SANC Circular 8/2019

26 November 2019

TO: National Department of Health
  Provincial Departments of Health
  Private Health Care Providers
  All Stakeholders


Training of Registered Nurses and Midwives to perform paracervical lock as an aspect of pain management during termination of pregnancy (TOP)


The South African Nursing Council (SANC) is cognizant of a number of initiatives by Non-Governmental Organizations (NGO’s) aimed at improving the health outcomes in an effort to improve the health and wellbeing of South Africans, which is highly commendable. However, it has come to the attention of Council that some of the training provided to nurse practitioners requires them to function beyond their Scope of Practice, as outlined in the Regulations Relating to the Scope of Practice of Persons Who are Registered or Enrolled under the Nursing Act, 1984. (GG No. R2598 of 30 November 1984).


This matter was discussed by the Council at its meeting held in September 2019. The Council expressed concern in particular with the training of Registered Nurses and Midwives to perform Paracervical block (PCB) to clients undergoing Manual Vacuum Extraction during Termination of Pregnancy (TOP). The SANC maintains that Paracervical block is an invasive procedure which is outside the current Scope of Practice of Registered Nurses and Midwives. For this reason, training of nurses to perform such a procedure is not supported by SANC. While the SANC supports professional development, it urges and encourages employers to ensure that in-service trainings/capacity building/skills development initiatives provided to nurse practitioners complies with the regulatory prescripts of the nursing profession and does not unduly expose nurses and midwives to potential unprofessional conduct.


Nurse practitioners are also reminded that they are independent practitioners who are personally accountable for their decisions and actions while carrying out their responsibilities in the profession and are urged to practice their profession within the ambit of legislation.


Kind Regards


Ms SA Mchunu
Registrar and CEO
South African Nursing Council