Medical Abortion in Midwifery Scope of Practice: A Qualitative Exploration of the Attitudes of Registered Midwives in British Columbia
Medical Abortion in Midwifery Scope of Practice: A Qualitative Exploration of the Attitudes of Registered Midwives in British Columbia
复制标题
DOI：
10.1111/jmwh.13059
复制
发表时间：
2019-12-02
影响因子：
2.7
通讯作者：
Kornelsen, Jude
中科院分区：
文献类型：
--
作者：
Dowler, Melanie;Rushton, Eleanor;Kornelsen, Jude
简介 在加拿大和国际上，获得堕胎仍然具有挑战性，特别是对于那些生活在农村和偏远社区的人来说。国际研究和政策呼吁培训包括助产士在内的高级实践临床医生，以提供堕胎服务，以填补不断扩大的准入差距。其他司法管辖区的研究考察了助产士对这种潜在的执业范围扩大的态度，但不列颠哥伦比亚省尚未进行此类研究。这项定性研究探讨了注册助产士对于扩大其执业范围以包括在不列颠哥伦比亚省提供药物流产的态度。方法 对不列颠哥伦比亚省注册助产士进行深入的定性访谈，并使用主题分析进行分析。结果 进行了十五次访谈。对访谈的分析确定了 5 个主要主题：将药物流产纳入助产士实践范围以增加获取机会、助产士护理模式与药物流产服务的一致性、注册助产士作为生殖权利监护人的作用、看待该职业的范式转变的必要性以及潜在范围扩大的实用性。讨论 这项研究表明，一些不列颠哥伦比亚省的注册助产士有兴趣将药物流产纳入其执业范围。助产士有潜力弥补堕胎提供者服务不足的地区和无法进行药物堕胎的社区的一些医疗保健服务差距。需要进一步研究以更全面地了解整个不列颠哥伦比亚省注册助产士的观点。
Introduction Across Canada and internationally, access to abortion remains challenging, particularly for those living in rural and remote communities. International research and policy call for the training of advanced practice clinicians, including midwives, to provide abortion services to fill the ever-increasing access gap. Research in other jurisdictions has examined the attitudes of midwives toward this potential expansion of scope of practice, but such studies have not been undertaken in British Columbia. This qualitative research study explored the attitudes of registered midwives toward expanding their scope of practice to include the provision of medication abortion in British Columbia. Methods In-depth qualitative interviews with British Columbia registered midwives were conducted and analyzed using thematic analysis. Results Fifteen interviews were conducted. Analysis of the interviews identified 5 primary themes: the incorporation of medication abortion into the midwifery scope of practice to increase access, the congruence of the midwifery model of care and provision of medication abortion, the role of registered midwives as guardians of reproductive rights, the need for a paradigm shift in how the profession is viewed, and the practicalities of potential scope expansion. Discussion This study shows some British Columbia registered midwives are interested in including medication abortion in their scope of practice. Midwives have the potential to bridge some of the health care delivery gaps in areas underserved by abortion providers and communities where medication abortion is not available. Further research is needed to more fully understand the perspectives of registered midwives in British Columbia as a whole.