Can nurses perform manual vacuum aspiration (MVA) as safely and effectively as physicians? Evidence from India

Dilatation and curettage versus manual vacuum aspiration for first trimester clandestine abortions

“…Jejeebhoy et al reported that trained nurses could perform the procedure as efficiently as physicians with the same complications rate. 13 Antibiotic cover after abortion was similar in both groups with no statistically significant difference in the mean duration of use in the two groups. In our series, six women in the D&C group had uterine perforations as against none in the MVA group (P=0.004).…”

Feasibility of Expanding the Medication Abortion Provider Base in India to Include Ayurvedic Physicians and Nurses

“…Evidence from India on the feasibility of abortion provision by other competent providers is sparse. A recent study found that manual vacuum aspiration performed by nurses is as safe and effective as that done by allopathic physicians; 12 however, similar studies related to medication abortion have not been conducted. In the current study, we sought to generate evidence that could inform policymakers and the medical community in India about the feasibility of expanding the categories of health care providers authorized to provide medication abortion.…”

“…11,12 Moreover, a recent study from Nepal, where nurses are legally permitted to terminate pregnancies using medication, found that medication abortions provided by nurses and auxiliary nurse-midwives were as successful as those provided by physicians.…”

Determinants of the implementation of a new practice in hormonal contraception by Quebec nurses

“…Indeed, most of studies conducted thereafter in developing and industrialized countries demonstrated the safety and efficacy of interventions such as providing hormonal contraceptives, prenatal and postnatal care, inserting IUDs and performing deliveries, C-sections and surgical abortions, when delivered by various non-physician health workers (community health workers, nurse assistants, etc.) (Armstrong & Stover, 1994;Aziz & Osman, 1999;Farr, Rivera, & Amatya, 1998;Eren, Ramos, & Gray, 1983;Gardner et al, 2008;Harper, Balistreri, Boggess, Leon, & Darney, 2001;Hoke, et al, 2012;Jejeebhoy, et al, 2011;Lassner, et al, 1995;Mullany, et al, 2010;Parsons et al, 2013;Stanback, Mbonye, & Bekiita, 2007;Warriner, et al, 2006;Warriner, et al, 2011). An increase in the number of providers can lead to significant gains in contraceptive use and may also free up the time of higher-level providers thus allowing them to handle more complex cases (Janowitz, Stanback, & Boyer, 2012;Mwaikambo, Speizer, Schurmann, Morgan, & Fikree, 2011).…”