California Introduces Bill To Expand Access To First-Trimester Abortions

As states across the country impose restrictions to limit women’s access to abortion, California lawmakers are taking the opposite route. On Wednesday, Democratic lawmakers introduced legislation to expand the availability of first-trimester abortions by allowing more medical professionals — such as nurses and midwives — to perform the procedure.

Assembly Bill 154 revives last year’s push to allow nurses to perform nonsurgical abortions. Gov. Jerry Brown (D) ended up signing a watered down version of that bill, which only allowed non-doctors to perform early abortions after going through training in a specific pilot program. The California’s Nurses Association opposed the initial version of last year’s bill because they wanted to see the results from a multi-year study on early abortion that researchers were conducting at the University of California-San Francisco — but since the results from that study were published last week, lawmakers say the political landscape is different now.

The six-year study led by UCSF found that first-trimester abortions are just as safe when they are performed by professional nurses, physician assistants, and midwives as when they are performed by doctors. In a press release about their results, the researchers explained that expanding the abortion procedure beyond doctors could ultimately help eliminate the economic and racial barriers that prevent some women in California from accessing early abortions:

Nationally, 92 percent of abortions take place in the first trimester but studies find that black, uninsured and low-income women continue to have less access to this care, according to the researchers.

In California, 13 percent of women using state Medicaid insurance obtain abortions after the first trimester. Because the average cost of a second trimester abortion is substantially higher than a first trimester procedure and abortion complications increase as the pregnancy advances, shifting the population distribution of abortions to earlier gestations may result in safer, less costly care, according to the research team.

“Increasing the types of health care professionals who can provide early aspiration abortion care is one way to reduce this health care disparity,” said lead author Tracy Weitz, PhD, MPA, a UCSF associate professor and director of Advancing New Standards in Reproductive Health at the UCSF Bixby Center for Global Reproductive Health. “Policy makers can now feel confident that expanding access to care in this way is evidence-based and will promote women’s health.”

In a press conference on the 40th anniversary of Roe v. Wade to unveil the bill, California lawmakers said they are committed to ensuring that women can access reproductive care no matter where they live in the state. According to the bill’s sponsors, 52 percent of California counties don’t have an abortion provider other than hospitals, which may have limited services. “California will not go back. We are going to go forward,” said state Sen. Hannah-Beth Jackson (D).

But other states across the country are going back, as women’s access to first-trimester abortions continues to be threatened. In states like Iowa, Texas, and Wisconsin, anti-choice lawmakers are imposing unnecessary barriers to early abortion — even though restrictions on first-trimester abortions simply lead to a rise in more costly later term abortion procedures.