The role of CNMs in abortion care

Specialties CNM

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Hello

I am wondering if there is any programs that educate/train midwives in abortion care. There are currently six states which allow NPs to perform procedures. I am wondering if abortion care is included within the midwifery curriculum of any school.

I am posting for strictly educational and healthcare inquiries into the field. Please refrain from responding if you have any sort of moral judgment on this particular topic.

To LookingAhead:

In response to your question, yes reproductive choices (including abortion) get a fair amount of discussion in our program and among my classmates. We have also discussed the issue in some of our classes of having CNMs, NPs, and PAs be first trimester abortion providers. If it were possible in California, I'm sure there are many of us Master's nursing students who would like to learn how to do aspiration abortions. As it is now, only those CNMs, NPs, and PAs who are enrolled in the ANSIRH study can be trained and perform aspiration abortions. So, if legislature wasn't holding us back, yes there would be a lot of interest on behalf of the students to learn aspiration abortions while in school.

What we are allowed to do right now as Nurse-midwifery students is learn how to do laminaria insertions to dilate the cervix. That is as much as we can do besides medical abortions.

Yes, lots and lots of interest in expanding the scope of practice for CNMs, NPs, and PAs to do aspiration abortions.

I'm in the school of nursing at OHSU and I have been told that at OHSU, if someone were to stay on for the DNP portion of study (currently offered, not required), the student is required to pick an area in which to focus for their additional study; examples suggested to me were ultrasound, long-term management of abnormal paps, C-section first assist, providing surgical abortion, etc. Selecting your study field would be contingent upon having a preceptor that would be willing to work with you during your DNP terms.

So, to answer your question, I think you *could learn surgical abortion at that program, because CNMs can legally provide surgical abortions in OR and it could be the additional scope of practice you hoped to gain competency in during your DNP year. However, aspiration abortion is not included in the Master's level CNM program at OHSU.

I wrote a paper about this last semester. WHO feels that mid level providers are fully capable of performing early term abortions, both medical and aspiration. As there is a shortage of these providers, I feel that APN scope of practice should include this. Would I want to perform them? Maybe not. But it is certainly something that an APN can do.

I would like to be an abortion provider after finishing women's health NP school in one of the few states where there are no physician only laws - I'm happy to field questions for anyone interested in doing this, as I've researched it quite a bit. - ALSO presently no schools offer this as part of training, but ANSIRH's work is great and keep abreast as to what's happening legislatively in California regarding mid levels doing abortion care.

Carrying a pregnancy to term is far more dangerous/complicated than doing a first trimester abortion. This is totally within scope of practice and I'm excited to see more people interested in it. With few MDs doing abortion care, we need more engaged, excited NPs/CNMs providing!

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Good for you mz-marit! We need open minded clinicians like yourself. Abortion is an important service, though people do not like to talk about it. I applaud you for stating your desire and I hope that you get to do exactly as you plan. Thank you for stepping up.

Specializes in TELE, CVU, ICU.
Actually, i currently work at Planned Parenthood of the Columbia Willamette. CNMs do perform surgical and medical abortions. It depends on the state

I am interested in receiving appropriate training and would consider A DNP/CNM pathway if I were able to provide full abortion services.

Specializes in TELE, CVU, ICU.
I would like to be an abortion provider after finishing women's health NP school in one of the few states where there are no physician only laws - I'm happy to field questions for anyone interested in doing this, as I've researched it quite a bit. - ALSO presently no schools offer this as part of training, but ANSIRH's work is great and keep abreast as to what's happening legislatively in California regarding mid levels doing abortion care.

Carrying a pregnancy to term is far more dangerous/complicated than doing a first trimester abortion. This is totally within scope of practice and I'm excited to see more people interested in it. With few MDs doing abortion care, we need more engaged, excited NPs/CNMs providing!

I would also like to be an abortion provider. After reading the responses on this thread, I think it would be more appropriate for me to go for a DNP women's health or family practice instead of the CNM route. I have to do more research and find a good program (and pay off student loans!) before I commit though.

Specializes in TELE, CVU, ICU.
I'm in the school of nursing at OHSU and I have been told that at OHSU, if someone were to stay on for the DNP portion of study (currently offered, not required), the student is required to pick an area in which to focus for their additional study; examples suggested to me were ultrasound, long-term management of abnormal paps, C-section first assist, providing surgical abortion, etc. Selecting your study field would be contingent upon having a preceptor that would be willing to work with you during your DNP terms.

So, to answer your question, I think you *could learn surgical abortion at that program, because CNMs can legally provide surgical abortions in OR and it could be the additional scope of practice you hoped to gain competency in during your DNP year. However, aspiration abortion is not included in the Master's level CNM program at OHSU.

I was looking at the post master's DNP and it does not seem like it is offered at that level either http://www.ohsu.edu/xd/education/schools/school-of-nursing/programs/upload/DNP-postmasters-POS-1516-070115.pdf

http://www.ohsu.edu/xd/education/schools/school-of-nursing/programs/upload/FNP-MNDNP-1516-FINAL-050415.pdf

Specializes in Reproductive & Public Health.

I am a CNM at planned parenthood and I do medical abortions. I could also do suction aspiration for missed abortions or failed medical abortions (if I worked at a clinic that did aspiration, which I do not), but state law prohibits non-physicians from doing suction abortions in my state. Which is a nonsensical regulation, by all accounts.

My abortion training in CNM school was a 2 hour lecture from an OBGYN at our hospital that worked at PP. I also did one med AB during integration in midwifery school. I think suction aspiration should be a fundamental, entry level midwifery skill. It's a potentially life saving intervention and well within entry level scope.

eta- OMG, just realized I posted on this thread way back when I was in nursing school! awww.

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