Nurses and midwives should be allowed to perform early-stage abortions, MPs told

Nurses and midwives should be given powers under the law to perform early-stage abortions, while the need for two doctors to sign off on the procedure should be scrapped, a report for MPs has said.

A shift is needed to reflect current practice in England, Wales and Scotland, according to recommendations made by the largest study of abortion in Britain.

At present, nurses and midwives are unable to prescribe abortion pills (given up to ten weeks of pregnancy in England), with the pills instead signed off by a doctor.

The new study said this should change so appropriately trained nurses and midwives can offer abortion pills, cutting bureaucracy and speeding up women’s access to early abortions.

Furthermore, the need for two doctors to say an abortion can go ahead should be scrapped, with nurses and midwives instead being able to stamp the paperwork for the patients they are treating, MPs were told.

Changes to law should also be made which allow nurses and midwives to perform vacuum aspirations for abortion up to 14 weeks, the report added.

Experts behind the study said these staff are already allowed to do this for women suffering miscarriage, arguing it should be extended to include abortions.

The report to MPs, which was funded by the National Institute for Health and Care Research, further called for an expansion of places considered suitable for abortion, such as community sexual and reproductive health services.

Currently, abortions are not allowed in these clinics and must be conducted on NHS premises such as NHS hospitals, or in other areas designated by the health secretary, including a person’s home.

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Researchers from the London School of Hygiene & Tropical Medicine (LSHTM) presented the study to the All Party Parliamentary Group on Sexual and Reproductive Health.

Experts interviewed 772 health professionals, 48 women with recent experience of abortion and held consultations with 15 key stakeholders.

Their research found that medical abortions, in which patients typically take abortion medication at home, now account for 87% of abortions in England and Wales.

While women in the study said they valued the convenience, ease, comfort, privacy and confidentiality of taking abortion pills at home, they also wanted the choice to request a surgical abortion.

According to the report, a reliance on abortion medication could lead to loss of crucial skills, adding there is a need to ensure sufficient numbers of staff are trained in surgical abortion so choice is maintained.

Kaye Wellings, professor of sexual and reproductive health research at LSHTM, said it "makes sense for nurses and midwives to be able to sign off abortions" as the provision is becoming "increasingly nurse-led".

She said there was "merit" in permitting nurses and midwives additional powers as it would "ensure that sufficient cadres of professionals have the skills needed to offer women a choice and address the current risk of valuable skills being lost".

"Evidence from the National Institute for Health and Care Excellence has already shown that women prefer nurse-delivered services, and our research has confirmed the current law that compels abortions to be performed by doctors is preventing best practice, compassionate care in the UK," she added.

Baroness Barker, co-chairwoman of the APPG on sexual and reproductive Health, said "there has never been a more important time to look at bringing abortion provision in line with modern healthcare practice".

She added the report’s findings "demonstrate the importance of listening to women’s views and experiences in order to ensure they have full control over their reproductive healthcare".

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