Nursing's Role in Unintended Pregnancy Management

Abstract

Background: Currently, at least half of all women in the US will experience an unintended pregnancy by the age of 45. Unintended pregnancy has negative consequences for the health of women and their children, and is associated with significant costs to the health care system. All nurses have a responsibility to understand the importance of reproductive health care in the primary care of women and their families, and to be prepared to respond to patients' needs for the prevention and management of unintended pregnancy. A public health framework provides an opportunity to identify the role of the nurse in primary, secondary, and tertiary prevention strategies that can contribute to the management of unintended pregnancy for the health of women and their families. Purpose: This project was designed to expand the role of advanced practice nurses (APNs) in the tertiary prevention of unintended pregnancy by expanding their skills to include aspiration abortion. Methodology: As part of a larger project to expand the inclusion of abortion services in primary care settings, APNs are being trained using a comprehensive competency-based curriculum to provide first trimester aspiration abortions. Summative and formative data is collected on both the training process and outcomes. Complication rates are recorded for comparison with a cohort of physician-provided procedures. Findings: Findings to date indicate that APNs performing aspiration abortions have a complication rate that is the same as or only slightly higher than that of the physician cohort. Summary Concluding Statement: Nurses are at the front lines of women's primary care, and have an important role in the prevention of unintended pregnancy at the primary and secondary levels of care. This project has been designed to demonstrate the safety of APNs as providers of tertiary level care for the prevention of unintended pregnancy.