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New bill would allow nurse practitioners in California to perform some abortions

San Francisco Chronicle, March 3, 2022

By Joe Garofoli

Anticipating an increase in people coming to California to seek abortions should Roe vs. Wade fall, state Senate leader Toni Atkins announced a bill Thursday that would enable nurse practitioners to perform first-trimester abortions without being under a doctor’s supervision.

The measure is one of 10 bills moving through the Legislature that are designed to strengthen abortion protections and provide services for tens of thousands of people expected to travel to California from the 26 states where the procedure probably would become illegal should the U.S. Supreme Court kill or severely gut the landmark abortion rights measure when it decides a case before it this year.

The court’s conservative 6-3 majority might move to limit abortion rights when it decides a Mississippi case it heard last year that proposes to ban abortions after 15 weeks. The 1973 Roe decision allows a woman to terminate a pregnancy before 24 weeks, after which a fetus could survive outside the womb.

Atkins, D-San Diego, said clinics around the state are already seeing clients traveling from other states seeking abortion services. While it is unknown how many women would be traveling to California should Roe fall, the number of out-of-state women of childbearing age who would find their nearest clinic in California would increase from 46,000 now to 1.4 million, many of them from Arizona, according to a report from the Guttmacher Institute.

“If you had asked me 30 years ago, when I was managing a clinic services for women’s reproductive health center, if I’d still be talking about defending Roe v. Wade and fighting for abortion access in 2022, I would have just said, ‘I certainly hope not,’” Atkins said this week. “But here we are.”

Nurse practitioners are advanced practice registered nurses. They hold master’s or doctorate degrees and can diagnose and prescribe medications, conduct physical exams and order screening or preventative therapies.

The measure would enable nurse practitioners who have been practicing at least three full-time equivalent years or 4,600 hours as of Jan. 1, 2023, to meet the requirements to be able to perform the procedure without a doctor’s supervision. It is unknown how many of the 30,000 nurse practitioners in California are expected to qualify under those conditions, according to the California Association for Nurse Practitioners.

Atkins and other abortion rights advocates said that the measure would also help people living in rural and underserved communities. Advocates say 40% of California counties do not have clinics that provide abortion services.

The measure will create “a host of qualified providers who can fill that gap, providing care not only for Californians, but for those who may seek care outside of their own states should Roe fall,” said Shannon Olivieri Hovis, director of NARAL Pro-Choice California.

Patti Gurney, president of the California Association for Nurse Practitioners, said federal guidelines recommend that there be 60 to 80 primary care physicians for every 100,000 people. But in California there are only 50 per 100,000, she said.

Over the next decade, there is expected to be a shortfall of more than 4,100 primary care providers of all kinds — mostly in rural counties, according to the California Future of Health Workforce Commission.

“This shortage is only growing. This bill will expand access to care for those who need it most,” Gurney said.

The California Medical Association has pushed back on previous attempts to expand the roles of non-physicians. Atkins said she has had preliminary discussions with the organization’s leaders about the measure.

“At this early point, we don’t have a position on the bill yet,” California Medical Association spokesperson Shannan Velayas said.

Link to article on San Francisco Chronicle

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