Publication of Updated Guidance: ‘Termination of Pregnancy: An RCN Nursing Framework’
3 December 2020
The Royal College of Nursing (RCN) has recently published updated guidance entitled ‘Termination of Pregnancy: An RCN Nursing Framework’ (17 November 2020), intended for nursing and midwifery staff caring for women undergoing abortion, that highlights new references and reading that should be familiar to those working in this field.
According to the National Institute for Health and Care Excellence (NICE), a third of women will have one or more abortions during their reproductive life. It is therefore important that staff working in this specialist area, whether within the National Health Service (NHS) or the independent sectors, receive continued professional development of the highest quality.
The latest version of the RCN guidance highlights legislative changes and updated recommendations. These include:
- The recommendation that education should be provided for all staff involved in the service, as prompted by the 2019 RCN Women’s Health Forum Committee’s survey to research the level of staff skills and education provision.
- The change in legislation in Northern Ireland on 1 April 2020, relating to termination of pregnancy (TOP); to date, the Department of Health in Northern Ireland has yet to commission TOP services and women are able to access abortion procedures in England, Scotland and Wales free of charge. The legislation acknowledges the need for conscientious objection for staff.
- Timescales have been added and women should be offered an assessment within 1 week of their request.
- Anti-D information has been updated; women having medical treatment up to 9+6 weeks’ gestation no longer need this intervention and the framework confirms this.
- The information around nurses performing surgical TOP has been removed; changes are expected. [NB. It is worth noting that while the Abortion Act 1967 does not state that nurses and midwives cannot do surgical abortions, the Department of Health will not approve nurses and midwives performing surgical abortions.]
The new references and extended reading list that staff should be sure they are familiar with (and which are detailed in the updated guidance) include:
- Department of Health in Northern Ireland (2020) – A New Legal Framework for Abortion Services in Northern Ireland: UK Government Consultation Response
- National Institute for Health and Care Excellence (NICE) (2019) – Abortion Care (NICE Guideline 140)
- Royal College of Obstetricians and Gynaecologists (2020) – Coronavirus (COVID-19) Infection and Abortion Care
- Royal College of Nursing (2019) – Nursing Education in Termination of Pregnancy Services
- Royal College of Nursing (2020) – Genital Examination in Women: A Resource for Skills Development and Assessment (4th edition)
Changes in the provision of abortion care across the UK are currently being developed; the RCN guidance is due to be updated again in 2021/2022.
Termination of Pregnancy – An RCN Nursing Framework November 2020
Laura Rutherford, Lead Nurse, Emergency Gynaecology Assessment Unit (EGAU), North West Anglia NHS Foundation Trust, Peterborough City Hospital, Peterborough, UK and Nurse/Midwife Representative on BSACP Council