Emergency nurses left in the dark on abortion laws

Emergency nurses left in the dark on abortion laws | Image Credit: © sudok1 - © sudok1 - stock.adobe.com.

Lack of guidance in abortion ban states

Information and guidance for providing care to obstetric patients from nursing leaders or hospital administrators is not being given to emergency department nurses (ED) nurses in states with abortion bans, according to a recent study from the University of Massachusetts Amherst.¹

This data was discussed at the American Organization for Nursing Leadership 2025 annual conference, leading to informed discussion. According to nurses, the lack of support is leading to feelings of frustration, anger, and moral distress.¹

“Basically, the nurses felt like they were set adrift with no guidance, no support, no backup, and they were concerned for their patients,” said Lisa Wolf, PhD, lead author and associate professor at the Elaine Marieb College of Nursing.¹

According to Wolf, the quality of care is impacted by the lack of communication. This includes whether patients receive care at all.¹

Evaluating nurse perception toward obstetric care

The study was conducted to evaluate how nurses perceive abortion bans in the context of providing obstetric care.² Participants included ED nurses in states with and without abortion bans, with no exclusion criteria.

Qualitrics, an online platform, was used to obtain participants’ demographic data and information about their practice settings. A semistructured interview was developed using nursing and anthropological perspectives, then performed across 1 hour over Zoom for each participant. These were recorded and transcribed using Zoom software.²

Research team members analyzed the data and reached a thematic meaning. Saturation was determined by interview 18, with appropriate geographic representation reached through the final 4 interviews.²

Participant demographics and institution communication

There were 22 ED nurses included in the final analysis, 19 of whom worked in a state with some care-limiting legislation. Of nurses, 82% were female, 72.7% White, 50% aged 35 to 44 years, 45% with a bachelor’s degree, and 59% working as general staff nurses.²

According to participants, institutions had robust communication structures for most practice changes, including new equipment, new processes, and infection control. On an institutional level, communication structures included staff meetings, emails, communication books, online education, and 1-to-1 instruction.²

Poor communication about abortion bans

Of nurses working in states with an abortion ban, 30% did not know if a ban had been implemented in their state. Eighteen of these participants reported not receiving any information about the restrictions from their administration. The 1 other participant only received verbal communication. No written documentation was provided.²

While ED nurses reported confusion surrounding the clinical implications of important bans, these participants expressed a belief that other reasons were responsible for this lack of communication. This generated a political theme.²

“It's political, it's religious. It just kind of stems on a bunch of issues you don't really want to talk about work,” said one participant. Similar beliefs were expressed by other participants.²

Some participants also expressed thoughts that nurses were not informed of a potential threat to their license because of abortion bans to avoid instances where they would leave their practice. Regardless of individual beliefs about the reasons, many participants considered that the decision not to inform nursing staff about abortion was consciously made by administrations.²

Silence and fear among nurses

Nurses reported negative interpersonal effects from this lack of communication, including increased difficulty communicating with patients. Some nurses shared they would not discuss abortion with their patients, generating a theme of silence.²

“If somebody else finds out that I gave that patient that information … they could potentially bring a civil lawsuit against me,” said a participant from Texas.²

Moral distress and isolation

These difficulties led many ED nurses to express distress, with a theme of do no harm. This distress was heightened by the lack of communication, especially in nurses who knew about the care trajectory for pregnancy emergencies such as ectopic pregnancies and incomplete miscarriages. Overall, this highlighted a trend of anger and frustration among ED nurses.²

“The overwhelming takeaway for me was the communicative isolation that nurses faced,” said co-author Lynnette Arnold, MD, a linguistic anthropologist at UMass Amherst.¹ “They were essentially operating in the same kind of informational vacuum that all the rest of us are.”

References

1. ED nurses report radio silence when it comes to guidance for care of pregnant patients in states with abortion bans. University of Massachusetts Amherst. March 31, 2025. Accessed April 8, 2025. https://www.eurekalert.org/news-releases/1078875.
2. Wolf L & Arnold L. Medical-legal communication among emergency nurses in states with abortion bans. The Journal of Nursing Administration 2025;55(4):E17-E23. doi:10.1097/NNA.0000000000001562