Midwives and other health professionals will be permitted to perform first-trimester abortions under a bill passed by the California legislature.
Pro-choice groups applauded the bill, saying too many California women do not have easy access to an abortion provider. Opponents said the bill will heighten health risks for women by allowing non-physicians to perform abortions.
It will “lower the standard of care for women,” California Assemblywoman Kristin Olsen, Republican, said Friday.
Assemblywoman Toni Atkins, the bill’s sponsor, said questions about the bill had been answered in four legislative hearings, and it clearly would not diminish the standard of care.
The measure, A.B. 154, passed handily, 49-25. It now goes to Gov. Jerry Brown, a Democrat and a pro-choice supporter, for his expected signature.
Early support for the Atkins bill came from a study published in January in the American Journal of Public Health (AJPH).
Some 5,800 physician-performed first-trimester abortions were compared with around 5,700 abortions performed by recently trained nurse midwives, nurse practitioners and physician assistants.
The rate of complications was higher in the non-doctors’ group — 1.8 percent compared to 0.9 percent with the doctors. But most complications were “minor,” and the non-doctors’ outcomes were deemed “statistically no worse than those performed by the more experienced physician group.”
Most abortions are performed in early pregnancy — before 12 weeks gestation — and vacuum or “aspiration” abortions are the most common kind of first-trimester procedures. It involves preparation and dilation of the cervix, and insertion of a straw-shaped cannula that is attached to a suction pump. When the cannula is placed against the fetus, it will suction the fetus out of the uterus, along with other uterine contents.
The process is considered safe for women, although it has risks for infection, bleeding, perforation of reproductive organs and the possibility that a second procedure would be needed if contents were left behind.
Supporters of A.B. 154 said having more health care professionals trained to perform first-trimester abortions will benefit women and save the state Medicaid funds, since second-trimester abortions cost more.
“Black, uninsured, and low-income women have less access” to first-trimester abortions, and “increasing the types of health care professionals involved in abortion care is one way to reduce this health disparity,” the AJPH article said.
NARAL Pro-Choice of California urged passage of the bill, along with ACCESS Women’s Health Justice, American Civil Liberties Union of California, Black Women for Wellness, California Latinas for Reproductive Justice, Planned Parenthood Affiliates of California, and California Women’s Health Alliance.
Pro-life groups said the industry is already underregulated, which is why most states are trying to set new rules for abortion clinics and require abortion doctors to have hospital-admitting privileges.
“The pro-abortion lobby will stop at nothing to force an abortion-first mentality on women and families — committing violence against weak and defenseless preborn children, and ignoring commonsense protections for women in some of their most vulnerable moments,” said Lila Rose, president of Live Action.