‘Nurses must be allowed to perform abortions’

source:http://www.thehindu.com/news/national/other-states/nurses-must-be-allowed-to-perform-abortions/article7066423.ece

The government’s proposal has drawn sharp criticism from medical associations

Open to the idea of inclusion of nurses and AYUSH doctors as abortion providers, the Rajasthan government will soon start negotiations with stakeholders to arrive at a consensus on the issue.

“If you ask me, I am all for it. Nurses and AYUSH doctors should be allowed to perform abortions,”' Niraj K. Pawan, additional Mission Director, National Health Mission told The Hindu, but added that no decision would be taken without extensive consultations.

The Centre recently announced its proposal to amend the Medical Termination of Pregnancy Act, 1971 to allow nurses and AYUSH (Indian system of medicines) doctors to perform abortions to provide safe abortion. The move has drawn sharp criticism from the medical associations.

“As an administrator, I would say it should be permitted, but with due precaution and diligence. We know for sure that 25 per cent of pregnancies are ‘unwanted’ which happen for various reasons including failure of contraceptives and teenage pregnancy is also a fact. Women come to us on a daily basis but many a time the case is bad when the woman reaches us,” Mr. Pawan explained.

There has to be a mechanism to deal with these issues. Safe abortion facilities are also a must from a family welfare point of view, he said.

In Rajasthan, 80 per cent of all trained doctors offer abortion facilities. Of the estimated 2.22 lakh abortions done annually here, officially between 2012-2014, only 40,000 women were offered abortion facilities, 35 per cent of these in district Hospitals, 18 per cent in the Medical College Hospitals and just 3.2 per cent at the Primary Health Centre. Under-reporting of abortions is a challenge in Rajasthan . Only public health facilities maintain records.Unsafe abortions are also one of the causes of maternal mortality.

Safe technologies

According to Vinoj Manning, Country Director, Ipas India the opposition to the inclusion of Nurses and AYUSH doctors as abortion providers come from an obsolete understanding or deliberate discounting of the huge advances made in safe abortion technologies like vacuum aspiration and medical abortion in the last two decades.

Mr. Manning further said what the Indian government is considering is standard practice in many public health systems of the world. Today nurses and other non-physician cadre provide early abortion services in around 17 countries.