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Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver

Author

Listed:
  • Weitz, T.A.
  • Taylor, D.
  • Desai, S.
  • Upadhyay, U.D.
  • Waldman, J.
  • Battistelli, M.F.
  • Drey, E.A.

Abstract

Objectives. We examined the impact on patient safety if nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs) were permitted to provide aspiration abortions in California. Methods. In a prospective, observational study, we evaluated the outcomes of 11 487 early aspiration abortions completed by physicians (n = 5812) and newly trained NPs, CNMs, and PAs (n = 5675) from 4 Planned Parenthood affiliates and Kaiser Permanente of Northern California, by using a noninferiority design with a predetermined acceptable risk difference of 2%. All complications up to 4 weeks after the abortion were included. Results. Of the 11 487 aspiration abortions analyzed, 1.3% (n = 152) resulted in a complication: 1.8% for NP-, CNM-, and PA-performed aspirations and 0.9% for physician-performed aspirations. The unadjusted risk difference for total complications between NP-CNM-PA and physician groups was 0.87 (95% confidence interval [CI] = 0.45, 1.29) and 0.83 (95% CI = 0.33, 1.33) in a propensity score- matched sample. Conclusions. Abortion complications were clinically equivalent between newly trained NPs, CNMs, and PAs and physicians, supporting the adoption of policies to allow these providers to performearly aspirations to expand access to abortion care.

Suggested Citation

  • Weitz, T.A. & Taylor, D. & Desai, S. & Upadhyay, U.D. & Waldman, J. & Battistelli, M.F. & Drey, E.A., 2013. "Safety of aspiration abortion performed by nurse practitioners, certified nurse midwives, and physician assistants under a California legal waiver," American Journal of Public Health, American Public Health Association, vol. 103(3), pages 454-461.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2012.301159_7
    DOI: 10.2105/AJPH.2012.301159
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    Cited by:

    1. Lydia Mainey & Catherine O’Mullan & Kerry Reid‐Searl & Annabel Taylor & Kathleen Baird, 2020. "The role of nurses and midwives in the provision of abortion care: A scoping review," Journal of Clinical Nursing, John Wiley & Sons, vol. 29(9-10), pages 1513-1526, May.
    2. Susanne Sjöström & Helena Kopp Kallner & Emilia Simeonova & Andreas Madestam & Kristina Gemzell-Danielsson, 2016. "Medical Abortion Provided by Nurse-Midwives or Physicians in a High Resource Setting: A Cost-Effectiveness Analysis," PLOS ONE, Public Library of Science, vol. 11(6), pages 1-9, June.

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