Expanding the Abortion Provider Workforce: A Qualitative Study of Organizations Implementing a New California Policy
| Autor: | Molly F. Battistelli, M. Antonia Biggs, Sara L. Magnusson, Lori Freedman |
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| Rok vydání: | 2018 |
| Předmět: |
030505 public health
Sociology and Political Science Public Health Environmental and Occupational Health MEDLINE Champion Obstetrics and Gynecology Context (language use) Certification Abortion Variety (cybernetics) 03 medical and health sciences 0302 clinical medicine Nursing Workforce 030212 general & internal medicine Business 0305 other medical science Qualitative research |
| Zdroj: | Perspectives on Sexual and Reproductive Health. 50:33-39 |
| ISSN: | 1538-6341 |
| DOI: | 10.1363/psrh.12051 |
| Popis: | Context Access to abortion care in the United States varies according to multiple factors, including location, state regulation and provider availability. In 2013, California enacted a law that authorized nurse practitioners (NPs), certified nurse-midwives (CNMs) and physician assistants (PAs) to provide first-trimester aspiration abortions; little is known about organizations' experiences in implementing this policy change. Methods Beginning 10 and 24 months after implementation of the new law, semistructured interviews were conducted with 20 administrators whose five organizations trained and employed NPs, CNMs and PAs as providers of aspiration abortions. Interview data on the organizations' experiences were analyzed thematically, and facilitators of and barriers to implementation were identified. Results Administrators were committed to the provision of aspiration abortions by NPs, CNMs and PAs, and nearly all identified improved access to care and complication management as clear benefits of the policy change. However, integration of the new providers was uneven and depended on a variety of circumstances. Organizational disincentives included financial and logistical costs incurred in trying to deploy and integrate the different types of providers. Some administrators found that increased costs were outweighed by improved patient care, whereas others did not. In general, having a strong administrative champion within the organization made a critical difference. Conclusions California's expansion of the abortion-providing workforce had a positive impact on patient care in the sampled organizations. However, various organizational obstacles must be addressed to more fully realize the benefits of having NPs, CNMs and PAs provide aspiration abortions. |
| Databáze: | OpenAIRE |
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