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Nurses and midwives 'could carry out early abortions'

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Early medical abortions could be performed by properly trained nurses and midwives in developing countries, in addition to doctors, a report has concluded.

The move could help save some of the estimated 47,000 women worldwide who die as a result of unsafe abortions, the study published in The Lancet said.

Early first-trimester medical abortions are currently underused in many developing countries due in part to only doctors being authorised to administer medical abortion services.

Nearly all (98%) of the 22 million unsafe abortions each year take place in developing countries.

However, utilising midwives and nurses could expand access to low-cost, life-saving abortion services in developing countries, where abortion is legally permitted and doctors are scarce.

Dr I K Warriner, from the World Health Organisation, and colleagues designed a trial in Nepal to establish whether medical abortions can be provided as safely and effectively by mid-level healthcare workers as doctors.

The clinical outcomes were similar, with 97.3% complete abortions performed by mid-level healthcare workers and 96.1% by doctors, with no serious complications recorded.

The report’s authors said: “Appropriately trained providers can administer safe, low-technology medical abortion services for women who might otherwise turn to unsafe abortion, exposing themselves to the risks of disabilities and death.”

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Readers' comments (3)

  • to the anonymous author of this article , please note "life-saving abortion" as used in your article is a contradiction in terms as the life of the child ends....to all Medical people who assist abortion or perform abortion or sit in the fence, please open your eyes to the truth ....abortion is killing human beings and it must be stopped....do not be party to legalised murder.


    "in your arms or in your tummy she's always your baby but never your body"

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  • I do not beleive that the decision to end any pregnancy is taken lightly by the woman concerned.

    Of course this topic will result in many comments, and those who believe there should NEVER be recourse to abortion will be vociferous.

    Every case is individual. The woman who, after a lot of heart searching and a great deal of thought, requests this proceedure will have to live with that decision. Until we can actually "live in their shoes" we have no right to criticise.

    The women I know who have had to consider and on some occasions seek abortion have not done so without a great deal of thought and have required, and deserved, appropriate support afterwards.

    My concern about this would be more along the lines of, in consideration of the level of poverty and corruption in some countries, the possiblity of staff once trained, selling this service inappropriately.

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  • "Early medical abortions could be performed by properly trained nurses and midwives in developing countries, in addition to doctors, a report has concluded."

    This is the issue in the article above and not passing moral judgement on whether abortion is right or wrong. There are other platforms for this sensitive and valid debate.

    Please could we stick here to the important issues raised in the article so that a meaningful debate can be put forward and further conclusions drawn on the competency of nurses, as well as doctors, to carry out abortions in safer conditions than the current practice of non-medical abortions, especially in poorer countries. These will continue to occur whether it is considered right or not, until some acceptable way is found to change this and it is preferable to carry them out in the safest possible environment by qualified practitioners.

    The arguments raised in the above comments against abortion are valid but are an entirely separate matter which require a different platform for debate.

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