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You’re sitting here thinking “Oh great, another article by s.e. about reproductive rights, I’m about to get very angry and throw something.”
Well, I have good news for you! I’ve been assigned to the Department of Good Things today, and that means that I’m writing about a reproductive rights victory. Senate Bill 1501 in California could change the landscape for abortion access not just in its home state, but potentially across the nation, and by “change the landscape for abortion access,” I mean “radically improve access to abortion services.” That’s pretty rad, am I right?
*hands out party hats*
Introduced by Democratic Senator Christine Kehoe, SB 1501, the Safe Early Access Bill, proposes a change to the Reproductive Privacy Act, initially passed in 2000. Under its current form, only doctors can perform aspiration abortions, which account for 75 percent of abortions in the first trimester. Senator Kehoe proposes to extend this to certified nurse midwives, physician assistants and nurse practitioners under the scope of their licenses.
This means that in addition to offering the medical abortions they already provide, they could also perform aspiration abortion, which significantly improves the chances of accessing abortion services in the first trimester for California women. As it stands now, over half of California counties do not have accessible abortion providers, and people may need to travel four hours or more to access care.
Low-income women are hit particularly hard by this. Those without private insurance and an established primary care provider have a tough time accessing an abortion, which can delay care. As a pregnancy progresses, the available procedures narrow; first trimester abortions are generally safe and uncomplicated, but this changes as pregnancies shift into the second trimester.
Particularly for rural Californians, getting an abortion can require lengthy travel and stress. They need to locate abortion providers in areas they can access and coordinate their schedules. Some are relying on public transit, which is limited in rural areas, and also have to consider the cost of time off from work and finding a place to stay, as transportation schedules are often inconvenient and necessitate an overnight trip.
Ana Rodriguez, head of ACCESS Women’s Health Justice, told the story of “Jane,” a single mother who was forced to sleep in a hospital bathroom the night before her abortion because she had to travel so far and she had nowhere else to stay. ACCESS receives numerous calls daily from women seeking help with abortion services, and as a cosponsor of the bill, they’re excited about the possibility of allowing women to get care in their own communities, from healthcare providers they know and trust.
Historically, restricting medical abortion to qualified doctors made sense, clinically. As researcher Tracy Weitz explains, though, medical culture has shifted. Highly qualified certified care providers can safely perform aspiration abortions in the first trimester, as demonstrated in a pilot study conducted by UCSF across the state of California. The study indicated that there were no statistical differences in patient outcomes between procedures performed by doctors and those offered by trained certified nurse midwives, nurse practitioners and physician assistants. Incidentally, it also showed that in the cases of complications, almost all could be safely managed on an outpatient basis.
In fact, Oregon, Montana, New Hampshire and Vermont already allow these providers to perform aspiration abortions, because they have no specific laws regulating abortion on the books. California could set a precedent with SB 1501 by codifying safe and legal access to outpatient surgical abortion in the first trimester for its residents with a law attorney Margaret Crosby (American Civil Liberties Union) calls a “truly contemporary abortion law for California.”
If passed, the bill would be great news for California. But it would also be great news for the country. It creates a model for other states to use in improving access to abortion services, and as more practitioners start offering abortions, scientific evidence to support the validity of the initial UCSF study will mount up. That evidence can support reproductive justice advocates as they fight for better care in other states, and also serves to slap down spurious arguments used by anti-choicers in an attempt to block access to abortion care, like claims that abortion is harmful to women’s health.
We are, as readers know, facing a war on reproductive rights in the United States, which broke out in earnest in 2010 with the midterm election. Since then, 26 states have enacted one or more anti-choice laws, for a total of 69. Every day, it seems like I’m reading about a new attack on reproductive rights, and I’m beginning to feel like we are returning to the Comstock era; first they came for abortions, then they came for the birth control...
SB 1501 is the guttering candle in a fierce wind. It’s a reminder that it’s still worth it to fight, and that some victories are occurring. Now it’s time to make this a real victory for California by ensuring it passes, which means: Californians, contact your legislators. Tell your friends to call their legislators. Ask them to tell their friends. Make sure California continues to blaze a trail in reproductive rights law.