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Review
. 2025 Dec;33(1):2518672.
doi: 10.1080/26410397.2025.2518672. Epub 2025 Aug 6.

Abortion learning mechanisms for nurses and midwives: a scoping review of evidence

Martha Nicholson  1 , Lesley Hoggart  2
Affiliations
Review

Abortion learning mechanisms for nurses and midwives: a scoping review of evidence

Martha Nicholson et al. Sex Reprod Health Matters. 2025 Dec.

Abstract
in English, French, Spanish

Access to safe, affordable, and supported abortion care is a crucial component of reproductive justice and human rights. Abortion seekers consider nurses and midwives to be more supportive than other health professionals. Nurses and midwives have long been recommended providers of comprehensive abortion care, including second trimester care. This iterative scoping review aimed to explore the evidence on abortion learning mechanisms available to nurses and midwives and what can be improved about abortion training. Using the Arksey and O'Malley (Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1): 19-32) and Levac et al. (Scoping studies: advancing the methodology. Implement Sci. 2010;5(1): 69) scoping review frameworks, four databases were searched, resulting in 879 articles published in English from 01.01.2010 to 01.08.2024. The authors included 43 studies and identified five learning mechanisms. The evidence is presented under three themes: (1) the adequacy of abortion learning mechanisms for nurses and midwives, (2) listening to nurses and midwives' experiences, and (3) barriers to abortion training. This review found that in almost all legal and practice contexts, abortion training may be de-prioritised and hard to access because of institutional barriers, especially in centres of education. In conclusion, there is a low investment in abortion training for nurses and midwives. Policy-makers, health care systems, and educators should consider ways to continuously instil nurses and midwives with skills, confidence, and social authority to provide person-centred abortion care to combat harmful bias and mitigate the risk of reproductive coercion.

L’accès à des soins d’avortement sûrs, abordables et bénéficiant d’un appui est un élément essentiel de la justice reproductive et des droits humains. Les personnes souhaitant avorter considèrent que les infirmières et les sages-femmes les soutiennent davantage que d’autres professionnels de santé. Les infirmières et les sages-femmes sont depuis longtemps des prestataires recommandés pour des soins d’avortement complets, notamment au deuxième trimestre. Cette étude itérative de la portée visait à explorer les données sur les mécanismes d’apprentissage de l’avortement à la disposition des infirmières et des sages-femmes, ainsi que les améliorations possibles à apporter à cette formation. En utilisant les cadres d’étude de la portée d’Arksey et O’Malley (2005) et de Levac et al. (2010), quatre bases de données ont été consultées, ce qui a permis d’identifier 879 articles publiés en anglais entre le 1er janvier 2010 et le 1er août 2024. Les auteurs ont inclus 43 études et identifié cinq mécanismes d’apprentissage. Les données sont présentées sous trois thèmes: (1) l’adéquation des mécanismes d’apprentissage de l’avortement pour les infirmières et les sages-femmes; (2) l’écoute des expériences des infirmières et des sages-femmes; et (3) les obstacles à la formation à l’avortement. Cet examen a révélé que, dans presque tous les contextes juridiques et pratiques, la formation à l’avortement peut être dépriorisée et difficile d’accès en raison d’obstacles institutionnels, notamment dans les centres éducatifs. En conclusion, l’investissement dans la formation à l’avortement des infirmières et des sages-femmes est faible. Les décideurs politiques, les systèmes de santé et les éducateurs devraient envisager des moyens de transmettre de manière continue aux infirmières et aux sages-femmes les compétences, la confiance et l’autorité sociale nécessaires pour assurer des soins d’avortement centrés sur la personne, afin de lutter contre les préjugés néfastes et d’atténuer le risque de coercition reproductive.

El acceso a servicios de aborto seguros, asequibles y apoyados es un componente fundamental de la justicia reproductiva y los derechos humanos. Las personas que buscan un aborto creen que las enfermeras y parteras son más comprensivas que otros profesionales de salud. Desde hace mucho tiempo, se recomienda a las enfermeras y parteras como prestadores de servicios de atención integral al aborto, que incluye la atención en el segundo trimestre. El objetivo de esta revisión exploratoria iterativa era examinar la evidencia de los mecanismos de aprendizaje sobre aborto disponibles a enfermeras y parteras e identificar qué se puede mejorar en la capacitación sobre aborto. Utilizando los marcos de revisiones exploratorias de Arksey y O’Malley (2005) y Levac et al. (2010), se realizó una búsqueda en cuatro bases de datos, que produjo 879 artículos publicados en inglés de 01.01.2010 a 01.08.2024. Los autores incluyeron 43 estudios e identificaron cinco mecanismos de aprendizaje. La evidencia se presenta bajo tres temas: (1) la idoneidad de los mecanismos de aprendizaje para enfermeras y parteras, (2) escuchar las experiencias de enfermeras y parteras, y (3) barreras a la capacitación sobre aborto. Esta revisión encontró que en casi todos los contextos legislativos y de práctica, la capacitación sobre aborto podría ser despriorizada y difícil de acceder debido a las barreras institucionales, especialmente en centros de educación. En conclusión, se invierte poco en la capacitación sobre aborto para enfermeras y parteras. Los formuladores de políticas, sistemas de salud y educadores deberían considerar las maneras de infundir continuamente en las enfermeras y parteras habilidades, confianza y autoridad social para proporcionar servicios de aborto centrados en la persona, combatir los prejuicios dañinos y mitigar el riesgo de coerción reproductiva.

Keywords: abortion; education; midwifery; nursing; scoping review; training.

Plain language summary

Abortion care should be safe, affordable, and available in all communities. To facilitate this, health professionals need information and confidence to provide abortion care. Nurses and midwives are the largest group of health professionals globally and can safely provide abortion care when trained. With this scoping review, we wanted to find out if abortion training for nurses and midwives is reported as adequate, and what can be improved. We searched for and reviewed journal articles published between 2010 and 2024. Firstly, we found that abortion training in nurses and midwives’ centres of education was reported as inadequate. However, abortion care training through “on-the-job” opportunities was more successful. Collaboration with external organisations was shown to be an optimal way to deliver abortion training. Secondly, we learnt that nurses and midwives feel frustrated and confused because of gaps in abortion knowledge. Where available, continuous training was shown to allow nurses and midwives time to develop confidence. This is especially important because, in many settings, abortion is criminalised and stigmatised. Lastly, nurses and midwives face significant barriers to learning about abortion care. Barriers include faith-based and personal views held by health professionals and educators, and the limited investment in abortion care training and provision. Overall, we found that nurses and midwives learn in diverse ways. However, even those working or learning in settings with supportive abortion laws may have inadequate abortion training. Nursing and midwifery educators should invest in training and collaborate with external organisations to boost knowledge and skills in abortion provision.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Screening flow chart
Figure 2.
Figure 2.
Number of studies by region.
Figure 3.
Figure 3.
Research methods
Figure 4.
Figure 4.
Number of studies by year of data collection
See this image and copyright information in PMC

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