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Privileging Midwives for Abortion Care
Keeley McNamara1, Marisa Poverman2, Marisa Nádas2,3,4
1Obstetrics and Gynecology, New York Presbyterian-Hudson Valley Hospital, Cortlandt Manor, New York.
Journal of Midwifery & Women'S Health
|October 18, 2023
Summary
Expanded access to abortion is critical. A new pilot program in New York City established a pathway for midwives to provide abortion care, improving access and demonstrating safety for advanced practice clinicians.
Area of Science:
- Reproductive Health
- Medical Education
- Healthcare Policy
Background:
- The overturning of Roe v. Wade necessitates expanded abortion access, particularly through safe and effective methods.
- Advanced Practice Clinicians (APCs), including midwives, are well-documented as safe providers of abortion care.
- Existing healthcare systems may lack formal pathways for APCs, such as midwives, to gain privileges for abortion provision, hindering access.
Purpose of the Study:
- To develop and describe a formal pathway for midwives to obtain privileges for independent abortion provision within a large urban healthcare system.
- To assess the safety and feasibility of a midwifery-led pilot program for abortion care.
- To explore attitudes towards abortion care provided by APCs among healthcare staff.
Main Methods:
- Development of a midwifery-led pilot program for abortion provision, including necessary training and stakeholder engagement.
- Conducting staff meetings to explore attitudes regarding APCs providing abortion care.
- Collecting and reporting safety statistics from the pilot program.
Main Results:
- A formal pathway for midwives to provide abortion services was successfully developed and implemented.
- The pilot program demonstrated safe outcomes in abortion provision by midwives.
- Staff attitudes towards APCs providing abortion care were explored, contributing to understanding provider acceptance.
Conclusions:
- Establishing formal training and privileging pathways for midwives can significantly improve abortion access.
- Midwifery-led abortion care is safe and effective, aligning with the broader scope of practice for APCs.
- This model can be replicated in other healthcare systems to enhance reproductive healthcare services.
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