With Roe in doubt, states weigh letting nurses do abortions

May 31, 2022, 9:26 PM | Updated: Jun 1, 2022, 8:16 pm
FILE - Gretchen Raffa, vice president of public policy, advocacy and organizing at Planned Parentho...

FILE - Gretchen Raffa, vice president of public policy, advocacy and organizing at Planned Parenthood of Southern New England, Inc., appears with a group of Connecticut elected officials as she speaks at a news conference, Tuesday, May 3, 2022, at the Connecticut State Capitol in Hartford. Raffa thanked lawmakers for passing legislation this session that attempts to protect providers and patients from out-of-state legal actions filed in anti-abortion states. (AP Photo/Susan Haigh, File)

(AP Photo/Susan Haigh, File)

              A protester demonstrates at the Connecticut State Capitol, Tuesday, April 19, 2022 in Hartford. As new abortion restrictions are imposed in some parts of the U.S., states with more liberal leadership have been passing laws to let a wider range of medical providers to do the procedures. (AP Photo/Sue Haigh)
              FILE - Gretchen Raffa, vice president of public policy, advocacy and organizing at Planned Parenthood of Southern New England, Inc., appears with a group of Connecticut elected officials as she speaks at a news conference, Tuesday, May 3, 2022, at the Connecticut State Capitol in Hartford. Raffa thanked lawmakers for passing legislation this session that attempts to protect providers and patients from out-of-state legal actions filed in anti-abortion states. (AP Photo/Susan Haigh, File)

NEW HAVEN, Conn. (AP) — Abortion rights advocates saw a problem: There’s a limited pool of medical providers who can legally perform abortions. In some states, one solution has been to authorize more providers beyond just physicians.

But to allow other providers — such as advanced practice registered nurses, physician assistants and certified nurse midwives — to perform early term abortions, changes in state laws were needed.

These legislative drives gained increased urgency once a leaked Supreme Court draft opinion showed the justices appear ready to overturn Roe v. Wade.

“All of these restrictions and bans that we’re seeing across the country are pointing more progressive states in the direction of, ‘How do we expand care?'” said Elizabeth Nash, state policy analysist for the Guttmacher Institute in New York, a think tank that supports abortion rights.

The proposed provider expansions face pushback from critics. They say letting non-doctors perform abortions could put women’s health at risk, especially if medical complications arise, and they question whether mid-level practitioners are qualified.

Here’s a look at how the provider issue is playing out:


The goal, supporters say, is to expand abortion access ahead of a potential influx of out-of-state patients from places where abortion might become illegal. Having more providers will also reduce wait times for in-state patients, and improve access for underserved communities.

The various proposals authorize advance practice clinicians to provide medication abortions, in-clinic abortions or both.

Abortion rights advocates say these clinicians often perform more complicated procedures such as IUD insertions, early miscarriage management and endometrial biopsies, a procedure where a small piece of the lining of the uterus is removed to check for cancer or other issues.

Supporters say randomized trials have shown that aspiration abortions — a common early term abortion that involves a suctioning procedure — can be safely performed by these clinicians.

“We know that this procedure is effective and has an incredibly low 1% complication rate,” said Amanda Skinner, CEO of Planned Parenthood of Southern New England.


When lawmakers in Connecticut considered a provider expansion bill earlier this year, the state’s medical society warned of a potential “slippery slope” toward what it called “mid-level providers” doing surgical procedures, which are more risky. In submitted testimony, the Connecticut Medical Society said any new law should be very clear about limiting these providers to only doing in-clinic or in-office aspiration abortions.

Among those who are against expanding abortion is Carol Tobias, president of the National Right to Life Committee.

“It’s not a surprise that the states would loosen or change the requirements of who can do them,” she said, calling it “a sign of desperation that they’re willing to put more women’s lives at risk.”

The focus, she said, should instead be on helping women “get through a difficult situation.”


Responding to the Supreme Court leak, New Jersey Gov. Phil Murphy, a Democrat, recently announced he wants to codify into law regulations adopted in 2021 by the State Board of Medical Examiners, which allow a range of medical providers to perform aspiration abortions, and to set up a fund to pay for training.

Four months earlier, he had signed a law guaranteeing abortion rights.

“We know without access,” Murphy said, “rights mean nothing.”

In Connecticut — a Democratic-leaning state where Roe is codified into state law — a provider expansion bill passed with bipartisan support and was signed into law last month.

Abortion clinics in the state are already starting to see patients arrive from Texas, more than 1,800 miles (2,900 kilometers) away, where a new law restricts abortion after roughly six weeks.

That’s according to Skinner, the regional Planned Parenthood CEO, who spoke during an interview at a clinic in New Haven.

Right now, she says women face a frustrating two-week wait for in-clinic abortions at Planned Parenthood, the largest provider in the state.

Besides Connecticut, laws were enacted in Maryland, Washington and Delaware this year to help shore up their provider pools by allowing non-physicians to perform certain early term abortions.

Lawmakers in California are currently considering a bill that would update a 2013 law and allow some nurse practitioners to perform abortions without the supervision of a doctor, as currently required.


Lawmakers in some states where Republicans control the legislature, the governor’s office, or both have tried to pass legislation expanding the pool of abortion providers.

The bills faced an uphill battle.

North Carolina is surrounded by states with so-called trigger laws, which would immediately ban abortion if Roe is overturned.

The state already has a shortage of physicians who perform abortions, and this will likely get worse if out-of-state women start seeking abortions there, said state Rep. Julie von Haefen, a Democrat.

“We have 100 counties in North Carolina. Ninety-three of those counties do not have an abortion provider. All of our abortion clinics are centralized in our urban areas,” she said. “So that is going to cause a big problem — even just for women just traveling within our state. We have a large state.”

Von Haefen filed a comprehensive bill last year to remove what she calls “barriers” to abortions, including ending a ban on non-physicians performing abortions.

That legislation failed, and von Haefen is not optimistic it will come up for a vote this year. The state has a Republican-controlled General Assembly and a Democratic governor.

Similar bills to expand the abortion provider pool were proposed in Arizona and Nebraska, but faltered as well.

Instead, Nebraska abortion-rights lawmakers and lobbyists said they focused on successfully fighting off a trigger law and two other anti-abortion bills this year.

That’s according to Sofia Jawed-Wessel, an associate professor of health and kinesiology at the University of Nebraska at Omaha, who spoke via email as a private citizen and not on behalf of the university.

“I’m certain we will continue to push those pro-choice bills in future sessions, depending on the outcome of Roe and the very likely special session that will be called should Roe be overturned,” she said.

Copyright © The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.


Evelyn Knapp, a supporter of former President Donald, waves to passersby outside of Trump's Mar-a-L...
Associated Press

Trump legal woes force another moment of choosing for GOP

From the moment he rode down the Trump Tower escalator to announce his first presidential campaign, a searing question has hung over the Republican Party: Is this the moment to break from Donald Trump?
24 hours ago
FILE - The Silicon Valley Bank logo is seen at an open branch in Pasadena, Calif., on March 13, 202...
Associated Press

Army of lobbyists helped water down banking regulations

It seemed like a good idea at the time: Red-state Democrats facing grim reelection prospects would join forces with Republicans to slash bank regulations — demonstrating a willingness to work with President Donald Trump while bucking many in their party.
24 hours ago
FILE - This Sept. 2015, photo provided by NOAA Fisheries shows an aerial view of adult female South...
Associated Press

Researchers: Inbreeding a big problem for endangered orcas

People have taken many steps in recent decades to help the Pacific Northwest's endangered killer whales, which have long suffered from starvation, pollution and the legacy of having many of their number captured for display in marine parks.
2 days ago
FILE - Hiring signs are displayed at a grocery store in Arlington Heights, Ill., Jan. 13, 2023. Emp...
Associated Press

Pay transparency is spreading. Here’s what you need to know

U.S. employers are increasingly posting salary ranges for job openings, even in states where it’s not required by law, according to analysts with several major job search websites.
2 days ago
Meadowdale High School 9th grade students Juanangel Avila, right, and Legacy Marshall, left, work t...
David Klepper and Manuel Valdes, Associated Press

Seattle high school teacher advocates for better digital literacy in schools

Shawn Lee, a high school social studies teacher in Seattle, wants to see lessons on internet akin to a kind of 21st century driver's education, an essential for modern life.
2 days ago
South Carolina Senators hear from the parents of people who died from fentanyl overdose on Jan. 19,...
Associated Press

With overdoses up, states look at harsher fentanyl penalties

State lawmakers nationwide are responding to the deadliest overdose crisis in U.S. history by pushing harsher penalties for possessing fentanyl and other powerful lab-made opioids that are connected to about 70,000 deaths a year.
2 days ago

Sponsored Articles

SHIBA volunteer...

Volunteer to help people understand their Medicare options!

If you’re retired or getting ready to retire and looking for new ways to stay active, becoming a SHIBA volunteer could be for you!
safety from crime...

As crime increases, our safety measures must too

It's easy to be accused of fearmongering regarding crime, but Seattle residents might have good reason to be concerned for their safety.
Comcast Ready for Business Fund...
Ilona Lohrey | President and CEO, GSBA

GSBA is closing the disparity gap with Ready for Business Fund

GSBA, Comcast, and other partners are working to address disparities in access to financial resources with the Ready for Business fund.

Medicare open enrollment is here and SHIBA can help!

The SHIBA program – part of the Office of the Insurance Commissioner – is ready to help with your Medicare open enrollment decisions.
Lake Washington Windows...

Choosing Best Windows for Your Home

Lake Washington Windows and Doors is a local window dealer offering the exclusive Leak Armor installation.
Anacortes Christmas Tree...

Come one, come all! Food, Drink, and Coastal Christmas – Anacortes has it all!

Come celebrate Anacortes’ 11th annual Bier on the Pier! Bier on the Pier takes place on October 7th and 8th and features local ciders, food trucks and live music - not to mention the beautiful views of the Guemes Channel and backdrop of downtown Anacortes.
With Roe in doubt, states weigh letting nurses do abortions