Bills would remove doctors from abortion process

June 4, 2013

By Katy Grimes


While other states have been passing laws restricting when a woman can have an abortion, for several years California politicians have been trying to move legislation in the other direction. Taking up efforts defeated last year, Assemblywoman Toni Atkins, D-San Diego, is pushing AB 154 to allow nurses, midwives and physician assistants to perform abortions.

California’s back-door into new policy

A California “pilot project” which started as a program to increase access to gerontology care in 1973 morphed into being used to train midwives and nurses to perform surgical abortion procedures.

The abortion program was quietly concealed in the pilot gerontology program behind a phrase in the code “expanding early pregnancy care.” But since 2006, this project has been used in some cities to train nurses and medical assistants to do abortions.

And state regulations were suspended in order to allow “Nurse Midwives, Nurse Practitioners and Physician Assistants” to do these procedures, according to former Assemblywoman Linda Halderman and former Sen. Sam Aanestad. Both lawmakers looked into the pilot program while still in office, and tried to get it stopped.

Planned Parenthood claims this bill is necessary to “integrate abortion care into current practice settings.”

39 states still prefer doctors

If signed into law, California would be the fifth state to permit non-physician abortions. Thirty-nine other states require a licensed physician to perform abortions.

Assemblyman Dr. Richard Pan, D-Sacramento, has another bill, AB 980, which would remove the current requirements that abortions are to be done in a medically surgical and sterile setting, with a post-abortion recovery area adequate for recovering patients, and a counseling area that is maintained and provides privacy for patients requesting it.

Planned Parenthood, the bill’s sponsor, says the existing requirements are contrary to public interest and are even unconstitutional.

I spoke with several nurses who said that midwives are unregulated and used primarily to assist with normal, healthy, full-term live births. A woman delivering with a midwife that shows any signs of complications is rushed to a doctor at a hospital in a sterile setting.

Previous legislation

Last year Sen. Christine Kehoe, D-San Diego, authored SB 1501, a bill originally written about boating and waterways. But Kehoe gutted it and replaced the language with the abortion bill.

Prior to SB 1501, there was SB 1338, also by Kehoe, which would have allowed nurse practitioners, nurse midwives and physician assistants to provide first-trimester abortions. Kehoe scaled her bill down to include only 41 providers that are involved in a UC San Francisco pilot program throughout the state. But a Senate committee deadlocked on the vote, and the bill failed to pass.

That bill was also sponsored by Planned Parenthoood, NARAL, the California Nurses Association, and the SEIU. Most of the bill’s analysis was provided by these organizations.

However, Kehoe took the language from the failed bill, then placed it in budget bill SB 623. Kehoe received much criticism for trying to cram a failed bill into a budget trailer bill without the usual  committee hearings, public notification or debate.

I wrote about Kehoe’s bills last year.

Back to the future

Atkins and proponents of the bill claim many women in California do not have access to abortion clinics, and end up waiting longer to obtain an abortion.

But as of 2009, California had 107 Planned Parenthood clinics around the state, the most of any state in the country. And that is just Planned Parenthood clinics; there are many clinics affiliated with Planned Parenthood, and many private doctors perform abortions.

So what’s the problem?

According to Planned Parenthood on its Web page advocating for AB 154, “Early abortion access is a critical public health issue. An estimated one in three women will decide to terminate a pregnancy by age 45. Yet many women often do not have sufficient access to early abortions because of the limited number of physicians providing the services in their communities. Almost half of the counties in California have no accessible abortion provider, requiring women to travel significant distances to terminate a pregnancy or wait for an appointment for services.”

This is ironic. An important Democrat political issue and campaign strategy for many years has been the claim that women needed access to doctor-performed abortions instead of illegal back-alley abortions by non-physicians.

“Existing law makes it a public offense, punishable by a fine not exceeding $10,000 or imprisonment, or both, for a person to perform or assist in performing a surgical abortion if the person does not have a valid license to practice as a physician,” language in the bill explains. Should these bills be passed by the Legislature and signed by Gov. Jerry Brown, that language would be eliminated by these bills, with non-physicians allowed to perform the abortions.

Opponents of these bills also say poor ethnic women are being unfairly targeted.

The Assembly passed Atkins’ legislation last week on a vote of 50-25. Only one Democrat, Assemblyman Rudy Salas of Bakersfield, voted with Republicans in opposition. Four Assembly members abstained from voting: Travis Allen, Ken Cooley, Steve Fox and Chris Holden.

The bill next will be heard and debated in the Senate.

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