{"title":"享有堕胎护理特权的助产士。","authors":"Keeley McNamara CNM, MSN, Marisa Poverman CNM, WHNP-BC, MSN, Marisa Nádas MD, MPH, Michaela Mallow MPH, Sharon Gerber MD, MPH","doi":"10.1111/jmwh.13577","DOIUrl":null,"url":null,"abstract":"<p>Since the US Supreme Court overturned <i>Dobbs v Jackson</i>, expanded access to abortion has been critical. Abortion is safe, and related complications are rare. The safety of abortion provision by advanced practice clinicians (APCs) is well documented. Despite the increase in targeted restrictions for patients and clinicians in many states post-<i>Dobbs</i>, in recent years there have been meaningful gains in recognition and codification of abortion as part of an expanded scope of practice for APCs. Thus, creating a formal written pathway for midwives to obtain privileges in abortion provision could also improve abortion access. In New York City's public health care system, the largest in the United States, midwives provide a significant portion of perinatal and gynecologic care. Yet, until recently, a process to privilege midwives in the provision of abortion services did not exist. In response, midwives and physicians at a large New York City hospital system sought key stakeholder support to develop a pathway for certified nurse-midwives and certified midwives, licensed midwives in New York state, to obtain the necessary training needed for independent abortion provision. This article describes the development of a midwifery-led pilot program to improve abortion access by increasing the availability of trained midwifery abortion providers, along with the results of staff meetings exploring attitudes toward abortion care by APCs. We report our safety statistics from this pilot program and share existing evidence for safety of abortion provision by midwives and other APCs.</p>","PeriodicalId":16468,"journal":{"name":"Journal of midwifery & women's health","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Privileging Midwives for Abortion Care\",\"authors\":\"Keeley McNamara CNM, MSN, Marisa Poverman CNM, WHNP-BC, MSN, Marisa Nádas MD, MPH, Michaela Mallow MPH, Sharon Gerber MD, MPH\",\"doi\":\"10.1111/jmwh.13577\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Since the US Supreme Court overturned <i>Dobbs v Jackson</i>, expanded access to abortion has been critical. Abortion is safe, and related complications are rare. The safety of abortion provision by advanced practice clinicians (APCs) is well documented. Despite the increase in targeted restrictions for patients and clinicians in many states post-<i>Dobbs</i>, in recent years there have been meaningful gains in recognition and codification of abortion as part of an expanded scope of practice for APCs. Thus, creating a formal written pathway for midwives to obtain privileges in abortion provision could also improve abortion access. In New York City's public health care system, the largest in the United States, midwives provide a significant portion of perinatal and gynecologic care. Yet, until recently, a process to privilege midwives in the provision of abortion services did not exist. In response, midwives and physicians at a large New York City hospital system sought key stakeholder support to develop a pathway for certified nurse-midwives and certified midwives, licensed midwives in New York state, to obtain the necessary training needed for independent abortion provision. This article describes the development of a midwifery-led pilot program to improve abortion access by increasing the availability of trained midwifery abortion providers, along with the results of staff meetings exploring attitudes toward abortion care by APCs. We report our safety statistics from this pilot program and share existing evidence for safety of abortion provision by midwives and other APCs.</p>\",\"PeriodicalId\":16468,\"journal\":{\"name\":\"Journal of midwifery & women's health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2023-10-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of midwifery & women's health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jmwh.13577\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of midwifery & women's health","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jmwh.13577","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"NURSING","Score":null,"Total":0}
Since the US Supreme Court overturned Dobbs v Jackson, expanded access to abortion has been critical. Abortion is safe, and related complications are rare. The safety of abortion provision by advanced practice clinicians (APCs) is well documented. Despite the increase in targeted restrictions for patients and clinicians in many states post-Dobbs, in recent years there have been meaningful gains in recognition and codification of abortion as part of an expanded scope of practice for APCs. Thus, creating a formal written pathway for midwives to obtain privileges in abortion provision could also improve abortion access. In New York City's public health care system, the largest in the United States, midwives provide a significant portion of perinatal and gynecologic care. Yet, until recently, a process to privilege midwives in the provision of abortion services did not exist. In response, midwives and physicians at a large New York City hospital system sought key stakeholder support to develop a pathway for certified nurse-midwives and certified midwives, licensed midwives in New York state, to obtain the necessary training needed for independent abortion provision. This article describes the development of a midwifery-led pilot program to improve abortion access by increasing the availability of trained midwifery abortion providers, along with the results of staff meetings exploring attitudes toward abortion care by APCs. We report our safety statistics from this pilot program and share existing evidence for safety of abortion provision by midwives and other APCs.
期刊介绍:
The Journal of Midwifery & Women''s Health (JMWH) is a bimonthly, peer-reviewed journal dedicated to the publication of original research and review articles that focus on midwifery and women''s health. JMWH provides a forum for interdisciplinary exchange across a broad range of women''s health issues. Manuscripts that address midwifery, women''s health, education, evidence-based practice, public health, policy, and research are welcomed