NURSE MIDWIVES ATTITUDES TOWARD ABORTION PERFORMANCE AND RELATED PROCEDURES

In 1990 a symposium was held by the American College of Obstetricians and Gynecologists and the National Abortion Federation to address the national shortage of physician abortion providers. One symposium recommendation was that nurse-midwives be trained to perform first-trimester legal abortions under physician supervision. A national mail survey was conducted to determine the attitudes of nurse-midwives toward performing abortion and related procedures. One-half of the nurse-midwives who were members of the American College of Nurse-Midwives as of October 1991 were polled, and 1,208 questionnaires (71.1%) were returned, resulting in a sample representative of the general membership and students. Seventy-nine percent of respondents would not support federal and state efforts to limit access to abortion, 52% would or possibly would vote in a secret ballot to permit the performance of abortion by certified nurse-midwives; 24% would, or possibly would, incorporate abortion procedures into their practice; and 19% would, or possibly would, perform abortions in an abortion clinic. The lowest level of support to permit the certified nurse-midwife practice of abortion came from the midwest (31%) and southeast (41%) and the greatest from the west coast (65%). Supporters for the nurse-midwife performance of abortion were more likely to have practiced well-woman gynecology and provided abortion-related services such as abortion referrals, pre- and postabortion workups and the treatment of abortion-related complications. They were more likely to have inserted intrauterine contraceptive devices and laminaria, and to have performed circumcision. Opinions about the performance of abortion were not related to age, education, or student status, the majority of nurse-midwives (91%) would be willing to refer a woman to another provider for an abortion, prescribe RU 486 (57%), and perform dilation and curettage for spontaneous abortion (56%). The American College of Nurse-Midwives membership reported many different reasons for support of and opposition to professional involvement with abortion. Further research suggestions for institutional policy and individual practice are offered.