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You are here: Home / Civil Rights / Women's Rights / Women's Rights Are Human Rights / Safe, Legal and Plentiful

Safe, Legal and Plentiful

by $8 blue check mistermix|  October 11, 20139:33 am| 16 Comments

This post is in: Women's Rights Are Human Rights

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California just passed the first expansion of abortion access in the US in seven years:

That makes new legislation in California all the more significant: A law signed Wednesday by Gov. Jerry Brown allows more medical practitioners to perform first-trimester abortions. It also may be the first state law to expand or maintain access to the procedure since Hawaii did so in 2006 (their law keeps abortion legal in the state if the Supreme Court case Roe v. Wade were to be overturned).

The California legislation allows trained nurse practitioners, physician assistants and nurse midwives to perform first-trimester abortions. Four states — Washington, Montana, Vermont and New Hampshire — already allow nurse practitioners to perform the procedures.

That piece is worth reading in full, because it has a lot of good information from the indispensible Guttmacher Institute.

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Reader Interactions

16Comments

  1. 1.

    Xecky Gilchrist

    October 11, 2013 at 9:44 am

    I’m curious to hear if the “leave it to the states” brigade approves.

    Not that I care, it’s just fun to hear ’em squeal.

  2. 2.

    aimai

    October 11, 2013 at 10:02 am

    I am so thrilled with this I just can’t tell you. However I’m annoyed, as usual, by my little college radio station–great music but lousy news updates which, being written by the Emerson College Students, are just fascinatingly badly written. They reported this during their five second news spots as “California permits non-medical professionals to perform abortions” as though the new law lisenced janitors and Ihop fry cooks to do them rather than, you know: medical professionals who are not doctors.

  3. 3.

    Higgs Boson's Mate (Crystal Set)

    October 11, 2013 at 10:35 am

    Not to worry, the Teahadists will add expelling California from the Union to their list of demands.

  4. 4.

    Bill in Section 147

    October 11, 2013 at 10:51 am

    California law now REQUIRES you to have…an abortion. – Fox Chyron

    California law now requires you to have access to proper medical care if you decide to have an abortion. – Actual news

    Selfishly I will admit that my first reaction was happiness that this would piss-off conservatives.

  5. 5.

    Amir Khalid

    October 11, 2013 at 10:55 am

    @aimai:

    They reported this during their five second news spots as “California permits non-medical professionals to perform abortions” as though the new law lisenced janitors and Ihop fry cooks to do them rather than, you know: medical professionals who are not doctors.

    Good God. That doesn’t even reach “failure of journalism”. That stops well short of it, at “failure of reading comprehension”.

  6. 6.

    chrome agnomen

    October 11, 2013 at 11:10 am

    i wish they ALL could be california girls

  7. 7.

    BruinKid

    October 11, 2013 at 11:13 am

    Irin Carmon said it quite provocatively by noting that this measure will help prevent the horror story of jailed abortion doctor Kermit Gosnell. So if the pro-life crowd were actually serious about preventing that from happening, they should be supportive of this new law.

    Oh fuck it, of course they won’t be. Because they’re fucking hypocrites, all the way.

  8. 8.

    geg6

    October 11, 2013 at 11:43 am

    I know that Californians are not all thrilled with everything Brown has done, but, damn, I’d love to have him here in the Keystone State. Instead, I have fucking Governor “Close Your Eyes If You Don’t Want to Watch” Corbett. WTF did I ever do to the FSM to deserve that?

  9. 9.

    Violet

    October 11, 2013 at 1:01 pm

    @BruinKid: If they were truly pro life they’d be in full support of birth control pill access. That way more or most children would be planned and.wanted. They are not. As usual they are all about controlling women.

  10. 10.

    Ilya

    October 11, 2013 at 1:15 pm

    @aimai: I wholeheartedly approve of increasing access to abortion providers and birth control. However, I’m not sure if doing so by increasing the number of untrained medical professionals who can provide these services is the way to go. Put it this way: if we suddenly had a shortage of oncologists, would the appropriate answer be to give nurses the ability to choose chemotherapeutic regimens? And in doing so, are we actually helping patients, or simply encouraging a two-tiered system where patients with insurance get access to an actual oncologist / OB/GYN, and patients without insurance get to see an unqualified individual?

    For now, the services these professionals are allowed to provide are things like RU-486 and misoprostol, which are usually safe, but can lead to pretty deadly bleeding in some women, which only an experienced OB/GYN can address. Are you comfortable exposing some of the most vulnerable members of society to that risk?

    Source: am MD, though not an OB/GYN or living in California.

  11. 11.

    Gretchen

    October 11, 2013 at 2:10 pm

    @Ilya: nobody’s talking about having untrained people do this. They’re talking about having specially trained people specializing in women’s health, like certified nurse-midwives and certified nurse-practitioners do it. Midwives do things like deliver babies every day. They could handle doing abortions.

  12. 12.

    Mnemosyne

    October 11, 2013 at 3:05 pm

    @Ilya:

    However, I’m not sure if doing so by increasing the number of untrained medical professionals who can provide these services is the way to go.

    A nurse practitioner is “untrained”? Then why on earth is s/he allowed to see patients and make diagnoses? Why are nurse-midwives allowed to deliver babies if they’re “untrained”?

    Sorry, but I’m sensing some doctor snobbery here in deciding that nurse practitioners and nurse-midwives aren’t sufficiently trained to handle an uncomplicated abortion. We’re not talking about the LPN being allowed to do it, but I guess you saw the word “nurse” and assumed that nurses are automatically inferior.

  13. 13.

    Ilya

    October 11, 2013 at 3:38 pm

    @Gretchen: @Mnemosyne:

    Mnemosyne, I think you’re reading a lot more into my comment than is there. I think my psychiatrist colleagues call that projection. I wonder if either of you are medical professionals? Because if you were, you wouldn’t use the words nurse practitioner and nurse midwife interchangeably, the two are VERY differently trained. I think a nurse midwife can handle dispensing abortion medications, and knows when she needs an OB doc to help out. A nurse practitioner that went through a 2-year FNP program of 100 clinical hours in obstetrics? Not so much. That’s far less than the average medical student gets in OB training, let alone an OB/GYN doc who has had at least ~10,000 clinical hours in OB and gynecology. Something like 10% of these women who initially try medical abortions eventually need a D&C, a surgical procedure. Do you think NPs can provide that?

    But go ahead, ascribe my skepticism to doctor snobbery.

  14. 14.

    Mnemosyne

    October 11, 2013 at 3:56 pm

    @Ilya:

    A survey of abortion education in medical school conducted in 2005 by Dr. Eve Espey and others noted that 44 percent of schools offered no formal preclinical elective abortion education and that 25 percent of OB-Gyn clerkships reported no formal education about abortion training. The Guttmacher Institute reported 1,787 providers in 2005, down from 2,908 in 1982. Eighty-seven percent of U.S. counties have no abortion providers.

    Sorry, what was that about OB/GYNs being more highly trained than a lowly nurse-midwife or nurse practitioner who specializes in OB/GYN?

    Something like 10% of these women who initially try medical abortions eventually need a D&C, a surgical procedure. Do you think NPs can provide that?

    Strangely, I’m not outraged that I might see a general practitioner for one part of my care and later need to see a specialist if there’s a problem or complication. I have a persistent ear infection that my GP prescribed two different antibiotics for and it still didn’t clear up, so I saw an otolaryngologist about it this morning. Should I have run to the specialist the instant my ear started bothering me rather than seeing the GP first?

    ETA: If fewer and fewer doctors are being trained in how to do abortions or are offering them, what’s your solution? Should women just learn to do it themselves at home rather than rely on an “untrained” nurse-midwife?

  15. 15.

    Mnemosyne

    October 11, 2013 at 4:37 pm

    @Ilya:

    Also, too, if I sound annoyed and snotty about this, it’s because MD OB/GYNs have been shirking their responsibilities on abortion care for several decades now, and when California (and four other states) come up with a plan to try and work around those doctors who can’t be bothered to learn how to do abortion care, there’s carping about how nurses aren’t sufficiently trained to take over what the doctor neglected to learn.

    If OB/GYNs hadn’t refused to do their jobs, this bill wouldn’t be necessary, but unfortunately they left a gap in care that needs to be filled somehow, like it or not.

  16. 16.

    Ilya

    October 11, 2013 at 11:24 pm

    @Mnemosyne: Mnemosyne, you have absolutely no idea what you are talking about. The OB/GYN clerkship refers to the 6 weeks that most medical students spend on OB and gynecology in medical school – which is far more than NPs spend in their training, but a tiny fraction of the total training that an OB/GYN physician receives, given that these docs do FOUR YEARS of training post-medical school, during which they rack up their 10,000 clinical hours. The 44% number sounds correct – I definitely wasn’t exposed to abortion services during my medical school training. Then again, I don’t provide abortion services, since I’m a general surgeon, not an OB/GYN doc. So basically we’re talking about someone who got 100 hours of training in obstetrics (the NP) compared to someone who got 10,000 hours (the OB/GYN doc). Which one would you send your daughter to?

    Your comment about OB/GYNs not stepping up to the plate re: abortion rights is insulting. Tell that to Dr. Tiller and the other martyrs for the cause.

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