Emergency department care for early pregnancy loss: A scoping review of patient experiences and compassionate clinical practices in the United States

ElsevierVolume 85, March 2026, 101763International Emergency NursingAuthor links open overlay panel, , , Highlights•

Emergency Department is often seen as chaotic, with long wait times and limited emotional support for early pregnancy loss.

Providers reported diagnostic uncertainty, lack of training in compassionate care and time constraints as key barriers.

There is an urgent need for structured training and communication models to improve patient care during early pregnancy loss.

AbstractBackground

Early pregnancy loss (EPL), including miscarriage and ectopic pregnancy, affects a significant proportion of pregnancies and often leads patients to seek urgent care in the emergency department (ED). Despite this, the quality of care received varies and individuals often have negative experiences. This scoping review provides a comprehensive overview of published research examining ED care for EPL, specifically focusing on patient experiences and compassionate clinical practices.

Methods

The PRISMA-ScR checklist was utilized for the review. A literature search was performed to identify studies on individuals’ health care experiences in the ED setting following EPL, with particular attention paid to compassionate or empathetic care and the practices used to provide it. Searches were conducted in PubMed, PsychInfo, SocINDEX, and CINAHL. Four reviewers independently screened the records.

Results

Of the 89 records reviewed, 15 studies met the inclusion criteria. Themes emerging from the literature include an urgent need for improved education for ED healthcare professionals on accurate diagnosis, empathetic communication, and evidence-based management of EPL, standardized care protocols, and trauma-informed approaches tailored to reproductive loss.

Conclusion

Findings from the review can inform future efforts to redesign ED practices to support patient-centered EPL care, particularly as EDs remain the primary site for EPL management in the United States.

Keywords

Pregnancy

Abortion, Spontaneous

Emergency Service

Delivery of Health Care

© 2026 The Authors. Published by Elsevier Ltd.

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