Learn more about advancing access to abortion care

Dr. Amy Levi presenting early results of some of ANSIRH’s HWPP Project research.

Resources | References: APCs in the US | References: APCs internationally


Studies demonstrating the competence of CNMs, NPs and PAs as abortion providers in the United States

  • Alan Guttmacher Institute. 1992. Vermont Physicians Assistants Perform Abortions, Train Residents. Family Planning Perspective 24:225.
  • Boyman K, Gibson C, Forman L. 2004. Comparison of complication rates in first trimester surgical abortions performed by physicians and midlevel providers. Paper presented at National Abortion Federation Annual Meeting, April 19, 2004, Burlington, VT.
  • Brown SA, Grimes DE. 1995. A meta-analysis of nurse practitioners and nurse midwives in primary care. Nursing Research 44(6):332-339.
  • Freedman M, Jillson D, Coffin R, et al. 1986. Comparison of complication rates in first trimester abortions performed by physician assistants and physicians. Am J Public Health 76(5):550-554.
  • Goldman MB, Occhiuto JS, Peterson LE, et al. 2004. Physician assistants as providers of surgically induced abortion services. American Journal of Public Health 94(8):1352-1357.
  • Hord CE, Delan GE. 1994. The Midwife’s Role in Abortion Care. Midwifery 10:136-141.
  • Kruse B, Gordon R, J. Tanenhaus J. 2001. The Role of Midlevel Providers in Abortion Care in the United States, Ipas. (Copies available from Ipas)
  • Lieberman D, Lalwani A. 1994. Physician-Only and Physician Assistant Statutes: A Case of Perceived But Unfounded Conflict. Journal of American Medical Women’s Association 49:146-149.
  • McKee K, Adams E. 1994. Nurse midwives’ attitudes toward abortion performance and related procedures. J Nurse Midwifery 39(5):300-311.
  • Narrigan D. 1998. Early Abortion: Update and Implications for Midwifery Practice. Journal of Nurse Midwifery 43:6.
  • Shotorbani S, Zimmerman F, Bell J, et al. 2004. Attitudes and intentions of future health care providers toward abortion provision. Perspect Sex Reprod Health 36(2):58.

For additional references, please see the APC ToolKit, Appendix 6.

CNM, NP & PA providers and abortion care internationally

  • Akhter HH. 2001. Expanding access: mid-level providers in menstrual regulation, Bangladesh experience. Ipas/IHCAR.
  • Berer M. 2009. Provision of abortion by mid-level providers: international policy, practice and perspectives. Bulletin of the World Health Organization 87:58-63.
  • Chong YS, Mattar CN. 2006. Mid-level providers: a safe solution for unsafe abortion. Lancet 368: 1939-40.
  • Dickson-Tetteh K, Billings DL. 2002. Abortion care services provided by registered midwives in South Africa. Int Fam Plan Perspect 28: 144-50.
  • Htay TT, Sauvarin J, Khan S. 2003. Integration of post-abortion care: the role of township medical officers and midwives in Myanmar. Reprod Health Matters 11: 27-36.
  • Kruse B, Gordon R, Tanenhaus J. 2001. The Role of Midlevel Providers in Abortion Care in the United States, Ipas. (Copies available from Ipas)
  • Jonsson IM, Zätterström C, Sundström K. Midwives’ role in management of medical abortion: Swedish country report. In: Expanding access: advancing the role of midlevel providers in menstrual regulation and elective abortion care, Pilanesberg National Park, South Africa 2_6 December 2001.
  • Sibuyi MC. 2004. Provision of abortion services by midwives in Limpopo province of South Africa. Afr J Reprod Health 8: 75-8.
  • Warriner IK, Meirik O, Hoffman M, Morroni C, Harries J, My Huong NT, et al. 2006. Rates of complication in first-trimester manual vacuum aspiration abortion done by doctors and mid-level providers in South Africa and Vietnam: a randomised controlled equivalence trial. Lancet368: 1965-72 .
  • Vaz F, Bergström S, Vaz Mda L, Langa J, Bugalho A. 1999. Training medical assistants for surgery. Bull World Health Organ 77: 688-918
  • Yumkella F. 1999. Nurse-midwives role for the expansion of comprehensive post abortion care services: the case of Kenya and Uganda. In: Third African population conference, Durban, South Africa, 6-10 December 1999. The African population in the 21st century. Vol. 3. Dakar: Union for African Population Studies, pp.193-209.