Abortions

klone, MSN, RN · Feb 25, 2015

It's very rare that a midwife would have to participate with abortions, and you can certainly choose not to. That's generally the domain of MDs. I think that only in California are advance-practice nurses allowed to perform abortions independently.

You do, however, need to be able to counsel women on their reproductive options, and that will sometimes include abortion. As well as all methods of contraception.

Liz_1224 · Feb 25, 2015

Yay! I'm relieved. I can talk to a woman about an abortion, so long as I don't have to perform it. That was the one thing I was worried about.

**LibraSunCNM, BSN, MSN, CNM** · Feb 25, 2015

I got this info from another poster:

California, Vermont, Oregon, Montana and New Hampshire allow CNMs, NPs and PAs to provide surgical abortions, and Washington State, New Mexico, New York, Massachusetts, Illinois, Connecticut, Maryland and New York allow "non-physicians" to administer medical abortions. There are some grey areas, but generally speaking, all other states only allow physician-only abortions.

http://www.ansirh.org/research/pci/access.php

Hope that is helpful.

cayenne06, MSN, CNM · Feb 27, 2015

Aspiration is a good skill for any midwife to have (it's equally useful for missed ABs obviously), but no. It is not considered an "entry level" or required skill.

Off topic a little. . .

My personal opinion is that all midwives and OBs should know HOW to provide first trimester surgical and medical abortions. It's a simple skill, no more complicated than putting in an IUD and exponentially less complex than managing a birth. I really believe that it should be a required skill to enter practice because it is just so fundamental to reproductive health care, just as much so as baby catching. Whether or not a provider chooses to provide abortion services is, however, completely up to them. Assuming, of course, that they are willing to counsel and refer in an unbiased and supportive way.

Just because I am trained to safely conduct a birth, that in no way means I am obligated to provide that service in my practice. I am, however, still expected to have the basic competency to provide childbirth care, and I am ethically bound to refer my pregnant patients for such care if I do not provide it myself.