The Space in the Middle: Attitudes of Women's Health and Neonatal Nurses in the United States about Abortion

Published:November 26, 2021DOI:



      Despite playing an integral part in sexual and reproductive health care, including abortion care, nurses are rarely the focus of research regarding their attitudes about abortion.


      A sample of 1,820 nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses were surveyed about their demographic and professional backgrounds, religious beliefs, and abortion attitudes. Scores on the Abortion Attitudes Scale were analyzed categorically and trichotomized in multinomial regression analyses.


      Almost one-third of the sample (32%) had moderately proabortion attitudes, 29% were unsure, 16% had strongly proabortion attitudes, 13% had strongly antiabortion attitudes, and 11% had moderately antiabortion attitudes. Using trichotomized Abortion Attitudes Scale scores (proabortion, unsure, antiabortion), adjusted regression models showed that the following characteristics were associated with proabortion attitudes: being non-Christian, residence in the North or West, having no children, and having had an abortion.


      Understanding nurses’ attitudes toward abortion, and what characteristics may influence their attitudes, is critical to sustaining nursing care for patients considering and seeking abortion. Additionally, because personal characteristics were associated with antiabortion attitudes, it is likely that personal experiences may influence attitudes toward abortion. A large percentage of nurses held attitudes that placed them in the “unsure” category. Given the current ubiquitous polarization of abortion discourse, this finding indicates that the binary narrative of this topic is less pervasive than expected, which lends itself to an emphasis on empathetic and compassionate nursing care.
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      Amy Alspaugh, PhD, is Assistant Professor of Nursing, University of Tennessee, Knoxville College of Nursing and a Certified Nurse-Midwife. Her research interests include reproductive health in people with the capacity for pregnancy age 35 and older, abortion in nursing, and the midwifery workforce.


      Renee Mehra, PhD, is a current postdoctoral scholar at UCSF. Her research explores how social and psychosocial factors influence inequities in maternal and infant health.


      Kate Coleman-Minahan, PhD, is an Assistant Professor of Nursing at the University of Colorado and a family nurse practitioner. Her research interests include sexual and reproductive health in low-income, minority, and immigrant young women and abortion knowledge and attitudes in advanced practice clinicians.


      Thomas J. Hoffmann, PhD, is an Associate Professor in the Epidemiology & Biostatistics Department at UCSF. His research interests include applied work encompassing a wide variety of genetic association studies related to human health, including work on age-related hearing impairment, cardiovascular disease, and cancer.


      Candace W. Burton, PhD, is an Assistant Professor in the School of Nursing at the University of California, Irvine. Her research focuses on the biobehavioral and biological health effects of intimate partner violence and sexual assault.


      Meghan Eagen-Trokko, PhD, is an Associate Professor and Director of Nursing at UW Bothell. Her scholarship uses a feminist perspective to explore how social structures/norms and life events intersect to affect women's health outcomes.


      Toni M. Bond, PhD, is a postdoctoral scholar at UCSF. Her work is advancing the field of reproductive justice through her qualitative research on the impact of oppressive theological doctrines in the reproductive and sexual lives of Black women.


      Linda S. Franck, PhD, holds the Jack and Elaine Koehn Endowed Chair in Pediatric Nursing at UCSF. She has clinical, research, and academic mentorship experience in maternal, newborn, child, and adolescent health care, with a particular emphasis on improving patient and family partnered health care.


      Liz Cretti Olseon, MPH, MSN, is an Adult Primary Care Nurse Practitioner and currently works clinically at UC Davis. Her clinical expertise includes contraception, mental heath, and primary care and she has a background in public health.


      Nikki Lanshaw, MPH, is the Project Director for the ACTIONS program. She has worked in administrative, communications, and policy analyst roles throughout her career and is interested in integrating health equity and social justice into health policy proposals and research.


      Jacqueline D. Rychnovsky, PhD, is a board certified Pediatric Nurse Practitioner and United States Navy Commanding Officer with the Navy Medicine Research & Development Enterprise at the Naval Medical Research Center. Her research involves postpartum fatigue and women's health for active duty military.


      Monica R. McLemore, PhD, is Associate Professor and co-director, ACTIONS program, UCSF. Her research focuses on the health, well-being, and livelihood of low-income and women of color. She works across the reproductive spectrum: abortion, birth, cancer risk, contraception/family planning, healthy sexuality, pleasure, and consent.