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Post-abortion care
LETTERS TO THE EDITOR
Post-Abortion Care
ennial Congress of the International Confederation of Midwives.” JMWH Jul/Aug 2002;47(4):247. 2. Mueller S, Dudley S. Access to abortion: fact sheet. National Abortion Federation, Washington, D.C., 1997.
EDITOR: Thank you for the article by Miller, Billings and Clifford on Midwives and Post-Abortion Care (PAC) (JMWH July/August 2002). It is so important to have articles and information on expanded midwifery skills that effect women’s health, and, in the case of PAC, mean life or death for so many women across the globe. Access to post-abortion care is a key aspect of safe motherhood, and placing it squarely on the agenda of nurse-midwifery will increase access and quality of care more than most any other tactic. Let’s have more articles like this. Ellen Israel, CNM, MPH Senior Reproductive Health Associate Pathfinder International Watertown, MA EDITOR: I want to commend Suellen Miller, Deborah Billings, and Barbara Clifford for their interesting and informative article on midwives and postabortion care in the July/ August 2002 issue of JMWH. It is an important and timely article. The authors do misstate one statistic, however, that I’d like to correct. They write “In the United States it is estimated that 3% of women who have abortions require hospitalization because of serious complications (1).” In fact, modern induced abortion is an exceedingly safe procedure and serious complications are rare. The correct statistic is that about 3% of women who have abortions should have their abortion in the hospital because of serious risk factors, life threatening medical conditions or circumstances that require special life support equipment and expertise not found in a clinic (2). Janet Singer, CNM, MSN Advisory Board, Midwives for Choice Providence, Rhode Island
1. Miller S, Billings D, Clifford B. “Midwives and Post Abortion Care: Experiences, Opinions and Attitudes Among Participants at the 25th Tri-
© 2002 by the American College of Nurse-Midwives Issued by Elsevier Science Inc.
We would like to thank Janet Singer for her thoughtful letter regarding our recently published article on midwives and postabortion care, particularly for the clarification that she makes regarding the statistic on abortion complications in the United States. As Ms. Singer states, these are not complications related to the abortion procedure, but rather to preexisting conditions that put women at greater risk during one of the safest surgical procedures that a woman can undergo. According to the National Abortion Federation’s (NAF) Fact Sheet on safety of abortion: “Serious complications arising from abortions before 13 weeks are quite unusual. About 88% of the women in the United States who obtain abortions are less than 13 weeks pregnant. Of these women, 97% report no complications; 2.5% have minor complications that can be handled at the physician’s office or abortion facility; and less than 0.5% require some additional surgical procedure and/or hospitalization. Complication rates are somewhat higher for abortions performed between 13 and 24 weeks (1).” Suellen Miller, CNM, PhD Deputy Director, Women’s Global Health Imperative San Francisco, CA Deborah L. Billings, PhD Senior Research Associate, Ipas Mexico City, Mexico Barbara Clifford, CNM, MPH Tucson, AZ REFERENCE 1. Dudley S. Safety of Abortion. National Abortion Federation, Washington DC; 2000. Available at: http://www.prochoice.org/ [Accessed September 23, 2002].
Reduced Frequency Visits for Prenatal Care EDITOR:
REFERENCES
502
REPLY:
It was with great interest that I read the article, “Reduced frequency prenatal visits in midwifery practice: attitudes
Journal of Midwifery & Women’s Health • Vol. 47, No. 6, November/December 2002 1526-9523/02/$22.00
Post-Abortion Care
ennial Congress of the International Confederation of Midwives.” JMWH Jul/Aug 2002;47(4):247. 2. Mueller S, Dudley S. Access to abortion: fact sheet. National Abortion Federation, Washington, D.C., 1997.
EDITOR: Thank you for the article by Miller, Billings and Clifford on Midwives and Post-Abortion Care (PAC) (JMWH July/August 2002). It is so important to have articles and information on expanded midwifery skills that effect women’s health, and, in the case of PAC, mean life or death for so many women across the globe. Access to post-abortion care is a key aspect of safe motherhood, and placing it squarely on the agenda of nurse-midwifery will increase access and quality of care more than most any other tactic. Let’s have more articles like this. Ellen Israel, CNM, MPH Senior Reproductive Health Associate Pathfinder International Watertown, MA EDITOR: I want to commend Suellen Miller, Deborah Billings, and Barbara Clifford for their interesting and informative article on midwives and postabortion care in the July/ August 2002 issue of JMWH. It is an important and timely article. The authors do misstate one statistic, however, that I’d like to correct. They write “In the United States it is estimated that 3% of women who have abortions require hospitalization because of serious complications (1).” In fact, modern induced abortion is an exceedingly safe procedure and serious complications are rare. The correct statistic is that about 3% of women who have abortions should have their abortion in the hospital because of serious risk factors, life threatening medical conditions or circumstances that require special life support equipment and expertise not found in a clinic (2). Janet Singer, CNM, MSN Advisory Board, Midwives for Choice Providence, Rhode Island
1. Miller S, Billings D, Clifford B. “Midwives and Post Abortion Care: Experiences, Opinions and Attitudes Among Participants at the 25th Tri-
© 2002 by the American College of Nurse-Midwives Issued by Elsevier Science Inc.
We would like to thank Janet Singer for her thoughtful letter regarding our recently published article on midwives and postabortion care, particularly for the clarification that she makes regarding the statistic on abortion complications in the United States. As Ms. Singer states, these are not complications related to the abortion procedure, but rather to preexisting conditions that put women at greater risk during one of the safest surgical procedures that a woman can undergo. According to the National Abortion Federation’s (NAF) Fact Sheet on safety of abortion: “Serious complications arising from abortions before 13 weeks are quite unusual. About 88% of the women in the United States who obtain abortions are less than 13 weeks pregnant. Of these women, 97% report no complications; 2.5% have minor complications that can be handled at the physician’s office or abortion facility; and less than 0.5% require some additional surgical procedure and/or hospitalization. Complication rates are somewhat higher for abortions performed between 13 and 24 weeks (1).” Suellen Miller, CNM, PhD Deputy Director, Women’s Global Health Imperative San Francisco, CA Deborah L. Billings, PhD Senior Research Associate, Ipas Mexico City, Mexico Barbara Clifford, CNM, MPH Tucson, AZ REFERENCE 1. Dudley S. Safety of Abortion. National Abortion Federation, Washington DC; 2000. Available at: http://www.prochoice.org/ [Accessed September 23, 2002].
Reduced Frequency Visits for Prenatal Care EDITOR:
REFERENCES
502
REPLY:
It was with great interest that I read the article, “Reduced frequency prenatal visits in midwifery practice: attitudes
Journal of Midwifery & Women’s Health • Vol. 47, No. 6, November/December 2002 1526-9523/02/$22.00