With Roe in doubt, states consider letting nurses abort


NEW HAVEN, Conn. (TSTIME) — Abortion rights advocates have seen a problem: There are a limited number of medical providers who can legally perform abortions. In some states, one solution has been to allow more providers beyond just doctors.

But to allow other providers — such as advanced practice registered nurses, physician assistants, and certified nurse midwives — to perform early abortions, changes to state laws were needed.

These legislative initiatives gained urgency once a leaked Supreme Court draft opinion showed the justices appeared poised to overturn Roe v. Wade.

Proposed vendor extensions are being pushed back by critics. They say letting non-doctors perform abortions could endanger women’s health, especially if medical complications arise, and they question whether mid-level practitioners are qualified.

“All of these restrictions and prohibitions that we’re seeing across the country are directing more progressive states to, ‘How can we expand care? think tank that supports abortion rights.

Here’s a look at how the vendor issue unfolds:


The goal, proponents say, is to expand access to abortion before a potential influx of out-of-state patients from places where abortion could become illegal. Having more providers will also reduce wait times for patients in the state and improve access for underserved communities.

The various proposals allow advanced practice clinicians to perform medical abortions, clinic abortions, or both.

Abortion rights advocates say these clinicians often perform more complicated procedures such as IUD insertions, early management of miscarriages, and endometrial biopsies, a procedure in which a small piece of the lining of the the uterus is removed to check for cancer or other problems.

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Proponents say randomized trials have shown that vacuum aspiration abortions — a common early abortion that involves an aspiration procedure — can be performed safely by these clinicians.

“We know this procedure is effective and has an incredibly low 1% complication rate,” said Amanda Skinner, CEO of Planned Parenthood of Southern New England.


When Connecticut lawmakers considered a provider expansion bill earlier this year, the state’s medical society warned of a potential “slippery slope” toward what it called “providers mid-level” performing surgeries, which are riskier. In its submitted testimony, the Connecticut Medical Society said any new law should be very clear about limiting these providers to only in-clinic or office-based vacuum abortions.

Among those opposing the expansion of abortion is Carol Tobias, chair of the National Right to Life Committee.

“It’s no surprise that states are relaxing or changing the requirements of who can do them,” she said, calling it “a sign of desperation that they’re ready to put the lives of more women in danger”.

The focus, she said, should instead be on helping women “get through a difficult situation.”


Responding to the Supreme Court leak, New Jersey Governor Phil Murphy, a Democrat, recently announced that he wants to codify into law regulations passed in 2021 by the State Board of Medical Examiners, which allow a range medical providers to perform vacuum aspiration abortions, and create a fund to pay for training.

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Four months earlier, he had signed a law guaranteeing the right to abortion.

“We know that without access,” Murphy said, “rights mean nothing.”

In Connecticut — a Democratic-leaning state where Roe is codified in state law — a vendor expansion bill that passed with bipartisan support was signed into law earlier this month.

Abortion clinics across the state are already starting to see patients arrive from Texas, more than 1,800 miles (2,900 kilometers) away, where a new law restricts abortion after about six weeks.

That’s according to Skinner, the regional CEO of Planned Parenthood, during an interview at a clinic in New Haven.

Right now, she says, women face a frustrating two-week wait for in-clinic abortions at Planned Parenthood, which is the state’s largest provider.

Besides Connecticut, laws were passed this year in Maryland, Washington and Delaware to help bolster their provider pools by allowing non-physicians to perform some early abortions. And California lawmakers are currently considering a bill that would update a 2013 law and allow certain nurse practitioners to perform abortions without a doctor’s supervision, as currently required.


Lawmakers in some states where Republicans control the legislature, the governor’s office, or both have attempted to pass legislation expanding the pool of abortion providers.

The bills faced an uphill battle.

North Carolina is surrounded by states with so-called trigger laws, which would immediately ban abortion if Roe were overthrown.

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The state lacks doctors who perform abortions, and that will likely get worse if women from out of state start seeking abortions there, said state Rep. Julie von Haefen, a Democrat.

“We have 100 counties in North Carolina. Ninety-three of those counties do not have an abortion provider. All of our abortion clinics are centralized in our urban areas,” she said. “So this is going to cause a big problem – even just for women who are just traveling in our state. We have a great state.

Von Haefen introduced a comprehensive bill last year to remove what she calls “barriers” to abortions, including ending the ban on non-doctors performing abortions.

This legislation failed, and von Haefen is not optimistic that it will come to a vote this year. The state has a Republican-controlled General Assembly and a Democratic Governor.

Similar bills to expand the pool of abortion providers have been proposed in Arizona and Nebraska, but they too have failed.

Instead, Nebraska abortion rights lawmakers and lobbyists said they focused this year on fighting a trigger law and two other anti-abortion bills, according to Sofia Jawed. -Wessel, associate professor of health and kinesiology at the University of Nebraska at Omaha.

“I’m sure we’ll continue to push for these pro-choice bills in future sessions, depending on Roe’s outcome and the very likely special session that will be called if Roe is overturned,” she said. declared by e-mail.


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