Medical Abortion in Midwifery Scope of Practice: A Qualitative Exploration of the Attitudes of Registered Midwives in British Columbia.
Journal
Journal of midwifery & women's health
ISSN: 1542-2011
Titre abrégé: J Midwifery Womens Health
Pays: United States
ID NLM: 100909407
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
11
02
2019
revised:
10
09
2019
accepted:
19
09
2019
pubmed:
4
12
2019
medline:
5
2
2021
entrez:
4
12
2019
Statut:
ppublish
Résumé
Across Canada and internationally, access to abortion remains challenging, particularly for those living in rural and remote communities. International research and policy call for the training of advanced practice clinicians, including midwives, to provide abortion services to fill the ever-increasing access gap. Research in other jurisdictions has examined the attitudes of midwives toward this potential expansion of scope of practice, but such studies have not been undertaken in British Columbia. This qualitative research study explored the attitudes of registered midwives toward expanding their scope of practice to include the provision of medication abortion in British Columbia. In-depth qualitative interviews with British Columbia registered midwives were conducted and analyzed using thematic analysis. Fifteen interviews were conducted. Analysis of the interviews identified 5 primary themes: the incorporation of medication abortion into the midwifery scope of practice to increase access, the congruence of the midwifery model of care and provision of medication abortion, the role of registered midwives as guardians of reproductive rights, the need for a paradigm shift in how the profession is viewed, and the practicalities of potential scope expansion. This study shows some British Columbia registered midwives are interested in including medication abortion in their scope of practice. Midwives have the potential to bridge some of the health care delivery gaps in areas underserved by abortion providers and communities where medication abortion is not available. Further research is needed to more fully understand the perspectives of registered midwives in British Columbia as a whole.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
231-237Informations de copyright
© 2019 by the American College of Nurse-Midwives.
Références
Norman WV. Induced abortion in Canada 1974-2005: trends over the first generation with legal access. Contraception. 2012;85(2):185-191.
Sethna C, Doull M. Spatial disparities and travel to freestanding abortion clinics in Canada. Womens Stud Int Forum. 2013;38:52-62.
Norman WV, Soon JA, Maughn N, Dressler J. Barriers to rural induced abortion services in Canada: findings of the British Columbia Abortion Providers Survey (BCAPS). PLoS One. 2013;8(6):1-8.
Norman WV, Soon JA, Maughn N, Dressler J. Canadian rural compared to urban first- and second-trimester abortion services: findings of the British Colombia abortion provider survey. Contraception. 2012;86(3):305.
Dressler J, Maughn N, Soon JA, Norman WV. The perspective of rural physicians providing abortion in Canada: qualitative findings of the BC Abortion Providers Survey (BCAPS). PLoS One. 2013;8(6):e67070.
Dressler J, Maughn N, Soon J, Norman W. Experiences of rural versus urban abortion providers in British Columbia: interview findings from the BC abortion providers survey. Contraception. 2012;86(3):305.
Vogel L. Abortion access grim in English Canada. CMAJ. 2015;187(1):17.
Sethna C, Palmer B, Ackerman K, Janovicek N. Choice, interrupted: travel and inequality of access to abortion services since the 1960s. Labour. 2013;48(71).
Johnstone R, Macfarlane E. Public policy, rights, and abortion access in Canada. Int J Can Stud. 2015;51:97-120.
Downie J, Nassar C. Barriers to access to abortion through a legal lens. Health Law J. 2007;15(977):143-173.
Handa M, Rosenberg S. Ontario midwives’ attitudes about abortion and abortion provision. Can J Midwifery Res Pract. 2016;15(1):8-35.
Shaw J. Reality Check: A Closer Look at Accessing Abortion Services in Canadian Hospitals. Ottawa, Ontario: Canadians for Choice; 2006.
Dunn S, Cook R. Medical abortion in Canada: behind the times. CMAJ. 2014;186(1):13-14.
Costescu D, On H, Guilbert E, et al. Medical abortion [In English and French]. J Obstet Gynaecol Can. 2016;38(4):366-389.
The Canadian Press. Health Canada eases restrictions on abortion pill Mifegymiso. CBC website. http://www.cbc.ca/news/health/mifegymiso-abortion-pill-health-canada-1.4391267. November 7, 2017. Accessed December 18, 2017.
Renner RM, Brahmi D, Kapp N. Who can provide effective and safe termination of pregnancy care? A systematic review*. BJOG. 2013;120(1):23-31.
Barnard S, Kim C, Park MH, Ngo TD. Doctors or mid-level providers for abortion. Cochrane Database Syst Rev. 2015;(7):CD011242.
The Role of Physician Assistants, Nurse Practitioners, and Nurse-Midwives in Providing Abortions: Strategies for Expanding Abortion Access. Recommendations from a National Symposium. Atlanta, Georgia; December 13-14, 1996. Washington DC; National Abortion Federation; 1997.
Berer M. Provision of abortion by mid-level providers: international policy, practice and perspectives. Bull World Health Organ. 2009;87(1):58-63.
Rocca CH, Puri M, Shrestha P, et al. Effectiveness and safety of early medication abortion provided in pharmacies by auxiliary nurse-midwives: A non-inferiority study in Nepal. PLoS One. 2018;13(1):e0191174.
Kopp Kallner H, Gomperts R, Salomonsson E, Johansson M, Marions L, Gemzell-Danielsson K. The efficacy, safety and acceptability of medical termination of pregnancy provided by standard care by doctors or by nurse-midwives: a randomised controlled equivalence trial. BJOG. 2015;122(4):510-517.
Warriner IK, Wang D, Huong NT, et al. Can midlevel health-care providers administer early medical abortion as safely and effectively as doctors? A randomised controlled equivalence trial in Nepal. Lancet. 2011;377(9772):1155-1161.
Sjöström S, Kopp Kallner H, Simeonova E, Madestam A, Gemzell-Danielsson K. Medical abortion provided by nurse-midwives or physicians in a high resource setting: a cost-effectiveness analysis. PLoS One. 2016;11(6):e0158645.
Weitz T, Anderson P, Taylor D. Advancing scope of practice for advanced practice clinicians: more than a matter of access. Contraception. 2009;80(2):105-107.
Jejeebhoy SJ, Kalyanwala S, Mundle S, et al. Feasibility of expanding the medication abortion provider base in India to include ayurvedic physicians and nurses. Source Int Perspect Sex Reprod Heal. 2012;38(3):133-142.
Jones RK, Henshaw SK. Mifepristone for early medical abortion: experiences in France, Great Britain and Sweden. Perspect Sex Reprod Health. 2002;34(3):154-161.
Erdman JN, DePiñeres T, Kismödi E. Updated WHO guidance on safe abortion: health and human rights. Int J Gynecol Obstet. 2013;120(2):200-203.
World Health Organization. Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd ed. Geneva, Switzerland; World Health Organization; 2012.
Fullerton JT, Thompson JB, Severino R; International Confederation of Midwives. The International Confederation of Midwives essential competencies for basic midwifery practice. an update study 2009-2010. Midwifery. 2011;27:399-408.
Fullerton J, Butler MM, Aman C, Reid T, Dowler M. Abortion-related care and the role of the midwife: a global perspective. Int J Womens Health. 2018;10:751-762.
Sabourin JN, Burnett M. A review of therapeutic abortions and related areas of concern in Canada. J Obstet Gynaecol Canada. 2012;34(6):532-542.
Canadian Association of Midwives. Reproductive Health Care Position Statement. Montreal, Quebec: Canadian Association of Midwives; 2015. https://canadianmidwives.org/wp-content/uploads/2016/06/CAM-ReproCarePS-eng-Feb2016-FINAL.pdf. Accessed June 15, 2017.
Lipp A. A woman centred service in termination of pregnancy: a grounded theory study. Contemp Nurse. 2008;31(1):9-19.
Lipp A. A review of termination of pregnancy: prevalent health care professional attitudes and ways of influencing them. J Clin Nurs. 2008;17(13):1683-1688.
Handa M, Rosenberg S. Ontario midwives’ attitudes about abortion and abortion provision. Can J Midwifery Res Pract. 2016;1:8-35.
Lindström M, Jacobsson L, Wulff M, Lalos A. Midwives’ experiences of encountering women seeking an abortion. J Psychosom Obstet Gynaecol. 2007;28(4):231-237.
Hwang AC, Koyama A, Taylor D, Henderson JT, Miller S. Advanced practice clinicians’ interest in providing medical abortion: results of a California survey. Perspect Sex Reprod Health. 2005;37(2):92-97.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101.
Braun V, Clarke V. What can “thematic analysis” offer health and wellbeing researchers? Int J Qual Stud Health Well-being. 2014;9(1):1-2.
Joffe H. Thematic analysis. In: Harper D, Thompson AR, eds. Qualitative Research Methods in Mental Health and Psychotherapy: A Guide For Students and Practitioners. 1st ed. Hoboken, NJ: John Wiley & Sons Ltd; 2011:209-223.
College of Midwives of British Columbia. Policy on Alternate Practice Arrangements. Vancouver, BC: College of Midwives of British Columbia; 2018. https://www.cmbc.bc.ca/wp-content/uploads/2019/03/Policy-on-Alternate-Practice-Arrangements.pdf. Accessed November 19, 2019.
Norman WV. Abortion in British Columbia: trends over 10 years compared to Canada. Contraception. 2011;84(3):316.
Verstraeten BSE, Mijovic-Kondejewski J, Takeda J, Tanaka S, Olson DM. Canada's pregnancy-related mortality rates: doing well but room for improvement. Clin Invest Med. 2015;38(1):E15-E36.