Abortion affects 43% of women by the age of 45. Despite these high numbers, some NPs have told me that this issue doesn't affect their patient population. If you haven't dealt with this issue, your patients may not be telling you, or perhaps you are not asking the right questions.
I am pro-choice, but not because I think women should have abortions. Most of my career has been spent helping women avoid pregnancy if they don't want it. I am pro-choice, but not out of personal beliefs that it is right or wrong, but because the women served by me and other NPs have their own personal beliefs about what is right and wrong for themselves. I believe in a woman's ability to make her own moral choices about pregnancy. I believe that abortion should remain legal and safe.
I became pro-choice well before I even became an NP. A sociology project I did as a sophomore in college convinced me. In my survey of various sexual health matters, I asked freshman and sophomore women if they had ever been pregnant and if they had had abortions. The final tally was that 5% of those women had had abortions. What makes this figure dramatic is that the survey was conducted in 1971[forms light horizontal]a year before Roe vs. Wade.
The women in this population of mostly white, affluent students had flown to Puerto Rico, to Scotland, or had gone to private clandestine providers in the U.S. With enough money, the procedures were accessible to them. However, many of the procedures they described were not as safe as today's early abortions. Many occurred later in the pregnancy, primarily because it took much longer to make arrangements. The procedures included inserting a catheter into the uterus and sending the woman home to miscarry. It was scary. In other parts of the world, women still die every day if legal abortion isn't available to them.
If you talk to clinicians who were practicing back then, they can also tell you about the women who came into emergency rooms and died on the OB floors. Those experiences made many health care providers pro-choice even before there was choice.
As NPs, we counsel and help patients make decisions for themselves. We should not be making moral decisions for them. We may feel ambivalent and even tense about the decision a woman may make, but we cannot be moral decision makers. Only the woman herself can make the right choice. As part of the global community, we need to recognize that we are hardly in the position to tell a woman from another culture thousands of miles away what choices she should make. We should support legalized safe abortion for women throughout the world. Doing less costs women their lives.
On April 24, 2004 in Washington, D.C., the National Organization for Women, Planned Parenthood Federation of America, NARAL and the Feminist Majority are organizing a March for the Freedom of Choice. Whether you plan to attend the march or not, it is an opportunity to support choice for women in your own community. Help save women's lives.
Susan Wysocki, RNC, NP, FAANP