Approximately 10% to 20% of all clinically recognized pregnancies and 30% to 40% of all conceptions end in a loss, with most occurring in the first trimester.[1],[2] Second-trimester fetal losses are much less common and decrease as pregnancy progresses. Between 1% and 5% of pregnancies are lost between 13 and 19 weeks of gestation, but only 0.3% are lost between 20 and 27 weeks of gestation.[3] Because an underlying cause is often indeterminate, following recommended guidelines for the maternal and fetal evaluation can increase yield and control healthcare costs. Additionally, in locations where OB/GYN specialists no longer perform dilation and evacuation, patients may be limited in their treatment options or may require transfer to another facility to obtain this service. OB/GYN hospitalists can improve care by ensuring protocols are in place, such as an evidence-based algorithm for the maternal and fetal evaluation and for a safe and effective regimen for medical induction in the second trimester. Additionally, when OB/GYN hospitalists are skilled in dilation and evacuation, patients have improved access to care.