Provide, Inc.

Nurses are the largest and most trusted health care profession; their engagement in providing women with abortion care is an essential component of access. However, competing health care needs combined with stigma around abortion mean most nurses are unprepared to provide this care to women.  Drawing on over a decade as the only forum for nursing faculty addressing abortion, the ROE Consortium for Nursing is currently addressing one of the biggest single reasons for this gap: the lack of competency-based unintended pregnancy prevention and care (UPPC) curricula in graduate and undergraduate nursing educations programs.  Consistent and comprehensive core competencies in unintended pregnancy care will ensure that each nursing program provides the knowledge, attitude, and skills needed by nurses to care for women in their practice; to date such competencies have neither been articulated nor adopted by nursing in the U.S. Objectives for the work ahead are:   Competencies: Develop core competencies via focus on nursing (year 1-2). Curriculum: Create a competencies-based curriculum on unintended pregnancy prevention and care (year 2-3).  Champions: Cultivate new champions in nursing education and practice (year 2-4).

Developed 1 new training site and 15 new abortion providers in rural and underserved communities by organizing customized training and providing 1:1 technical support.

Provide is conducting a five year initiative to integrate and enhance pregnancy options counseling and abortion referrals into primary health care and social service sites serving women at risk of unexpected pregnancy, while simultaneously working to create the culture change necessary among local professionals to expand abortion services and training in the longer term.  Currently active in Iowa, Kentucky, Oklahoma, South Carolina and West Virginia, the project pursues the following objectives: Provide tailored options counseling and referrals training and technical assistance to primary health care and social service sites; Prepare and activate health care and social service provider "champions" to create conditions that support future activity to expand abortion services and training, within and outside of their institutional settings. By assessing current abortion referral practice at health care and social service sites, identifying and cultivating site champions, and addressing site-specific barriers to providing complete referrals and options counseling, we have the opportunity to change the manner in which these systems function in a way that will be immediately meaningful for women.  Additionally, by creating opportunities for health and social service providers to engage that are rooted not within the controversy of abortion as a political or moral issue, but rather within the context of caring for one's clients and patients, we have the opportunity to normalize abortion, build empathy, and grow a community of support for abortion care.

In the three years since project launch, the Miscarriage Management Training Initiative has brought improved miscarriage care to family medicine, Ob/Gyn and primary care sites, teaching hard-to-reach audiences that include physicians, advanced practice nurses, physician assistants and military personnel how to safely empty the contents of a woman's uterus.  The project provides unique exposure to these skills in restrictive settings for abortion, including Catholic hospitals and federally qualified health centers.  Clinical skills training opportunities are available to enhance competency in uterine evacuation, and technical assistance in support of systems integration is available for all training sites.  Currently active in Washington, South Carolina and Oklahoma, program elements include:   Exposure: To educate/train a variety of clinical sites types and providers in patient-centered miscarriage management. Training: To provide clinical skills training opportunities at academic or clinical settings. Integration: To assist sites to implement manual vacuum aspiration and medication services and integrate miscarriage management into training curriculum and/or practice. Organizing: To use MM-TI as an organizing strategy to 1) gain entry in restrictive settings; 2) encourage professional, evidenced based, patient-centered reproductive health care; 3) identify pro-choice allies or champions.