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, director of the Georgia Advanced Practice Registered Nurses Association of the nurses.
(READ MORE: Georgia health official sounds alarm as report confirms spike in pregnancy-related deaths)
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 care, 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 Health Department data, 63 registered nurses were trained in non-metropolitan counties across the state, including three registered registered nurses in Lowndes County near the Georgia-Florida line.
The family planning program saw a significant increase in federal funding in last year’s budget, said Diane Durrence, the department’s director of women’s health. And since the program officially launched in March, the department has implemented new initiatives in reproductive health.
According to Nancy Nydam, the department’s communications director, the contraceptive implant has been available for free or at a 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.
“Incorporating RNs as implant service providers will increase the workforce available to deliver those services,” Nydam said. “There will be more staff available in more locations, especially in rural areas where there are fewer higher-level providers.”
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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 Georgia’s pregnancy-related death rate increased by about 20% over a three-year period that included the first year of the pandemic. 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 risk rates in the state. According to the Georgia Data Analytics Center’s physician distribution data, there are few 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.”
(READ MORE: Maternal mortality in the US has more than doubled over the past two decades, with uneven proportions based on race and geography.)
“It’s important for women in Georgia to have family planning options and the support of health care professionals, especially today,” said State Representative Carolyn Hugley, a Columbus Democrat who also sits on the subcommittee. 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. I think it’s a great opportunity for us to learn and see how we can alleviate some of these issues.”
Although registered professional nurses have been authorized under Georgian law to provide this service since 1989, nurses have competed 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 the bill further divided healthcare professionals.
Launching the 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 or 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 the Department of Health 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’re the first people to actually meet with patients, talk to them, and build a relationship with them. So I think it’s a great opportunity for us to expand on their work and learn from it.”
Read more at GeorgiaRecorder.com.
