San Diego Union-Tribune, March 3, 2022
By Paul Sisson
A new bill introduced by state Senate President Pro Tempore Toni Atkins of San Diego seeks to add first-trimester abortions to the range of services that experienced nurse practitioners can perform without the supervision of a physician.
Soon to be assigned to a committee, Senate Bill 1375 would clarify two existing pieces of legislation.
In 2013, Assembly Bill 154, also sponsored by Atkins, extended the ability to perform aspiration abortions to physician assistants, certified midwives and nurse practitioners provided they had proper training and were supervised by a qualified doctor. In 2020, Assembly Bill 890 allowed nurse practitioners to work without doctor supervision provided they had at least three years of experience and subject to additional rules and procedures that are still being worked out by state regulatory bodies.
The latest legislation, introduced on Feb. 18, seeks to clarify its predecessors, explicitly stating that those nurse practitioners who meet the requirements to practice on their own can perform abortions in addition to a wide range of other procedures. Generally, nurse practitioners, who have a high degree of medical training, are confined to working only under “standardized procedures” issued by a doctor.
In a media briefing Wednesday, Atkins, who said she often found herself hiring nurse practitioners when directing clinical services at a San Diego women’s health clinic, said she believes there is no technical reason why nurse practitioners, who tend to serve as the backbone of care in primary care settings, can’t do the work without supervision.
And, she added, California is already experiencing an increase in the number of women arriving from other states where abortion is highly discouraged and may soon be banned pending the outcome of the Supreme Court’s deliberations around a challenge to the 1973 abortion opinion Roe v. Wade.
“We already know that more women are making the trek to California, because they already know they’re not going to be able to get the service in their home state,” Atkins said. “As states like Texas and others start to restrict further abortion, it just makes sense that women are going to find other places to go.”
Expanding scope of practice, she further argued, would be a boon in small communities that often have trouble recruiting and holding onto doctors. In some cases, she said, clinics in rural communities have been forced to close when supervising doctors retired or moved.
There has recently been some talk about helping women financially to come to California if their home state does not allow abortion. Atkins said that a future bill is expected to address that issue, but that private, not public, money is likely to be used within a “framework” created by legislation.
Historically, the California Medical Association has opposed expansion of the “scope of practice” for nurse practitioners, but did not appear to have taken a formal position on SB 1375 Thursday.
Jodi Hicks, president of Planned Parenthood Affiliates of California, Dr. Marketa Houskova, executive director of the American Nurses Association California chapter, and others have expressed support for the bill.