NRL News

California bill advances to allow non-physicians to perform certain first-trimester abortion

by | May 29, 2013

By Dave Andrusko

California Assemblywoman Toni Atkins

California Assemblywoman Toni Atkins

Already one of the states with the most liberal abortion laws and the least abortion clinic supervision, the California Assembly is moving closer to a vote that would widen the pool of those who can perform some first-trimester abortions to include physician assistants, nurse practitioners, and nurse midwives.

Assemblywoman Toni Atkins (D) is the author of Assembly Bill 154. The measure would allow these non-physicians to perform early-term surgical “aspiration” abortions. (These personnel are already allowed to administer chemical abortifacients.)

Although obliquely described in news accounts, what happens is an aspiration abortion is that a powerful suction tube with a sharp cutting edge is inserted into the womb through the dilated cervix. The suction dismembers the body of the developing baby and tears the placenta from the wall of the uterus, sucking the baby’s remains into a collection bottle.

The bill redefines the abortion technique as “non-surgical,” according to Margaret A. Bengs in an op-ed for the Daily News.

Democratic Assemblyman Richard Pan’s companion measure—AB 980— “would exempt clinics performing these ‘nonsurgical’ abortions from the more stringent building code standards for surgery,” Bengs wrote.

The rationale for the move (as always) is expanding access.

“The growing shortage of abortion providers creates a significant barrier for women’s access,” Atkins said, according to the Mercury News. “Authorizing trained health professionals to provide early abortion services removes those barriers.”

The justification is a state pilot program created in 2007 (and recently extended to next January). Under it, 8,000 aspiration abortions have been provided by non-doctors. NRL News Today has written about the program on multiple occasions and in one analysis by Dr. Randall K. O’Bannon, critiqued a study appearing in the “American Journal of Public Health” which claimed that first trimester surgical or suction aspiration abortions can be done just as safely by nurse practitioners, certified nurse midwives, and physician assistants as they can be by doctors.

Combining the insights of Dr. O’Bannon and Ms. Bengs we see the study (produced by researchers from the University of Southern California-San Francisco (UCSF), “America’s abortion training academy”) is woefully inadequate.

#1. [Dr. O’Bannon] “As a group, the number of complications for the [non-physicians] were almost exactly twice (100) what they were for the abortion doctors (52). Researchers glide over this by noting that numbers of ‘major complications” were equal for both groups (a total of six–two uterine perforations, three infections, and one hemorrhage spread between the two groups). The difference, they point out, was really in “minor complications.” What were some of those “minor complications?

They included incomplete abortions; failed abortions” retention of blood in the uterus, cases of infection, endocervical injury, anesthesia-related reactions, and uncomplicated uterine perforation”—to name just a few categories where non-physicians had many more problems than physicians.

#2. [Ms. Bengs] “The bill’s advocates claim that because some counties don’t have an abortion provider, women must drive ‘long distances’ to get abortions, but only 1 percent of women live in those counties, according to the Guttmacher Institute. California, in fact, has one-third of the nation’s abortion providers and its abortion rate is 27 percent, far higher than the national average.”

#3. [Dr. O’Bannon]. In fact the problems may be even larger than reported. “It should also be noted that 30.5% of the patients participating in the study never came back to fill out follow-up surveys. Researchers counted them in the study anyway. They said that 41 of those patients did contact the facility when they experienced a complication and that what they ‘discovered via medical chart abstraction’ suggested ‘a low likelihood of missing complications among this group.’ Especially in light of the low follow up rate, it is important to note that researchers give no indication that they considered an alternative explanation: that these women, rather than returning to the abortion clinic where they were injured, may have instead sought help from a local emergency room or their own personal physician.”

How ironic at a time of Kermit Gosnell that a state—any state—would undermine some of the very few protections that exist for women.

Categories: Legislation