New California Law Will Allow Non-Doctors To Provide Abortions (This Is A Good Thing, Believe Me)

Welcome to the Golden State, where the rents are stratospheric, the burritos are delicious, and abortion is that much more accessible.
Publish date:
October 17, 2013
abortion, health care, reproductive rights

Remember SB 1501?

It’s okay, not everyone is a walking encyclopedia of state legislation, and I wrote about this way back in March of last year, which is practically like a different century in internet time. Anyway, quick refresher: SB 1501 would have allowed California’s certified midwives, physician assistants, and nurse practitioners to perform aspiration abortions, an extremely common form of abortion procedure, without the supervision of a doctor.

That would have radically expanded access to abortion services, which is probably why it was called the Safe Early Access Bill. And now, over a year and a half later, Governor Gerry Brown has finally signed AB 154, the Assembly’s version of the bill, into law. That took long enough, eh?

In case this isn’t obvious, this is what we like to call “good news” in the struggle for reproductive freedoms, because it ensures that patients can safely and easily access abortion services. And it illustrates how much you can get done in a state where the legislature and executive branch are heavily dominated by Democrats.

What is AB 154?

AB 154 is much like SB 1501, allowing non-doctors to perform aspiration abortions (but not D&Cs and other more complex surgical abortions), with the caveat that: “The measure requires the non-physicians to complete specified training and comply with standardized medical protocols for the non-surgical techniques.” Reasonable. We want medical providers trained in how to safely perform abortions.

According to Planned Parenthood, one in three women under 45 will need an abortion at some point in her life, and yet, thanks to the tightening pressures on abortion access, many women have difficulty getting services. The longer women have to wait for abortions, the more grueling the procedure can be. While non-doctors in California can provide medical abortions (used in very early pregnancy) with the use of RU-486, they couldn’t perform aspiration abortions...until now.

Half of California counties lack abortion services entirely. In those where it’s available, wait times are often extremely long, and clinics have difficulty meeting the needs of their patients. Expanding access makes abortion geographically accessible as well as logistically feasible for women who can’t wait, and can’t afford to take extensive periods of time off to access abortion services. Better yet, local, known providers can get the training, which allows women to see health care practitioners they already feel comfortable with.

Wait, won’t this make abortion dangerous by deregulating it?

I’m so glad you asked, imaginary Republican!

The short answer to this question is: “no.” The longer answer is that a lot of thought, and scientific research, went into this bill. The University of California, San Francisco just completed a detailed six year study looking at whether it would be safe and feasible to have non-doctors perform aspiration abortions. They found that properly trained personnel had complication rates identical to those of doctors -- less than 2% over 10,000 aspiration abortions performed by doctors and non-doctors in the study.

This law doesn’t deregulate abortion, it just expands abortion access by allowing trained non-doctors to perform a specific type of abortion access. In fact, it comes with some tight regulations to protect patients. That’s good news for patients who might have trouble accessing abortions, and it increases safety. Patients won’t have to wait for more expensive and potentially complicated second trimester abortions, and they won’t be pushed to seek abortion services from people who aren’t trained.

Furthermore, AB 154 keeps second trimester abortions, which are potentially more dangerous, firmly in the hands of doctors, who have more training and experience. The goal is to reduce the number of second trimester abortions needed by helping women get help early in their pregnancies, but for those who do need second trimester abortion care, a more advanced level of care would be required, and the state has no intention of letting women down. And, of course, women who prefer to see doctors for first trimester abortions certainly aren't barred from doing so!

Does this mean California will have drive-through abortion kiosks now?


Why is this good news?

Well, for one thing, better abortion access. Under this bill, more women will be able to access abortion from trusted providers early in their pregnancies, with less lost income, travel time, and other problems associated with getting to a care provider. They’ll also be less prone to complications, and will be able to receive community-based care and followup, both of which are very good things.

For low-income patients in particular, this bill could make a huge difference, especially in rural communities where it’s hard to get services. By making it easier to get safe, compassionate, legitimate abortion services, the state will be squeezing out illegal abortionists, thus looking out for women’s health and wellbeing.

Furthermore, California is setting a very clear pro-choice example. As numerous states pass increasing restrictions on reproductive rights access, California’s heading boldly in the opposite direction, and the decision makes the state stand out. California has always been known for its progressive politics, and many of those politics have filtered through the rest of the country; for example, California has always been ahead of the curve on environmental legislation.

The tide of anti-abortion sentiment and legislation in the United States won’t roll back just because one large state decided to make it easier to access abortion care, but this is a good start. Campaigners in other states can model their own access bills on California’s, and can work with organizations in California to develop a strategy to get them passed, or at least heard on the floor of the legislature.

Can I move to California?!

Yes. Welcome to the Golden State, where the rents are stratospheric, the burritos are delicious, and abortion is that much more accessible.