Maine considers allowing non-doctors to perform abortions

May 1, 2019

AUGUSTA, Maine (AP) — Rights and religious groups debated on Wednesday expanding the kinds of health care providers who can perform abortions in Maine.

The 40-year-old law, which states that only physicians can provide abortions, is already the subject of a federal lawsuit seeking to strike it down.

At a public hearing Wednesday, supporters and opponents discussed Democratic Gov. Janet Mills’ bill, which would add nurse practitioners, physician assistants and certified nurse-midwives to Maine’s list of abortion providers in hopes of expanding access.

The state’s first female governor’s legislation comes as Democrats, who won the state Senate and governor’s mansion from Republicans in 2018, are vowing to fight conservative efforts to limit abortion rights at the state and federal level.

Supporters say the current law is wrong to single out one medical procedure, while opponents worried the bill would increase the number of abortions in Maine.

“When Maine passed a law in 1979 preventing health care providers who aren’t physicians from providing abortion care, it was to protect people from untrained, unlicensed individuals who could potentially cause real harm,” said nurse practitioner Stephanie Small.

Now, Small said nurse practitioners receive more training and are allowed to prescribe medication, manage miscarriages and place intrauterine devices for contraception.

If the bill passes, Maine would join a small group of states — including Montana, Oregon, California, New Hampshire and Vermont — that allow certain non-physicians to perform medication and in-clinic abortion. Officials, regulators and courts in over a dozen states, including Washington , have argued that existing state law allows such providers to perform medication abortions, according to the Kaiser Family Foundation .

Meanwhile, roughly two-thirds of states only allow licensed physicians to perform medication abortions, according to abortion rights research organization Guttmacher Institute.

Under Maine’s bill, the kind of abortions that non-doctors would be allowed to perform would depend on their training and license. For example, the Planned Parenthood Northern New England clinic in Portland says it has one nurse practitioner trained for medication abortion and another trained for both medication abortion and in-clinic abortion.

Abortion providers and the American Civil Liberties Union of Maine argue the law leaves rural communities with few options for in-clinic abortions and makes it harder for patients to arrange an abortion via telemedicine. But Maine’s independent attorney general’s office has argued there isn’t strong evidence the law is leading to long drives for women.

Meanwhile, Mills, who was the state’s attorney general before becoming governor this year, has argued Maine’s ban lacks medical justification and ignores the nation’s low risk of complications from abortion.

Supporters also point to research that found abortion complications in thousands of cases in California were “clinically equivalent” whether performed by physicians or by newly trained nurse practitioners, certified nurse-midwives and physician assistants.

Opponents, including Concerned Women for America of Maine, said they knew their arguments against the bill face steep odds this year.

“Hope is important and it is difficult to advocate knowing today’s conversation was decided well before we began this hearing,” said Christian Civic League of Maine Policy Director Mike McClellan.

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