Why midwives would make great abortion providers

It’s the National Day of Appreciation for Abortion Providers. I think we can all understand in this current climate how difficult a job that is to hold. Not many other doctors have legislators meddling in their medical practice, determining what they can do, what they can say, who they can serve. Not to mention the extremists who want to murder providers, and target them with violence.

We all know that we need more providers. There aren’t enough people willing to do this work, and there is a lot of need. We often hear the statistic that 86% of all counties in the US have no abortion provider. I want a world where folks don’t have to go to a special clinic, or a special provider, for abortion care. I want a world where abortion care isn’t segregated from the rest of medical care that a person needs. Where family practice doctors perform procedures (this used to be much more common).

You know who would make great abortion providers?

Midwives.

Talk about full-spectrum care. Midwives already provide care across the spectrum of a woman’s reproductive life–from well-woman care, to pap smears and yearly exams, to prenatal care and childbirth. Abortion would be a logical addition to their scope of practice.

Unfortunately the politics of abortion in this country, and the politics of the medical establishment mean that this is a far-fetched goal. Anti-choice advocates would surely fight any attempt to broaden who is allowed to perform an abortion and doctors (or at least the professional associations that represent their interests) would surely fight any thing that would mean they lose their monopoly on a medical service.

The UK considered a move to allow nurses and midwives to perform the service in 2007, but to my knowledge it didn’t go anywhere.

Historically, midwives were the abortion providers. Before our more advanced medical procedures were invented, midwives were the ones who counseled women on what herbs to use, what other techniques they might have for regulating their menstruation and their fertility. Before women’s health was even considered as part of medical practice, midwives were there providing compassionate care to women and their reproductive lives.

I want midwives to take this back.

A person can dream right?

UPDATE:

Thanks to J at Ipas for pointing out their work training midwives internationally in abortion care:

In many areas around the globe, such as South Africa and Ethiopia, midwives are authorized to perform uterine evacuation or medication abortion. In fact, a national training program in South Africa for midwives has helped to reduce the number of abortion-related deaths.

“Every year, more than 67,000 women die from complications from unsafe abortion — largely because they don’t have access to safe reproductive health care. Midwives, who often live in the communities where women are, can play a key role in providing critical reproductive health services to women if they are trained and empowered,” says Ramatu Daroda, senior training and services advisor for Ipas and trained midwife.

Since 2001, Ipas has trained more than 10,000 midwives in abortion and postabortion care. Ipas strongly believes that midwives are an integral part of reproductive health service delivery; and supports midwifery training and incentives, so that midwives can continue to improve maternal health.

Awesome.

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7 thoughts on “Why midwives would make great abortion providers

  1. Sara March 10, 2011 / 12:47 pm

    Really interesting idea. As a midwifery student, I’m more than interested in supporting women on that full spectrum that you talk about- and I’m a doula who does that already. Let’s make this happen!

  2. Gretchen in Brooklyn March 10, 2011 / 1:04 pm

    This is my dream/plan, if Hunter will let me in!

  3. rcromer March 11, 2011 / 1:31 am

    I’m an abortion doula in Oregon where medical and aspiration abortion care are within the scope of practice for nurse practitioners and certified nurse-midwives. I’ve had the privilege to work alongside an amazing NP and CNM, and can say confidently: midwives (and NPs!) DO make great abortion providers.

    Nursing Students for Choice is a critically important, student-led organization helping to change the educational and training obstacles in the way of midwives, nurse practitioners and physician assistants providing abortion care. For more information how these obstacles are also being tackled on the “scope of practice” front, check out this helpful toolkit: http://apctoolkit.org/index.html.

    As for the role of professional midwives in abortion care in ways that would support, say, an at-home abortion like they do for home birth: this remains a dream of mine too.

    • deana may February 29, 2012 / 1:02 pm

      I’m wondering if you can refer me to where/who I can contact about becoming an abortion doula in Oregon (specifically Portland)

  4. Lily March 12, 2011 / 9:05 am

    I’m a student midwife in NYS. All midwives in this state can provide medical abortions (this falls under our scope of practice due to the fact that we have prescriptive privileges) and some who pursue extra training can provide surgical abortions.

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