A California lawmaker, bucking a trend in other states to restrict abortion, has proposed to broaden access by permitting nurse-midwives and others to perform procedures now done only by doctors.
The measure by Assembly Majority Leader Toni Atkins, a San Diego Democrat, would allow abortions by midwives, physician assistants and nurse practitioners in the first 12 weeks of pregnancy. Atkins said the bill is aimed at women in counties without abortion providers. The proposal goes before the Assembly Health Committee today.
California isn’t alone in its course. New York Governor Andrew Cuomo, a Democrat, has vowed to decriminalize late-term abortions when a woman’s health -- not just her life -- is at risk. A Washington plan to require insurers to cover abortions, backed by Democratic Governor Jay Inslee, passed the state House only to be turned back in the Senate by a Republican-dominated coalition.
“California has a history of forward-looking, innovative solutions to problems, from technology to health care,” Atkins said by e-mail. “Even though we are a strongly pro-choice state, more than half our counties have no abortion provider.”
“It’s appalling,” said Camille Giglio, a lobbyist for California Right to Life, an anti-abortion group. “They are using the excuse of fewer abortion clinics to promote cheaper abortions for the clinics by lesser-trained people who are using abortions for their livelihood rather than a service to women.”
Democratic Control
While Democrats control both chambers of the California legislature, a similar bill failed last year after some Democrats said they were concerned that abortions performed by non-physicians wouldn’t be as safe. The bill was amended to allow nurse practitioners and other clinicians to perform non- surgical abortions, and was signed by Governor Jerry Brown, a Democrat. Atkins’s bill would remove that restriction.
Researchers at the University of California, San Francisco, in January published a study in the American Journal of Public Health that said that complications from abortions conducted by nurse practitioners, nurse midwives or physician assistants were “clinically equivalent” to those performed by physicians.
If approved by lawmakers, California would be the fifth state to permit non-physician abortions, joining Montana, New Hampshire, Oregon and Vermont, according to a UC-San Francisco study. Thirty-nine states require a licensed physician.
New Restrictions
While the U.S. Supreme Court’s 1973 decision in Roe v. Wade struck down many state laws restricting abortion, statutes vary across the U.S. A flurry of new restrictions have been added in the past three years.
“States that are run by largely Republican and largely pro-life legislatures and governors are looking to push out from what they see as very substantial restrictions on their ability to create what they believe is better policy in this area,” said David Masci, a senior researcher with thePew Research Center’s Forum on Religion & Public Life, based in Washington.
In Kansas, Governor Sam Brownback signed legislation April 19 that bans abortions on the basis of fetal gender, declares that life begins at fertilization and prohibits public funding for abortions.
In North Dakota Governor Jack Dalrymple signed a law on March 26 making it a felony for a doctor to perform a nonemergency abortion once a fetal heartbeat can be detected, as early as six weeks into a pregnancy, with no exceptions for victims of rape or incest.
Legislators in 13 other states, including Alabama, South Carolina, Iowa and Mississippi, introduced similar legislation in the first three months of this year, according to Guttmacher.
Close Clinics
Alabama lawmakers in April joined six other U.S. states to require doctors performing abortions to have hospital-admitting privileges, which the legislation described as a safety measure and opponents said is an effort to close clinics.
The California legislation was praised by abortion-rights advocates.
“We are excited to see positive, proactive legislation moving,” said Tarek Rizk, director of communication for Washington-based NARAL Pro-Choice America. “It’s inspiring to see that some states are tackling these pro-woman maneuvers when there are other states that have pushed very aggressive anti- woman and anti-abortion laws.”
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