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Evidence to Improve Care


Care for Adults in All Settings

This quality standard addresses care for people experiencing complications, such as pain and vaginal bleeding, and/or the loss of their pregnancy in the first 13 weeks. It applies to all health care settings and includes diagnosis, follow-up, and management of physical and emotional aspects of care for early pregnancy complications or loss.

This standard includes pregnancy of unknown location (where a person has a positive pregnancy test but no pregnancy is visible in an ultrasound), tubal ectopic pregnancy (a condition in which the embryo implants in a fallopian tube), and intrauterine pregnancy loss (missed, complete, or incomplete miscarriage).

Health Quality Ontario is partnering with Pregnancy and Infant Loss (PAIL) Network and in collaboration with the Provincial Council for Maternal and Child Health (PCMCH) for the development of this quality standard.

Thank you for your comments and feedback. Based on all the feedback received we have updated the draft quality standard, patient guide and additional resources.

The updated guides and resources below are in draft form. Please check back here in a few months for the finalized versions.

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Quality Standard

Know what quality care looks like, based on evidence and expert consensus

Download the Draft

Quality Standards Draft

Patient Conversation Guide

If you have had an early pregnancy complication or loss: Know what to ask for in your care

Download the Draft

Quality Standards Draft

Case for Improvement (slide deck)

Share why this standard was created and the data behind it, to get the support you need to put it into practice

Download the Draft

Quality Standards Draft

Data Table

Identify where there are gaps in care in your region, to inform resource planning and improvement efforts

Download the Draft

Quality Standards Draft

Measurement Guide

See the technical specifications for the indicators within the quality standard

Download the Draft

Quality Standards Draft

Health Quality Ontario thanks the following individuals for their generous, voluntary contributions of time and expertise to help create this quality standard:

Jackie Thomas (co-chair)
Physician, Obstetrics and Gynaecology, Mount Sinai Hospital

Catherine Varner (co-chair)
Physician, Schwartz/Reisman Emergency Medicine Centre, Mount Sinai Hospital

Feben Aseffa
Lived Experience Advisor; Quality and Risk Management Specialist, Association of Ontario Midwives

Mostafa Atri
Divisional Head, Abdominal Ultrasound, Joint Department of Medical Imaging, University of Toronto

Tracy Condon
Social Worker, Partners in Pregnancy Clinic, Peterborough Family Health Team

Josh Gohl
Registered Nurse, Linamar Emergency Department, Guelph General Hospital

Sarah Gower
Rural Family Physician, Elora and Fergus

Kate MacWilliams
Clinical Nurse Specialist, Emergency Department, St. Michael’s Hospital

Amy Moland-Osborne
Registered Midwife, Boreal Midwifery Practice

France Morin
Perinatal Consultant, Champlain Maternal Newborn Regional Program

Heather Murray
Physician, Emergency Department, Kingston General Hospital

Sachiko Nagasawa
Clinical Psychologist, North Bay Regional Health Centre

Summer O’Neill
Registered Midwife, Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital

Andrea Paras
Lived Experience Advisor

Kristen Patrick
Nurse Practitioner, Sunset Country Family Health Team

Amanda Ross-White
Lived Experience Advisor; Author and Contributor, Pregnancy After Loss Support

Gareth Seaward
Vice-Chair, Quality Improvement and Patient Safety, Department of Obstetrics and Gynaecology, University of Toronto

Modupe Tunde-Byass
Physician, Department of Obstetrics and Gynaecology, North York General Hospital

For more information, contact

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