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Nurses 'should perform abortions'
Denis Campbell, health correspondent
Sunday October 14, 2007
The Observer, UK
Britain's nurses are calling for the law on abortion to be changed so that they can perform terminations on women in the early stages of pregnancy.
Their request comes as Channel 4 prepares to broadcast footage taken during the abortion of a 16-week-old foetus for the first time on British TV. The scenes in Wednesday's Dispatches documentary will fuel the growing debate on abortion, which Parliament is preparing to review for the first time since 1990.
The Royal College of Nursing, which represents the country's 390,000 nurses, has asked for the 1967 Abortion Act to be amended to allow both nurses and midwives with extra training to carry out surgical abortions on women in the first 13 weeks of pregnancy and also to prescribe the abortion pill. Only doctors may now perform terminations.
The RCN has made its demands in a written submission to the Commons select committee on science and technology, which starts an inquiry tomorrow into whether abortion law needs a major overhaul.
The document points out that a growing number of nurses and midwives already carry out a range of complex surgical procedures that have traditionally been the preserve of doctors, such as colposcopies, hysteroscopies and fitting intrauterine devices.
Dr Peter Carter, the RCN's general secretary, said: 'When the Abortion Act was written, it didn't include nurses. We want it clarified once and for all that nurses can do first trimester abortions. Nurses feel they could be involved in these [two] areas more closely.'
Women seeking an abortion would benefit because it would help them to get quicker access to treatment, said Carter. At the moment, women in some parts of the country face delays in accessing abortion services because of a growing ethical reluctance among doctors to be involved. The Royal College of Obstetricians and Gynaecologists (RCOG), which represents the 5,500 doctors in Britain who specialise in pregnancy and women's health, has thrown its weight behind the RCN's call. In its submission to the select committee it says: 'A recent randomised control trial published in the Lancet has shown that first trimester abortion using manual evacuation [the termination procedure often used on women up to 12 weeks] can be provided safely by appropriately trained nurses.'
Dr Kate Guthrie, an RCOG spokeswoman on abortion, said allowing nurses to carry out early terminations would help to relieve pressure on overstretched NHS staff and supplement the declining number of doctors prepared to carry out abortions. Speaking in a personal capacity, Dr Evan Harris, a Liberal Democrat MP on the committee and a former hospital doctor, said: 'The committee will look carefully at all the evidence before making a recommendation, although the support for this by both the RCOG and the RCN is obviously notable.
'It is likely that the 40-year-old ban on nurses providing abortions will be raised next year when the Human Tissue and Embryos Bill comes before Parliament and many MPs will look to the Royal Colleges for guidance.'
>snip<
link
If Britain allows this, the US will follow.
I've believed for a long time (and suggested more than once) that first-trimester abortions should be delegated as necessary to nurses, midwives, even trained laypeople who have been through some sort of program and received a certification.
It is a simple, low-risk outpatient procedure which takes all of five minutes or less.
Nurses routinely perform far more complex and invasive procedures than abortion.
It is currently restricted only to doctors for political- not medical, health, or safety- reasons. The reason is to increase barriers to access. A doctor's time is worth more than a nurse's; therefore, abortions cost more than they ought to. There are fewer doctors than nurses, and fewer still who offer abortion services.
This is a trifling waste of doctors' valuable time and expertise, which could better be spent elsewhere.
Women's reproductive health has already largely been delegated to nurse-practitioners; I can't remember the last time I saw a doctor for any reason at Planned Parenthood; it's nurse practitioners doing everything- pelvics, breast exams, pap tests, colposcopies, prescribing birth control, everything.
And that's fine. Keep the costs down, keep access unrestricted.
Put abortion in nurses' capable hands.
Women who prefer to have the procedure performed by an MD can pay extra.
Denis Campbell, health correspondent
Sunday October 14, 2007
The Observer, UK
Britain's nurses are calling for the law on abortion to be changed so that they can perform terminations on women in the early stages of pregnancy.
Their request comes as Channel 4 prepares to broadcast footage taken during the abortion of a 16-week-old foetus for the first time on British TV. The scenes in Wednesday's Dispatches documentary will fuel the growing debate on abortion, which Parliament is preparing to review for the first time since 1990.
The Royal College of Nursing, which represents the country's 390,000 nurses, has asked for the 1967 Abortion Act to be amended to allow both nurses and midwives with extra training to carry out surgical abortions on women in the first 13 weeks of pregnancy and also to prescribe the abortion pill. Only doctors may now perform terminations.
The RCN has made its demands in a written submission to the Commons select committee on science and technology, which starts an inquiry tomorrow into whether abortion law needs a major overhaul.
The document points out that a growing number of nurses and midwives already carry out a range of complex surgical procedures that have traditionally been the preserve of doctors, such as colposcopies, hysteroscopies and fitting intrauterine devices.
Dr Peter Carter, the RCN's general secretary, said: 'When the Abortion Act was written, it didn't include nurses. We want it clarified once and for all that nurses can do first trimester abortions. Nurses feel they could be involved in these [two] areas more closely.'
Women seeking an abortion would benefit because it would help them to get quicker access to treatment, said Carter. At the moment, women in some parts of the country face delays in accessing abortion services because of a growing ethical reluctance among doctors to be involved. The Royal College of Obstetricians and Gynaecologists (RCOG), which represents the 5,500 doctors in Britain who specialise in pregnancy and women's health, has thrown its weight behind the RCN's call. In its submission to the select committee it says: 'A recent randomised control trial published in the Lancet has shown that first trimester abortion using manual evacuation [the termination procedure often used on women up to 12 weeks] can be provided safely by appropriately trained nurses.'
Dr Kate Guthrie, an RCOG spokeswoman on abortion, said allowing nurses to carry out early terminations would help to relieve pressure on overstretched NHS staff and supplement the declining number of doctors prepared to carry out abortions. Speaking in a personal capacity, Dr Evan Harris, a Liberal Democrat MP on the committee and a former hospital doctor, said: 'The committee will look carefully at all the evidence before making a recommendation, although the support for this by both the RCOG and the RCN is obviously notable.
'It is likely that the 40-year-old ban on nurses providing abortions will be raised next year when the Human Tissue and Embryos Bill comes before Parliament and many MPs will look to the Royal Colleges for guidance.'
>snip<
link
If Britain allows this, the US will follow.
I've believed for a long time (and suggested more than once) that first-trimester abortions should be delegated as necessary to nurses, midwives, even trained laypeople who have been through some sort of program and received a certification.
It is a simple, low-risk outpatient procedure which takes all of five minutes or less.
Nurses routinely perform far more complex and invasive procedures than abortion.
It is currently restricted only to doctors for political- not medical, health, or safety- reasons. The reason is to increase barriers to access. A doctor's time is worth more than a nurse's; therefore, abortions cost more than they ought to. There are fewer doctors than nurses, and fewer still who offer abortion services.
This is a trifling waste of doctors' valuable time and expertise, which could better be spent elsewhere.
Women's reproductive health has already largely been delegated to nurse-practitioners; I can't remember the last time I saw a doctor for any reason at Planned Parenthood; it's nurse practitioners doing everything- pelvics, breast exams, pap tests, colposcopies, prescribing birth control, everything.
And that's fine. Keep the costs down, keep access unrestricted.
Put abortion in nurses' capable hands.
Women who prefer to have the procedure performed by an MD can pay extra.