Which Aspects of Abortion Care Do Healthcare Practitioners in Britain Think Nurses/Midwives Should Provide? Findings From the SACHA Study

Aim
To explore the views of healthcare practitioners in Britain regarding the role of midwives and nurses in the delivery of medical and surgical abortion.

Design
An observational study of the Shaping Abortion for Change study healthcare practitioner survey (2021–2022).

Methods
Relationships between healthcare practitioner type, participant characteristics, knowledge of and attitudes towards abortion, and views about nurses' and midwives' role in abortion care were examined using Pearson's Chi-squared tests of association and multivariable logistic regression.

Results
Amongst 763 participants including doctors, nurses, midwives and pharmacists, 71.6% supported specialist nurses in sexual and reproductive health and abortion clinics and hospitals, expanding their roles to include prescribing abortion medications and surgical abortion methods. Support was lower for midwives (35.8%) and primary care nurses (32.5%). There was considerable support for all nursing and midwifery groups to be involved in adjacent tasks of abortion care. Differences in support by healthcare practitioner type persisted after adjustment for exposure variables.

Conclusion
There is strong support for specialist nurses to expand their role in abortion care. This change could be implemented following clarification of the legal position. Some healthcare practitioner groups are more reluctant to support broader involvement of nurses and midwives in abortion provision.

Implications for the Profession and/or Patient Care
Expanding specialist nurses' role in abortion care could increase service capacity and improve patient access and experience. Understanding and addressing the concerns of healthcare practitioners opposing this change is critical for successful implementation and patient safety.

Impact
This study addresses the potential for nurse and midwife role expansion in abortion care. The findings highlight broad support for specialist nurses whilst identifying barriers to wider role expansion. The research informs policy discussions on workforce optimisation and access to abortion services across Britain.

Reporting Method
This study adheres to the STROBE guidelines for reporting observational studies.

Patient or Public Involvement
In the SACHA study, patient and public involvement was included at all stages to inform study design, recruitment, data collection and analysis.