(GA Recorder) – The Georgia Department of Health is launching its Power of Family Planning program, an initiative aimed at reducing unwanted or complicated pregnancies. And women in rural Georgia will benefit the most.
Now, trained nurses are allowed to put contraceptive implants like Nexplanon in the arm. Until now, the implant could only be inserted by a doctor, a nurse or a doctor’s assistant.
Georgia is the first state to give registered nurses the opportunity to perform this procedure.
The Georgia Maternal Mortality Review Committee, the American College of Obstetrics and Gynecology, the Centers for Disease Control and Prevention and others have pushed for long-acting reversible contraceptives to reduce unwanted pregnancies, said Victoria Gordon, chief of US Georgia Advanced Practice Registered Nurses Nurses Association.
This can reduce the risk of preterm birth, low birth weight in newborns and other pregnancy-related complications, she said.
“Georgia could serve as a model for many other states in finding creative ways to increase access to women’s health, gynecology and obstetric care when no provider is available,” Gordon said. “So it’s a creative way of using what you have to achieve what needs to be achieved.”
The first group of registered nurses was trained last fall, and based on DPH data, a total of 63 registered nurses were trained in non-metropolitan counties across the state, including a total of three registered registered nurses in Lowndes County near the Georgia-Florida line.
Diane Durrence, the department’s director of women’s health, said the family planning program saw a significant increase in federal funding in last year’s budget. And since the program officially launched in March, the department has implemented new initiatives in reproductive health.
Advertisement at the Cobb County bus stop for the Georgia Department of Public Health’s Power of Family Planning program. (Aaleah McConnell/Georgia Recorder)
According to Nancy Nydam, the department’s communications director, the contraceptive implant has been provided at no or low cost in public health facilities for several years.
The problem is that in many rural communities, patients do not have access to local health departments, which in many cases are the sole provider of these services, she said.
“Bringing nurses on board as providers of implant services will increase the workforce available to provide those services,” Nydam said. “There will be more staff available in more locations, especially in rural areas where there are fewer higher-level providers.”
One of the goals of the Power of Family Planning program is to prevent the risk of high-risk pregnancies caused by cardiovascular disease and hemorrhage, which are two of the leading causes of pregnancy-related deaths in the state, said the government’s director of relations , Katie Kopp, who chairs the Maternal Mortality Review Committee.
That committee recently found that the rate of pregnancy-related deaths in Georgia increased by about 20% over a three-year period that includes the first year of the pandemic. And according to the US Maternal Vulnerability Index, Georgia has a high maternal vulnerability score of 62 in reproductive health care. This means access to quality family planning and reproductive services, such as abortion, is limited.
Mitchell County and adjacent Worth County have the highest maternal at-risk rates in the state. Mitchell County is 72nd and Worth County is 84th. According to the Georgia Data Analytics Center’s physician staff distribution data, there are little or no maternal physicians in these rural counties.
The closest county with only one active practicing physician in maternal and perinatal care is Lowndes County.
As chair of the House Health Budget Subcommittee, Thomasville Republican Representative Darlene Taylor is helping to shape the state’s health care budget.
And like any other program, Taylor said she will be watching to see if this program is working and reaching the right places.
“I represent rural Georgia, so it’s important to me that we have the same level of access that we have in the larger communities,” Taylor said. “That’s something I think will help.”
Rep. Carolyn Hugley, a Columbus Democrat who also sits on the subcommittee, said it’s important that women in Georgia have family planning opportunities and the support of healthcare professionals, especially today. When the US Supreme Court overturned decades-old precedent protecting access to abortion last June, Georgia’s six-week abortion ban went into effect about a month later.
“We are in a situation where there are so many areas in our state where maternal health services are unavailable,” Hugley said. “People are a long way from doctors. There is a shortage of medical professionals in certain counties. So I think it’s a great opportunity for us to learn and see how we can mitigate some of these issues.”
Although registered professional nurses have been authorized to provide this service under Georgian law since 1989, nurses have been competing with higher-ranking doctors to expand their services for years, Hugley said. This turf war even extended to this year’s legislative period.
Ultimately, however, lawmakers passed Senate Bill 197, which bans non-physicians, including nurses and physician assistants in advanced practices, from using the title “physician” in their advertisements, even if they have a doctorate degree. Many nurses argued that this bill would further deepen the division among healthcare professionals.
Launching this program is a way, particularly for registered public health nurses, to expand their services to those who need them most, Gordon said.
“Public health care workers are often trained and instructed in a variety of different procedures that may not fall within the usual scope or realm of RN,” Gordon said. “Allowing a nurse to administer this drug just increases its availability in those counties.”
According to Nydam, the training of public health nurses is supported by funding from the federal Temporary Assistance for Needy Families Block Grant, which DPH receives from the Georgia Department of Human Services.
The company providing training for the implantation procedure is Organon, a New Jersey-based pharmaceutical company that previously only trained physicians and mid-sized providers.
Nurses must complete observed checkoffs in addition to completing training and meeting required standards set by Organon, Nydam wrote.
“Nurses have always been an important part of our healthcare network,” Hugley said. “They are the first people to actually meet patients, talk to them and develop a relationship with them. So I think it’s a great opportunity for us to expand their activities and learn from them.”
