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Interest in Medication and Aspiration Abortion Training among Colorado Nurse Practitioners, Nurse Midwives, and Physician Assistants

Published:April 21, 2020DOI:https://doi.org/10.1016/j.whi.2020.02.001

      Abstract

      Objectives

      We examined advanced practice clinicians’ (APCs: nurse practitioners [NPs], certified nurse midwives [CNMs], physician assistants) interest in training to provide medication and aspiration abortion in Colorado, where abortion provision by APCs is legal.

      Methods

      We surveyed a stratified random sample of APCs, oversampling women's health (CNMs/women's health nurse practitioners [WHNPs]) and rural APCs. We examined prevalence and predictors of interest in abortion training using weighted χ2 tests.

      Results

      Of 512 participants (21% response), the weighted sample is 50% NPs, 41% physician assistants, and 9% CNMs/WHNPs; 55% provide primary care. Only 12% are aware they can legally provide abortion. A minority of participants disagree that medication abortion (15%) or aspiration abortion (25%) should be in APC scope of practice. Almost one-third (29%) are interested in medication abortion training and 16% are possibly interested; interest is highest among CNMs/WHNPs (52%) (p < .01). Interest in aspiration abortion training is 15% with another 11% who are possibly interested; interest is highest among CNMs/WHNPs (34%) (p < .01). There are no significant differences in abortion training interest by rural practice location or by receipt of abortion education in graduate school. Participants not interested in medication and aspiration abortion training cited abortion being outside their specialty practice scope (44% and 38%, respectively) and religious or personal objections (42% and 34%). Among clinicians interested in medication abortion training, 33% believe their clinical facility is likely to allow them to provide this service, compared with 16% for aspiration abortion.

      Conclusions

      Interest in abortion training among Colorado APCs is substantial. However, facility barriers to abortion provision must be addressed to increase abortion access with APCs.
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      Biography

      Kate Coleman-Minahan, PhD, RN, FNP-BC, is an Assistant Professor at the University of Colorado College of Nursing and a CU Population Center Research Affiliate. She is a nurse practitioner and social scientist who studies access to contraception and abortion among marginalized populations.

      Biography

      Jeanelle Sheeder, MSPH, PhD, is Professor, Divisions of Family Planning and Adolescent Medicine, University of Colorado School of Medicine. Her expertise is in clinical research with a focus on family planning, contraceptive decision making, adolescents, and adolescent pregnancy.

      Biography

      Jaron Arbet, PhD, is a Research Associate in the Department of Biostatistics and Informatics at the Colorado School of Public Health. His research interests include statistical genetics, machine learning, and working with “big data.”

      Biography

      Monica R. McLemore, PhD, MPH, RN, FAAN, is an Associate Professor in the Family Health Care Nursing Department and affiliated scientist with Advancing New Standards in Reproductive Health, University of California, San Francisco. Her research is focused on reproductive health and justice.