SECTION IV SUMMARY
- To establish abortion care as within APC scope of practice, interested parties should examine four types of evidence: historical, professional/clinical, education/training, and evidence of legislative, legal and regulatory environments. This evidence can be used to prepare a professional portfolio, educate state licensing boards about advancing scope of practice, support fellow APCs whose scope is challenged, and work with APC educators to develop abortion care training programs.
- There is substantial historical evidence of support from APC professional organizations for abortion care as within APC scope of practice. In addition, the essential documents of the professional organizations (practice standards, clinical and professional competencies, and ethical codes of conduct) contain language supporting abortion care as within APC scope. There is also clear clinical evidence that early abortion is safe.
- APC education curricula show the existence of didactic and, to a lesser degree, clinical abortion care training in entry-level APC programs, with greater emphasis on and availability of both at the post-graduate level.
- Since abortion was legalized in 1973, a number of state attorneys general have issued legal opinions and professional regulatory entities have issued advisories clarifying APC authority to perform abortions, especially in states with outdated practice acts or provider-restriction statutes. Two state licensing boards have placed abortion care within the scope of practice of competent and trained advanced practice nurses.
- Among the bases for stakeholder challenges to outdated abortion care laws are right-toprivacy provisions in state constitutions; state agencies’ charge to protect citizens’ health, welfare, and safety; requests (often based on proactive legal analysis) of state attorneys general to interpret anachronistic provisions in state laws; and the population’s changing health care needs.
- APCs must proactively protect and advance their scope of practice, while acting within state laws and regulations that govern their practice and in concert with their own knowledge and skills. Waiting until your own or a colleague’s scope is challenged to educate legislators and professional regulatory boards can spell disaster.