Nurses are Key Members of the Abortion Care Team: Why aren’t Schools of Nursing Teaching Abortion Care? (original) (raw)
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PLOS ONE
In this study we explored nurse practitioner-provided medication abortion in Canada and identified barriers and enablers to uptake and implementation. Between 2020–2021, we conducted 43 semi-structured interviews with 20 healthcare stakeholders and 23 nurse practitioners who both provided and did not provide medication abortion. Data were analyzed using interpretive description. We identified five overarching themes: 1) Access and use of ultrasound for gestational dating; 2) Advertising and anonymity of services; 3) Abortion as specialized or primary care; 4) Location and proximity to services; and 5) Education, mentorship, and peer support. Under certain conditions, ultrasound is not required for medication abortion, supporting nurse practitioner provision in the absence of access to this technology. Nurse practitioners felt a conflict between wanting to advertise their abortion services while also protecting their anonymity and that of their patients. Some nurse practitioners perc...
Optimizing the Nursing Role in Abortion Care: Considerations for Health Equity
Canadian Journal of Nursing Leadership, 2022
Registered nurses (RNs) provide abortion care in hospitals and clinics and support abortion care through sexual health education and family planning care in sexual health clinics, schools and family practice. Nurse practitioners (NPs) improve access to abortion not only as prescribers of medication abortion but also as primary care providers of counselling, resources about pregnancy options and NURSING RESEARCH 55 Optimizing the Nursing Role in Abortion Care: Considerations for Health Equity abortion follow-up care in their communities. There is a need to better understand the current status of and potential scope for optimizing nursing roles in abortion care across Canada. In this article, we describe the leadership of nurses in the provision of accessible, inclusive abortion services and discuss barriers to role optimization. We present key insights from a priority-setting meeting held in 2019 with NPs and RNs engaged in medication abortion practice in their communities. As scopes of practice continue to evolve, optimization of nursing roles in abortion care is an approach to enhancing equitable access to comprehensive abortion care and family planning.
Trials and trails of accessing abortion in PEI
2014
To understand the various impacts on women’s lives of PEI’s abortion policies, we have conducted 45 research conversations ranging between 1-2 hours in our community to document the experience of trying to access abortion services in PEI. We spoke with women who have tried to access abortion and with friends, family, professionals, medical personnel, and advocates who have tried to assist women. Participants often filled various categories, however 22 participants had personally sought abortion services between 1979 and the present day. All participants have experienced multiple barriers and have witnessed blocked access to abortion. The access to abortion was described as a maze of multiple paths leading to dead ends, barriers, and delayed access but participants in the project somehow found a way to end the pregnancy. Some were forced to leave the province, others tried to self induce by their own hand or with the help of boyfriends and others used medical abortion; however withou...
The concept of ‘nursing’ in the abortion services
Journal of Advanced Nursing, 2010
Title. The concept of 'nursing' in the abortion services. Aim. This paper is a report of a study of the perceptions of nurses who work in abortion services. Background. International debate surrounds abortion. In England and Wales the Abortion Act which was introduced in 1967 recently came under public review in relation to its legal limit of 24 weeks gestation. The review did not extend to those working within abortion services, and these nurses' views remained unknown. Investigating the perceptions of nurses who work in abortion services adds a dimension to the debate from a professional perspective which has hitherto been absent. Methods. Qualitative semi-structured interviews were conducted in 2007 with nine nurses working in three different abortion clinics in the United Kingdom. NVivo was used to manage the interview data and thematic analysis identified patterns of nursing concepts and attitudes. Findings. Two global themes of 'Attitudes Towards' and 'Coping With' abortion were identified. Six organizational themes detailed these: 'society', 'nurses' and 'reasoning' in 'Attitudes Towards' and 'role', 'clients' and 'late gestation abortion' in 'Coping With'. Eleven basic themes further described the organizational themes. Kim's theory of Human Living was used to clarify and provide a rationale for the nursing approach to care in this setting. Conclusion. The ability of participants to care for their clients as individuals illustrates the nature of empowerment of the nurses to attain the goals of the client. Making this support explicit through defined roles for nurses would potentially enable nurses in abortion services to perform their role more effectively at all gestation times.
Abortion services and providers in Canada in 2019: results of a national survey
CMAJ open, 2022
I n 2019, about 84 000 medical and surgical abortions were reported to the Canadian Institute of Health Information. 1 One-third of women in Canada will have an abortion in their lifetime. 2 According to our first Canadian Abortion Provider Survey (CAPS) in 2012, abortion care was provided by fewer than 300 physicians, many of whom focused their practice on abortion care. 3 In contrast with rates greater than 80% in many European countries, 4-8 fewer than 4% of abortions were medical. 9 Procedures were provided by high-volume providers in specialized health care clinics, with limited access in rural areas. 3,10,11 In 2016, the United Nations Human Rights Commissioner expressed concern over inequitable access to abortion services in Canada, and called on the Canadian government to improve equitable access. 12 Several important health system and service changes have occurred since then. In 2017, mifepristone, the gold-standard medical abortion drug, 13 became available in Canada. 14-16 Restrictive regulations around prescribing and dispensing mifepristone were removed later that year. 17 Evidence supporting the effective and safe provision of medical abortion using mifepristone by a range of primary health care professionals 18,19 led to Health Canada's approval of provision of medical abortion by nurse practitioners. 20 The Society of Obstetricians and Gynaecologists of Canada issued evidencebased clinical practice guidelines on medical abortion in 2016 13 and on surgical abortion in 2018. 21
The End of Feminist Abortion Counseling? Examining Threats to Women's Health
Singer E.O., Ostrach B. (2017) The End of Feminist Abortion Counseling? Examining Threats to Women’s Health. In: Stettner S., Ackerman K., Burnett K., Hay T. (eds) Transcending Borders. Palgrave Macmillan, Cham, 2017
In-depth abortion counseling emerged as a key component of clinic-based abortion care during the women’s health movement of the 1970s in the United States. Abortion counselors and other clinic staff maintain that abortion is distinct from other medical procedures, and that institutional support in navigating what can be a stigmatized process is crucial. The authors of this chapter outline an ongoing shift in the field of abortion care in the United States, in which unhurried counseling is disappearing from abortion care, replaced with the minimum of legally required informed consent. Drawing from ethnographic research in abortion clinics and their own experience as abortion counselors, the authors examine current threats to comprehensive abortion counseling in independent clinics, and the implications of these changes for quality abortion care.
Marecek, J., Macleod, C., & Hoggart, L. (2017). Abortion in legal, social, and healthcare contexts.
Worldwide, abortion is one of the commonest gynaecological procedures (Sedghet al., 2012). The common occurrence of abortion around the globe, however, belies considerable diversity in the social, political, and ethical meanings of terminating a pregnancy, as well as the practices surrounding abortion. All of these vary from locale to locale, from one historical time to another, and among social groups within particular times and places.In this two-part Special Issue, we present feminist scholarship that addresses some of the diverse contexts and circumstances in which abortion takes place and the psychological implications of such contexts. This issue, Feminism & Psychology, 27(1), is Part 1 of the Special Issue ‘‘Abortion in Context’’; Part 2 will appear in May 2017 as 27(2). The pieces in Part 1 explore the legal, sociocultural, and healthcare contexts of abortion. These contexts set the conditions of possibility for women who seek to terminate a pregnancy and, to some extent, for the practitioners who provide them. Part 2 will be devoted to pieces that focus on women’s experiences of abortion – for example, decision-making, stigma, and post-abortion distress – and that examine how women’s experiences are embedded in the discursive, institutional, and material contexts of their lives.
Normalising abortion: what role can health professionals play?
BMJ Sexual & Reproductive Health
BackgroundDespite being a common gynaecological procedure, abortion continues to be widely stigmatised. The research and medical communities are increasingly considering ways of reducing stigma, and health professionals have a role to play in normalising abortion as part of routine sexual and reproductive healthcare (SRH). We sought to investigate how health professionals may normalise abortion and challenge prevailing negative sociocultural narratives.MethodsAs part of the Sexuality and Abortion Stigma Study (SASS), qualitative secondary analysis was conducted on two datasets containing health professionals’ accounts of providing abortion in Scotland and England. A subsample of 20 interviews were subjected to in-depth, thematic analysis.ResultsFour key themes were identified in heath professionals’ accounts: (1) encountering resistance to abortion from others working in SRH; (2) contending with prevailing negative sociocultural narratives of abortion; (3) enacting overt positivity ...
Social science & medicine (1982), 2018
Pregnancy termination is a common, beneficial medical procedure, but abortion care in the United States is stigmatized. Language, including categorization of some abortions as elective, may both reflect and convey stigma. We present a history of the term "elective" in reference to abortion, followed by data demonstrating its use by a sample of contemporary medical trainees and an analysis of the term's relationship to abortion stigma, medical training, and patient access to abortion care. We analyzed interviews with 41 U.S. medical students who had applied to residency programs in obstetrics and gynecology. Participants discussed experiences with, and attitudes toward, abortion before and during medical school, and plans to perform abortions in future practice. We inductively coded participants' use of "elective" in reference to abortion and analyzed their meanings. Participants did not use "elective" according to its medical definition, which c...
Barriers & Solutions: Abortion Provider Perspectives on Access to Safe Abortion
Barriers & Solutions: Abortion Provider Perspectives on Access to Safe Abortion, 2024
The Sexual and Reproductive Justice Coalition (SRJC) has been working with nurses and clinicians to support access to abortion services since 2015. South Africa’s commitment to reproductive justice and women’s rights is underscored by its legal framework, yet the effective delivery of Choice of Termination of Pregnancy (CTOP) services faces significant challenges. In 2021, the SRJC consulted providers to understand the barriers to and solutions to providing adequate abortion services. In 2023, the SRJC launched an investigation with providers to increase knowledge about nurses' and clinicians' perspectives on improving CTOP services. This report and policy brief synthesize our findings to identify critical barriers and propose actionable solutions to enhance comprehensive abortion care nationwide. Crucially, our findings identified facility-based stigma and discrimination, exacerbated by legal complexities and administrative practises relating to conscientious objection, and the lack of remuneration, monitoring, and support as the main drivers of poor access to abortion services. A key finding is that most providers, from public and private healthcare systems across provinces, view themselves and their work as integral to promoting gender equality, women’s rights and social justice. Importantly, we found a correlation between years of clinical CTOP provision and self-identification. The longer the CTOP provider was in practice, the more likely they were to identify themselves as a leading role player in South Africa’s achievement and sustained sexual and reproductive rights. Providers proposed solutions centred on increased investment in CTOP staff and infrastructure, including financial incentives to attract and retain skilled providers. Standardising policies and consequence management on conscientious objection, monitoring services, expanding CTOP training, and building societal acceptance are crucial to improving service delivery. Recommendations for action include integrating CTOP services into sexual and reproductive health services packages; increasing CTOP provider remuneration, resourcing peer learning and support; robust monitoring and consequence management for stigma and discrimination carried out within health systems; and enhancing policing and punishment of illegal operators. Community engagement through targeted awareness campaigns is also recommended to challenge stigma, educate the public about safe CTOP options, and promote informed SRH decision-making. In conclusion, implementing these recommendations can help South Africa bridge the gap between policy intentions and on-the-ground realities, ensuring equitable access to safe and legal CTOP services. By prioritising these efforts, South Africa upholds its constitutional mandates and positions itself as a global leader in reproductive justice and women’s rights.