There are no clear guidelines for managing conscientious objection in nursing; not only is it tolerated, but in many institutions, it becomes an unwritten policy. Many nurses who are supportive of reproductive health choices for women know nurses who refuse to care for patients requiring basic nursing care when undergoing termination inductions. Nurses can hide behind the availability of conscientious objection to refuse to participate in abortion care, in spite of the fact that the American Nurses Association Code of Ethics clearly states that:
“The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.”
As a registered nurse, I am horrified by such a lack of compassion. How will we train the next generation of abortion providers if we don’t teach patient-centered care? Fortunately, there is a growing movement among nurses to include reproductive health care and embrace choice in pre-licensure and advanced practice nursing education, as well as the incorporation of manual vacuum aspiration and medication abortion skills into advanced nurse practice. Nursing Students for Choice (presently called Nursing Students for Sexual and Reproductive Health) is becoming more and more visible on the campuses of the leading nursing schools, and the National Abortion Federation Clinicians for Choice group has recently expanded its membership to include all nurses, not just those in advanced practice.
Hopefully these nascent efforts within nursing will expand to nurses in all settings, not just those who have already committed to caring for women seeking reproductive health care. The importance of the interprofessional health care team is essential to the continued success of the provision of reproductive health care, and nurses are fundamental to teams that meet all dimensions of patient care.
Amy Levi is the Albers Professor of Midwifery at the University of New Mexico College of Nursing. She is a Fellow in the American Academy of Nursing, and a Fellow of the American College of Nurse-Midwives. She serves on the Advisory Board of Clinicians for Choice and Reproductive Options in Education, and is a member of the Board of Directors of the Association of Reproductive Health Practitioners. She is the Chair of the Research Section of the Division of Global Health of the American College of Nurse-Midwives, and serves on the Editorial Boards of the journals Midwifery and Evidence-Based Midwifery.