When the Supreme Court made the decision to overturn Roe v. Wade in 2022, individual states were suddenly granted the ability to form their own laws for protecting or banning abortion. This transition created a new focus on regulatory standards that, depending on the state you’re practicing in, may have changed significantly.
As a result, counseling a patient through their options and supporting them through their plan of care has become more complex, and requires a review of safe and ethical practice for nurses. Medication Abortion: A Clinical and Regulatory Review and Update by Premiere Education provides up-to-date information on abortion ethics and services.
These changes reinforce the importance of ethical standards in nursing when discussing medical abortion vs surgical abortion with patients. Continuing education is essential for knowing available options and how to appropriately pursue them for optimal patient outcomes.
Abortion Ethics
The ethics surrounding abortion are often affected by a variety of moral and social implications. A recent study indicated that abortion timelines are still a matter of debate in many states, and abortion ethics will likely continue to fluctuate in the future. Ethical and legal principles of abortion support and guide medical providers in their decision-making through challenging situations they may face when interacting with their patients and the medical community.
It’s important for nurses and healthcare providers to be informed and updated on the ethical and legal issues surrounding medical abortion vs surgical abortion in their region to help guide their patients to their best decision.
Surgical Abortions
A surgical abortion is an option for terminating a pregnancy that, depending on the medical provider, laws, regulations, and facility, can be performed in the first trimester through the beginning of the second trimester.
Surgical abortion is a very effective method for terminating the pregnancy, with a success rate of about 98%. Only 2% of those choosing this method need follow-up care. The procedure itself is relatively short, followed by a recovery period of 3-4 hours before the patient can return home.
Surgical abortions are usually reasonably comfortable for the patient, and pain can be managed with local anesthesia and oral medication. Most patients report experiencing mild discomfort and cramping but are able to return home shortly after.
The experience of a surgical abortion can be potentially traumatizing for patients, especially if they are young or do not have the support of a family member or friend. It’s critical for healthcare providers to inform patients of all of their options, what to expect from the procedure and potential side effects for a surgical abortion in a non-judgemental environment.
Medical Abortions
A successful medical abortion, also sometimes referred to as a non-surgical abortion, does not require any form of procedural intervention. A medical abortion uses medication to stimulate the body to pass the pregnancy from the uterus without surgical intervention. A medical abortion can be performed up to 10 weeks into gestation and has a success rate similar to surgical abortion. For those patients who are not successful when attempting a medical abortion, a procedural intervention is often needed as follow-up to support a safe patient outcome.
There are two medications used in a medical abortion that are given in a timed sequence. Mifepristone is used to block the normal hormone action during pregnancy, allowing the lining of the uterus to shed. Misoprostol then causes the uterus to contract, resulting in bleeding and the removal of the uterine contents.
Medical abortions require two visits. The first is typically in person, but in some areas of the country this can be accomplished via a telehealth modality. During the appointment medication will be prescribed and administered. The second visit will be a follow-up to confirm the pregnancy has been terminated.
The medical abortion option often results in more discomfort than a surgical abortion. The potential for strong cramping and the management of heavy bleeding for a number of hours should be clearly explained to the patient. It is often recommended that the patient have some form of over-the-counter pain medication to support them through the process.
Termination of the pregnancy occurs over a number of hours outside of the medical facility. It is strongly recommended that the patient has someone to support them for at least 24 hours after taking the second medication to safely manage any side effects or heavy bleeding.
Because medical abortion is non-invasive and takes place early in the pregnancy process, it is often a preferable option over surgical abortion. Healthcare providers should endeavor to inform patients about the relative risks of medical abortion vs surgical abortion, as well as communicate information about timelines and support requirements so they can make the best decision possible for their circumstances.
Safe and Ethical Considerations in Medical Abortion vs Surgical Abortion
The Supreme Court’s decision to overturn Roe v. Wade transitioned the decision-making on abortions to the local state governments. This change brings with it a greatly increased importance for healthcare providers and professionals to be informed about current ethical and legal issues surrounding medical abortion vs surgical abortion.
Medication Abortion: A Clinical and Regulatory Review and Update offered by Premiere Education will allow healthcare providers to keep current on standards and practices to provide the best abortion counseling and services possible. All our courses are created by licensed professionals. Medication Abortion: A Clinical and Regulatory Review and Update was developed by Anne Cockerham, PhD, RN, CNM, WHNP-BC, CNE, and professor at Frontier Nursing University.
