bleeding, passing clots, and abatement of pregnancy symptoms