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Midwives in Abortion Care: A Call to Action
Author(s) -
Tillman Stephanie,
Levi Amy J.
Publication year - 2019
Publication title -
journal of midwifery and women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.543
H-Index - 62
eISSN - 1542-2011
pISSN - 1526-9523
DOI - 10.1111/jmwh.13039
Subject(s) - call to action , abortion , action (physics) , medicine , psychology , nursing , pregnancy , business , genetics , physics , marketing , quantum mechanics , biology
In 2018, 3 significant resources supporting midwives in abortion care were published: a position statement entitled Midwives as Abortion Providers by the American College of Nurse-Midwives (ACNM)1; an evidence-based review ofThe Safety and Quality of Abortion Care in the United States by the National Academies of Sciences, Engineering, and Medicine (NASEM)2; and a collaborative effort between university and nonprofit groups to create the online resource Abortion Provider Toolkit3 for health care providers seeking to integrate abortion provision into practice. This wave of professional resource publications coincides with rapid and aggressive state and national political movements4,5 to restrict both abortion provision and individuals’ rights and access to abortion, despite its legality for over 45 years. In accordance with the publication of its new position statement Midwives as Abortion Providers, ACNM subsequently issued press releases opposing attempts to limit all-options counseling for health care providers who accept Title X funding6 and state legislative threats to limit or restrict abortion care.7 As an organization, ACNM speaks clearly about its support of abortion, including abortion provision by midwives and other qualified abortion providers, and the right to abortion access for all people. ACNM’s strong stance and the momentum of collaborative organization support, as well as evidence of midwives’ safe and quality abortion provision, has started a groundswell of midwives speaking out more publicly. Abortion care is part of full-scope sexual and reproductive health care, a category that encompasses pregnancy prevention, such as contraception and emergency contraception provision; evidence-based counseling and prompt referral; and postabortion evaluation, warning signs, counseling, and follow-up support. As sexual and reproductive health care providers, midwives’ scope of practice encompasses the full spectrum of abortion care services, regardless of their direct participation in abortion provision. Abortion care includes pregnancy confirmation, consultation, referral, and postabortion evaluation and emergency instruction in addition to abortion. Abortion provision, including medication and aspiration abortion services, is only one aspect of abortion care. The purpose of this commentary is to help all midwives understandmore fully what the role of the profession has been