In Mexico City, early elective abortion to terminate pregnancy
was legalized in April 2007.1–3
Up to June 2013, 100 000 abortions
have been provided by trained physicians in Ministry of
Health hospitals and clinics.4
In 2009, it was estimated that
13.5% (16 475/122 455) of all abortions in Mexico City were
safe and legal and provided by the public sector.5
Even though
some safe and legal abortions are done in private facilities,6
most abortions are done outside sanctioned facilities and are
potentially unsafe.7
Despite Mexico City’s efforts to expand
services and increase the availability of the mifepristonemisoprostol
regimen for medical abortion, patient demand
is outpacing service capacity. Furthermore, conscientious
objections from trained physicians8
have further restricted
service capacity.
To expand the capacity of the health workforce, taskshifting
has been proven to be an important strategy.9
Evidence
from low-resource settings suggests that trained, mid-level
providers can administer medical abortion with similar outcomes
as physicians.10–14
In Mexico, nurses tend to have a subordinate role compared
to physicians and have traditionally been excluded from
decision-making.15 Approximately one-third of the Mexico
City Ministry of Health personnel are physicians and one-third
are nurses.16 Authorizing nurses to provide medical abortion
could increase the potential capacity for provision of this
service and help to address increasing demand.