Paper
Thursday, July 12, 2007
Nurse Midwives and Post Abortion Care in Developing Countries: What is the Evidence?
Monica A. Onyango, RN, MPH, MS, International Health, Boston University School of Public Health, Boston, MA, USA
| Learning Objective #1: Describe the evolving role of nurse midwives on post abortion care in selected health care systems in the developing countries |
| Learning Objective #2: Analyze the existing evidence on nurse sensitive outcomes on post abortion care and recommend way forward. |
Although use of contraception has increased worldwide, millions of women still have an unwanted pregnancy every year globally. Some of these pregnancies are carried to term, others end in abortions. Moreover, millions of abortions are performed outside the legal systems and these abortions are unsafe. Over 95% of unsafe abortions occur in developing countries. Nurse midwives play an important role in women’s access to reproductive health and abortion related care. Most nurses work at the primary health care level (where there are no doctors). To expand opportunities to prevent unsafe abortions, nurse midwives in developing countries are increasingly being trained to implement post abortion care (PAC) and the use of manual vacuum aspiration (MVA) procedure to treat incomplete abortions. Traditionally, abortion care has been provided only by physicians in operating rooms under general anesthesia. Nonetheless, evidence from Kenya, South Africa, India, Vietnam and others, show that if nurse midwives are trained, they quickly become proficient in using MVA to treat incomplete abortion and the outcomes are comparable to those of physicians. Despite the programmatic and anecdotal evidence to support the role of nurse midwives in PAC, there have been no systematic studies quantifying the nursing sensitive outcomes to justify or give weight to their involvement in PAC programs. This presentation will be on a review of literature to establish the existing evidence on the practice of post abortion care by nurse midwives in developing countries. Areas for further research will be outlined and recommendations made for way forward.