Certified Nurse Midwives, Nurse Practitioners and Physician Assistants as Abortion Providers: Preliminary Findings

Early aspiration abortion is one of the safest and most common health care procedures for women and yet there has been a decrease in providers offering this care. This shortage, compounded by maldistrubtion of providers, results in barriers to abortion access which disproportionally impact low-income and minority women. NPs/CNMs/PAs are often primary care providers in underserved areas, and therefore well positioned to address women's need for comprehensive primary health care that includes abortion. Previous research and health professional organizations, including APHA, support NPs/CNMs/PAs as providers comprehensive early abortion care. To address patient demand and expand the pool of providers to include all clinicians with the appropriate education, training and skills, ANSIRH at UCSF has undertaken a pilot project to train and evaluate NPs/CNMs/PAs as providers of early aspiration abortion. This is an in-progress, multi-site prospective evaluation of 60 NPs/CNMs/PAs who are trained to competency in the provision of early aspiration abortion. Data are collected for an equal number of clinician and physician procedures on patient and clinician outcomes. Total anticipated sample size is 12,000. 78% (n=9,124) of eligible patients agree to have their abortion procedure provided by a clinician. Preliminary results from 36 NPs/CNMs/PAs, 96 physicians and 5,356 clinician and 4,568 physician patient procedures indicate that the rate of abortion-related complications is 1.6% (n=88) for NPs/CNMs/PAs and 1.1% (n=50) for physicians. Patients report high satisfaction rates. Preliminary results support the provision of early aspiration abortion by qualified NPs/CNMs/PAs. Abortion-related complications rates are well below anticipated rates for first-trimester aspiration abortion.