06/02/2023: The resources in this article have been updated.

Written by Sadia

In the United States, depending on certification, education, and training, midwives can be either licensed midwives (LMs), certified professional midwives (CPMs), or certified nurse midwives (CNMs). Midwives are essential public health agents in maternal health, newborn care, and community healing. Midwives are often depicted as providers who solely deliver babies, yet the midwifery scope of work includes preconception care, prenatal care, postpartum care, and abortion care. Outside of the United States, midwives often provide primary care to women and newborns as well.

Doulas are trained professionals who provide guidance and support to someone who is experiencing a significant reproductive event, such as pregnancy, childbirth, pregnancy loss, abortion, and the postpartum period. Doula training and certification can vary.

People seek the essential care of midwives and doulas in all aspects of the reproductive spectrum. In the United States, CNMs are allowed to prescribe medications in all 50 states, whereas CPMs and LMs have varying permissions depending on local and state legislation. Doulas do not have prescribing privileges; however, they provide education, resources, and support for those seeking abortion.

Here are some ways to support the role of midwives and doulas in abortion care:

• Support manual vacuum aspiration (MVA) and medication abortion (MAB) training opportunities for midwives in states where regulations and credentialing allow them to perform these services. In states that do not allow them to perform abortion care services, support policy efforts that expand clinician scope of practice laws to include APCs as abortion providers.
• Advocate for the use of doulas at your practice. It has been noted by clinicians and clinic staff that abortion doulas have had a positive impact on their practice. It has helped to reduce demand on clinicians at high-volume sites, and has allowed them to focus on the technical aspects of their work while being assured that the patient’s physical, emotional, and educational needs were still being taken care of.
• Work with midwives and doulas to integrate trauma-informed care into patient interactions and workplace
• Provide space and support when explaining all treatment and management options. Be mindful of safety and privacy concerns as you strive for the best care possible. Support the decision of patients who choose to receive care from midwives and doulas

RHAP Resources:

How to Use Abortion Pills Fact Sheet

How to Use Misoprostol-only for a Medication Abortion

Non-RHAP Resources:

North American Registry of Midwives

Birth Advocacy Doula Trainings

Advocates for Youth

Plan C

Howtouseabortionpill.org

Confronting Pregnancy Criminalization: A Practical Guide for Healthcare Providers, Lawyers, Medical Examiners, Child Welfare Workers, and Policymakers

Miscarriage and Abortion Hotline

Aspiring Midwives

Midwifery education in the U.S. – Certified Nurse-Midwife, Certified Midwife and Certified Professional Midwife

Sources:

Tillman, S, Levi, AJ. Midwives in abortion care. Journal of Midwifery and Women’s Health. 2019 Nov, 195-198. doi: https://doi.org/10.1111/jmwh.13039

Carvajal, B et al. Experiences of midwives and nurses when implementing abortion policies: A systemic integrative review. Midwifery. 2022 Aug, 103-110. https://doi.org/10.1016/j.midw.2022.103363

Lindsey A, Narasimhan S, Sayyad A, Turner D, Mosley EA. “I can be pro-abortion and pro-birth”: Opportunities and challenges for full spectrum care among doulas in Georgia. Front Glob Womens Health. 2023;4:966208. Published 2023 Mar 1. doi:10.3389/fgwh.2023.966208

Pharma-free: The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or products. The information in the Insights is unbiased, based on science alone.