Deborah Narrigan has a longstanding interest in the subject of abortion. She has been a member of the U.S. Food and Drug Administration Advisory Committee for Reproductive Health Drugs and participated in the review of the application of RU 486 in 1996.
EARLY ABORTION: Update and Implications for Midwifery Practice
Article first published online: 10 JAN 2011
1998 American College of Nurse Midwives
Journal of Nurse-Midwifery
Volume 43, Issue 6, pages 492–501, November-December 1998
How to Cite
Narrigan, D. (1998), EARLY ABORTION: Update and Implications for Midwifery Practice. Journal of Nurse-Midwifery, 43: 492–501. doi: 10.1016/S0091-2182(98)00057-3
CNMs/CMs and midwives as used herein refer to those midwifery practitioners who are certified by the American College of Nurse-Midwives (ACNM) or the ACNM Certification Council, Inc.; midwifery refers to the profession as practiced in accordance with the standards promulgated by the ACNM.
- Issue published online: 10 JAN 2011
- Article first published online: 10 JAN 2011
Medical abortion using methotrexate and misoprostol and manual vacuum aspiration are two new methods for pregnancy termination during the first 8 weeks of gestation. Compared to the regimen of mifepristone (RU 486) and misoprostol, both methods offer high rates of complete abortion and acceptability to users. Limitations of the new two-drug regimen compared with mifepristone include a longer time to effect abortion, transient gastrointestinal side effects, and risk of potential teratogenicity from methotrexate's cytotoxicity. Compared to standard surgical abortion, both methods allow women to avoid surgery, are more privately performed, and may be more easily accessible. The safety of first-trimester abortion provided by nurse practitioners and physician assistants has been established. Whether midwives add either new method to their practices depends on several factors. These include obtaining appropriate training, overcoming legal restrictions, and meeting professional and personal challenges inherent in providing early abortion care.