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Form · GYN-FRM-003 · Version 1.0 · Approved by the ASF Expert Committee

Supports: Standard 12 (Obstetrics and Gynaecology), criterion 12.14

Purpose

Records the care after a pregnancy loss, the support offered and the follow-up booked.

How to complete

Checks

Check Entry
Care given in private (yes) Yes
Clinical care explained Yes
Emotional support offered and answer Yes
Family involved (if wished) Yes or N/A
Follow-up booked (date) Yes

Evidence

Reference Note
E-009 Based on the WHO Managing complications in pregnancy and childbirth (2017) and ASF Expert Committee consensus.
E-006 ASF Policy Framework v1.2. Adapted.
E-009 ASF Expert Committee consensus.

Change history

Version Date What changed Approval
1.0 the date of approval First version set Expert Committee approval

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