Nurse Practitioners’ and Certified Nurse Midwives’ Experiences Providing Comprehensive Early Abortion Care in New England (original) (raw)
Related papers
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.
Witness: The Canadian Journal of Critical Nursing Discourse
Abortion is a common and safe procedure in Canada, with the Canadian Institute for Health Information reporting approximately 100,000 procedures per year. Yet access remains problematic. As abortion is unrestricted by criminal law in Canada, access is limited by geographic barriers and by a shortage of providers. We present a feminist critical lens to describe how the marginalization of nursing and nurses in abortion care contributes to social stigma and public misunderstanding about abortion access. The roles of registered nurses and nurse practitioners in abortion advocacy, service navigation, counselling, education, support, physiological care and follow up are underutilized and under-researched. In 2015, decades after its availability elsewhere in the world, Health Canada approved mifepristone (a pill for medical abortion). In 2017, provincial regulators began to authorize nurse practitioners to independently provide medical abortion care, as appropriate given the inclusion in n...
Contraception, 2009
A hopeful note in the contemporary abortion environment in the United States is the expanding role of advanced practice clinicians -nurse practitioners, physician assistants and nursemidwives -in first trimester abortion provision. A large percentage of primary health care in the US is currently provided by these non-physicians but their involvement in abortion care is promising, especially in light of the shortage of physician providers. Two national symposia in 1990 and 1996 approved the expansion of early abortion care to non-physicians. As of January 2004, trained advanced practice clinicians were providing medical, and in some cases, early surgical abortion in 14 states. This has required not only medical training but also political organising to achieve the necessary legal and regulatory changes, state by state, by groups such as Clinicians for Choice and the Abortion Access Project, described here in examples in two states and the reflections of three advanced practice clinicians. Recent surveys in three states show a substantial interest among advanced practice clinicians in abortion training, leading to cautious optimism about the possibility of increased abortion access for women. Most encouraging, advanced practice clinicians, like their physician counterparts, show a level of passionate commitment to the work that is rare elsewhere in health care in the US today. A 2004 Reproductive Health Matters. All rights reserved.
Australian Journal of Advanced Nursing, 2021
Objective: To explore factors that can influence implementation of a nurse-led model of care for early medication abortion provision in the primary healthcare setting of regional and rural Victoria, Australia. Background: Global research indicates that an increased involvement of primary healthcare nurses in the delivery of early medication abortion provision has the potential to improve abortion access. In Victoria, access in regional and rural areas is restricted despite abortion being legal. A nurse-led early medication abortion provision model is feasible and can potentially improve the current situation. Study design and methods: An online threeround classic Delphi method was used. This paper reports the qualitative findings. Non-probability sampling techniques were used to recruit a panel of professional experts. Data from the three questionnaires were collected and analysed using thematic analysis. Factors influencing model implementation were categorised into the Capability, Opportunity, Motivation-Behaviour framework. Results: A total of 24 medical and other health professionals participated. They identified a range of factors that can hinder model implementation, including a lack of affordable medication abortion education, no remuneration for nurse-led early medication abortion provision, and concerns related to stigma and support. Discussion and conclusion: Understanding and addressing barriers to model implementation may enable the development of primary healthcare nurses' role in the delivery of early medication abortion provision to improve abortion access. Impact: To improve abortion access in Victoria's under-served regions, the potential of nurse-led early medication abortion provision was explored. Barriers to model implementation relate to a lack of medication abortion education and funding, professional support and stigma concerns. The study identified a range of support elements that would enable primary healthcare nurses to develop new roles and responsibilities in the delivery of medication abortion services.
Early abortion services in the United States: a provider survey
Contraception, 2003
The objective of this study was to describe the availability of early surgical and medical abortion among members of the National Abortion Federation (NAF) and to identify factors affecting the integration of early abortion services into current services. Telephone interviews were conducted with staff at 113 Planned Parenthood affiliates and independent abortion providers between February and April 2000, prior to FDA approval of mifepristone. Early abortion services were available at 59% of sites, and establishing services was less difficult than or about what was anticipated. Sites generally found it easier to begin offering early surgical abortion than early medical abortion. Physician participation was found to be critical to implementing early services. At sites where some but not all providers offered early abortion, variations in service availability resulted. Given the option of reconsidering early services, virtually all sites would make the same decision again. These data suggest that developing mentoring relationships between experienced early abortion providers/sites and those not offering early services, and training physicians and other staff, are likely to be effective approaches to expanding service availability.
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...
Women Know Best—Findings from a Thematic Analysis of 5,214 Surveys of Abortion Care Experience
Women's Health Issues, 2014
Objective: Patient experience is an essential component of quality care. Few studies have comprehensively evaluated patient experiences of abortion care. The objectives of this study were to describe women's experiences of abortion care in their own words, and to determine themes across patient experiences. Study Design: Data for this thematic analysis, a qualitative method that allows for the identification, analysis, and report of patterns or themes within data, come from a larger study of safety and quality of aspiration abortion care across 22 clinical sites. Participants completed an abortion experience survey including fixed choice questions and an open-ended question: "Is there anything you would like to tell us about your experience?" The data were then categorized by responses to another survey question: "Overall, was your experience about, better, or worse than you expected?" Results: A total of 5,214 responses were analyzed. Women reported positive abortion care experiences with the majority of women rating their experience as better than expected (n ¼ 3,600). Two major themes that emerged from the data include clinic-and patient-level factors that impact how patients rate their experiences. Analysis of the responses categorized in the worse than expected group (n ¼ 136) found that women primarily faulted clinic-level factors for their negative experiences, such as pain control and management, and wait time for appointments and in clinic. Conclusion: This analysis highlights specific areas of abortion care that influence patients' experience. The few women who were disappointed by care in the clinic tended to fault readily modifiable clinical factors, and provided suggested areas of improvement to enhance positive experiences related to their abortion care.