Expanding abortion access
California bill to let non-doctors perform procedure contrasts with other states’ moves to add restrictions
SACRAMENTO — As states across the country are passing laws to restrict access to abortion, California lawmakers are considering a significant expansion of who would be able to perform the procedure in the state.
Under a bill that passed its first committee hearing Tuesday, nurse practitioners, nurse midwives and physician assistants would be able to perform what is known as an “aspiration” abortion, which is the most common abortion procedure and takes place in the first trimester of a pregnancy.
The current form of the bill, SB1338 by Sen. Christine Kehoe, D-san Diego, would allow for only 41 people in the state, in addition to doctors, who have been through a pilot study on the issue to perform aspiration abortions, but backers say they expect that number to be significantly expanded as the proposal moves forward.
Also on Tuesday, an Assembly committee passed a separate bill that would expand access to birth control by allowing registered nurses to
dispense the medication.
“These bills are stark contrasts to what is happening nationally and in too many states across the country,” said Kathy Kneer, president and CEO of Planned Parenthood Affiliates of California, which is backing both measures.
Restricting abortions
Several states have passed controversial laws this year that mandate additional requirements for women to access abortion services. Arizona’s governor two weeks ago signed into law a ban on most abortions after 20 weeks, and other states have passed laws meant to strip funding from Planned Parenthood or to close abortion clinics.
The Virginia Legislature considered a bill that required transvaginal ultrasounds prior to abortions, a debate that generated national attention, though that provision ultimately was stripped from the measure. Congress debated a measure to allow employers to deny health coverage benefits for birth control for employees, though the measure was defeated.
California would not be the first state to allow people other than physicians to perform the aspiration abortion procedure. That is allowed in New Hampshire, Vermont, Montana and Oregon. California is, however, the only state that is pushing to expand the scope of who can perform abortions.
The aspiration procedure involves inserting a small tube through the cervix and into the uterus and then pumping out the fetus and other contents in the uterus. It’s the most common type of abortion.
Backers say the measure will help women in rural areas access abortion services as well as allowing women in general to obtain abortions from medical providers they already know.
Abortion opponents said allowing people other than physicians to perform the procedure would place women at risk for medical complications.
“I’m surprised that supporters of abortion would think this is a good move. They are lessening the medical requirements for someone who can do an abortion,” said Carol Tobias, president of the National Right to Life Committee. “That does nothing to promote safety or to protect women’s health,”
Tobias said the bill, compared with what other states are doing, shows “California is out of step with the rest of the country.”
Safety demonstrated
But a study by researchers at UCSF has found that nurse practitioners, midwives and physician assistants can perform the abortions as safely as physicians.
In a five-year research project begun in 2007, and with the permission of state officials, 41 of those medical providers statewide were trained and performed the aspiration technique at clinics including Planned Parenthood and Kaiser Permanente. The project will end this fall, but researchers had enough information last year, based on more than 8,000 abortions, to conduct an analysis.
Tracy Weitz, an associate professor at UCSF who led the study, said it was the first of its kind in the United States and showed that there was no meaningful clinical difference between a physician and the other medical professionals performing the abortion.
She said an aspiration abortion is “medically very simple and has very rare complications” and that opponents were conflating the social and political aspects of abortion with the medical reality.
Sen. Joel Anderson, R-alpine (San Diego County), opposed the bill and said the measure was specifically meant to benefit Planned Parenthood.
“This bill seems to be geared to expand their business at all costs,” he said.
The measure faces an additional committee hearing Thursday.