Nurses are Key Members of the Abortion Care Team: Why aren’t Schools of Nursing Teaching Abortion Care?
DOI:
https://doi.org/10.25071/2291-5796.30Keywords:
Abortion, Canada, Nursing Education, Feminist Analysis, AccessAbstract
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 nurse practitioner scope of practice to order diagnostic tests, make diagnoses, and treat health conditions. Ensuring nurse practitioners are able to practice medical abortion has the potential to significantly increase abortion access for rural, remote and other marginalized populations. There is also an opportunity to optimize the registered nurse role in abortion care. However, achieving these improvements is challenging as abortion is not routinely taught in Canadian Schools of Nursing. We argue that to destigmatize abortion and improve access, undergraduate nursing and nurse practitioner programs across the country must begin to include abortion and family planning competencies.
Downloads
References
Association of Registered Nurses of Newfoundland and Labrador (2019). https://www.arnnl.ca/
Bishop, S. (2005). Nurses' experiences of caring for women who end pregnancies for fetal anomalies (2nd trimester terminations through labor induction techniques. Nursing & Health Sciences, 7(2), 143. https://doi.org/10.1111/j.1442-2018.2005.00233_2.x DOI: https://doi.org/10.1111/j.1442-2018.2005.00233_2.x
Bishop, S. (2007). Doing taboo work: Nurses' experiences of caring for women having second trimester pregnancy terminations for fetal anomalies through labour induction. http://search.proquest.com/docview/304807075
British Columbia College of Nursing Professionals (2019). https://www.bccnp.ca/Pages/Default.aspx
Canadian Association of Schools of Nursing (2017a). Entry to Practice Competencies for Nursing Care of the Childbearing Family for Baccalaureate Programs in Nursing. Retrieved from: https://www.casn.ca/wp-content/uploads/2016/09/FINAL-CHILDBEARING-FAMILY-COMPETENCIES-revised.pdf
Canadian Association of Schools of Nursing (2017b) Registered Nurses Education in Canada Statistics 2015-2016. Retrieved from: https://www.casn.ca/wp-content/uploads/2017/12/2015-2016-EN-SFS-FINAL-REPORT-supressed-for-web.pdf
Canadian Nurses Association (2017) Nurse Practitioners in Rural and Remote Communities. Retrieved from: https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/nurse-practioners-in-rural-and-remote-communities-fact-sheet.pdf
CIHI (2017). Induced abortions in Canada 2017. Retrieved from: https://www.cihi.ca/sites/default/files/document/induced-abortion-2017-en-web.xlsx
College and Association of Registered Nurses of Alberta (2019). https://www.nurses.ab.ca/
College of Nurses of Ontario (2019). https://www.cno.org/
College of Nurses of Ontario (2017). What NPs should know about Mifegymiso. Retrieved from: http://www.cno.org/en/news/2017/july-2017/what-nps-should-know-about-mifegymiso/.
College of Registered Nurses of Manitoba (2019). https://www.crnm.mb.ca/
College of Registered Nurses of Prince Edward Island (2019). https://www.crnpei.ca/
Dunphy, C. (2018). The new face of the abortion debate. Chateleine. Retrieved from: https://www.chatelaine.com/living/the-new-face-of-the-abortion-debate/
Haney, C. (2011). Nursing identity and abortion work. Masters thesis, University of British Columbia. Retrieved from: https://pdfs.semanticscholar.org/36fd/91b63edd1b2ab9becba286e38e8a41d971ed.pdf
Health Canada. (2015a). Drug Product Database. Retrieved from: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index-eng.php,
Health Canada. (2015b). Regulatory decision summary: MIFEGYMISO.Retrieved from: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/rds-sdr/drug-med/rds_sdr_mifegymiso_160063-eng.php
Health Canada Drug Product Database (2015). Mifegymiso. Retrieved from: http://www.hc-sc.gc.ca/dhpmps/prodpharma/databasdon/index-eng.php
Kishen, M., & Stedman, Y. (2010). The role of Advanced Nurse Practitioners in the availability of abortion services. Best Practice & Research Clinical Obstetrics & Gynaecology, 24(5), 569-578. https://doi.org/10.1016/j.bpobgyn.2010.02.014 DOI: https://doi.org/10.1016/j.bpobgyn.2010.02.014
McLemore, M., & Levi, A. (2011). Nurses and Care of Women Seeking Abortions, 1971 to 2011. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(6), 672-677. https://doi.org/10.1111/j.1552-6909.2011.01302.x DOI: https://doi.org/10.1111/j.1552-6909.2011.01302.x
Norman, W. V. (2012). Induced abortion in Canada 1974-2005: trends over the first generation with legal access. Contraception, 85, 185-91. https://doi.org/10.1016/j.contraception.2011.06.009 DOI: https://doi.org/10.1016/j.contraception.2011.06.009
Norman, W. V., Guilbert, E. R., Okpaleke, C., Hayden, A. S., Steven Lichtenberg, E., Paul, M., White, K. O. & Jones, H. E. (2016). Abortion health services in Canada: Results of a 2012 national survey. Can Fam Physician, 62, e209-e217.
Nova Scotia College of Nursing. (2019). https://www.nscn.ca/
Nurses for Sexual and Reproductive Health (2019). Nsrh.org
Nurse Association for New Brunswick (2019). http://www.nanb.nb.ca/
Ordre des infirmières et infirmiers du Québec (2019). https://www.ncsbn.org/Quebec.htm
Registered Nurses Association of the Northwest Territories and Nunavut (2019). https://www.rnantnu.ca/
Saskatchewan Registered Nurses Association (2019). https://www.srna.org/
Sedgh, G., Bearak, J., Singh, S., Bankole, A., Popinchalk, A., Ganatra, B… Alkema, L. (2016). Abortion incidence between 1990 and 2014: Global, regional, and subregional levels and trends. The Lancet, 388(10041), 258-267. https://doi.org/10.1016/S0140-6736(16)30380-4 DOI: https://doi.org/10.1016/S0140-6736(16)30380-4
Shaw, D. & Norman, W. V. (2019). When there are no abortion laws: a case study of Canada. Best Practice & Research Clinical Obstetrics & Gynaecology, https://doi.org/10.1016/j.bpobgyn.2019.05.010. DOI: https://doi.org/10.1016/j.bpobgyn.2019.05.010
Sheinfeld, L., Arnott, G., El-Haddad, J., & Foster, A. (2016). Assessing abortion coverage in nurse practitioner programs in Canada: A national survey of program directors. Contraception, 94(5), 483-488. https://doi.org/10.1016/j.contraception.2016.06.020 DOI: https://doi.org/10.1016/j.contraception.2016.06.020
Statistics Canada (2019). Live births by month. Retrieved from: https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1310041501
Stettner, S. (2016). Without Apology. Edmonton: Athabasca University Press. Retrieved from: https://uwspace.uwaterloo.ca/bitstream/handle/10012/11165/Stettner_2016-Without_Apology.pdf?sequence=1&isAllowed=y
Veiga, M., Lam, M., Gemeinhardt, C., Houlihan, E., Fitzsimmons, B., & Hodgson, Z. (2011). Social support in the post-abortion recovery room: Evidence from patients, support persons and nurses in a Vancouver clinic. Contraception, 83(3), 268-273. https://doi.org/10.1016/j.contraception.2010.07.019 DOI: https://doi.org/10.1016/j.contraception.2010.07.019
World Health Organization (2018). Global Abortion Policies Database. Retrieved from: http://srhr.org/abortion-policies/
Yukon Registered Nurses Association (2019). https://yukonnurses.ca/
Downloads
Published
How to Cite
Issue
Section
License
Witness publishes under a Creative Commons Attribution-NonCommercial 4.0 International license (CC BY-NC 4.0). Read the license terms at https://creativecommons.org/licenses/by-nc/4.0/. The author(s) retain copyright to their works.
