Provide works to make sure that women have access to abortion, especially those living in low-resource rural and Southern communities. Our work is rooted in the on-the-ground realities of women’s lives and of the systems and resources that are available to them. It is guided by our conviction that everyone has a role to play in supporting women’s access to abortion.

EVERYONE HAS A ROLE

UnplannedPregnancy Education in Nursing

Why Nursing Education?Many nurses do not have access to education on unintended pregnancy and abortion care, especially nurses living in states where abortion is highly stigmatized. This severely reduces our health care system’s ability to respond to the needs of thousands of pregnant women. It leads to staff shortages at family planning and abortion clinics and can prevent hospitals from being able to provide abortion care.

Provide, and the Provide-based ROE Consortium for Nursing, has been working on integrating unintended pregnancy care into nursing education and practice for 12 years. Our current focus is on a newly developed competency-based curriculum and on developing nursing leaders in Southern states.

By developing the expectation that all nurses will be able to care for women facing unintended pregnancy, and by creating curriculum resources that build that competency, we are working towards a future where no nurse is unprepared to care for unintended pregnancy. Towards a future in which all nurses feel competent, supported, and able. And towards a future where women are supported by the health care providers they trust, in whatever decisions they make.

Professional Ethics (PE)

Postpartum Contraception (PPC)

Public Health (PH)

Options Counseling (OC)

Quality and Safety (QS)

Global Health (GH)

Modules

http://provideaccess.org/nursingcurriculum/

The CurriculumThrough a national Delphi study, Essential Competencies in Unintended Pregnancy Prevention and Care (UPPC) for Nursing Education (Hewitt, C. and Cappiello, J., 2015), 85 nursing experts in UPPC reached consensus on 27 core educational competencies for nursing education, which provide a framework for this curriculum.

The modules help students hone their skills around the UPPC competencies. In the modules, students are given patient scenarios that require in-depth analysis to resolve the presented case with the highest quality of patient care. In addition, an orientation tools and self-assessment tools help the student learn and test their understanding before and after completing the module. Each module also includes faculty guides and teaching tips.

Options Counseling ModulePatient Scenario

The PatientIvy is 16 years old and her last menstrual period was 11 weeks ago. Sometimes she uses oral contraceptives and sometimes condoms, but neither consistently. She has never been pregnant before.

What HappenedIvy and her mother, Jody, come into the health center to confirm the pregnancy test Ivy took at home. While Ivy is in the bathroom, Jody reveals to the nurse that she was 17 years old when she gave birth to Ivy, and she knows how challenging it can be to be a young mother. She does not want this life for Ivy and would like the nurse to focus on abortion or adoption options if the test comes back positive.

Jody waits in the waiting room and when Ivy returns from the bathroom the nurse leaves to run the test. It is positive. Ivy and the nurse are alone together in the exam room.

Nurse: Ivy, your pregnancy test is positive. This means that you are pregnant. Ivy: That’s what I thought.Nurse: How are you feeling about this? Many women have mixed feelings about a pregnancy.Ivy: I think Brian would be a great dad. Maybe having a baby would be great for us, bring us closer. I don’t know.Nurse: Tell me more about what you are thinking. (Pause. Ivy does not respond). Ivy, this is an important decision for you and sometimes it can be helpful to get support and talk it through with family or friends. Would you like me to ask your mother to come in here to be with you?Ivy: Yes.

The nurse leaves and returns with Jody who sits next to Ivy.

Nurse: Ivy, you have several options to consider. You could choose to continue the pregnancy and parent the child, you could chose to have an abortion, or you could continue the pregnancy and plan an adoption. Ivy: But doesn’t having an abortion mean I can’t have kids later? What if this is my only chance to be a mom? Nurse: Since abortion became legal in the U.S. in the early 1970s, researchers have studied the safety and risks of abortion. Abortion is a very safe procedure and should pose no future problems for you. No matter what you chose to do, making a decision like this is often very difficult even when you know what the right choice for you is.Jody: Thanks so much. Depending on what Ivy decides to do, do you perform these procedures here, or does Ivy need to make an appointment somewhere else?

Discussion

1. While Ivy is in the bathroom, what can the nurse say to her mother Jody?2. What is non-directive, patient-centered options counseling?3. How can the nurse explain the safety of abortion?4. How can the nurse make an effective referral?