Nurses are Key Members of the Abortion Care Team: Why aren’t Schools of Nursing Teaching Abortion Care?

Abstract

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.