A bill that would allow non-physicians to perform abortions in the first trimester of pregnancy is awaiting signature by Gov. Jerry Brown of California by Sep. 30. The bill, AB 154, passed both houses of the state legislature with strong support from Planned Parenthood and pro-choice groups. Planned Parenthood stands to benefit most directly from the bill, as non-physician staff at its clinics would be able to obtain abortion licenses.
One doctor–who identified himself as pro-choice–told Breitbart News that “the bill is a disaster since it sends us back 100 years to the problems of the complications from back-steet abortions.” The bill’s critics warn that the training provided to non-physician staff is weak, that supervision by physicians in clinics will be minimal, and that there is real risk of injury or death to women who will be treated in such conditions.
The California Medical Association has endorsed AB 154 because of “provisions for training in the bill and the amendments that clarify physician supervision.” Yet the training is to be provided by the Board of Registered Nursing, not by physicians, and the protocols for defining “supervision” have not been specified. There is nothing in the legislation requiring a physician to be present or on-site during an abortion.
The bill permits licensed non-physicians to perform two kinds of abortion in the first trimester–by medication, and by aspiration, which requires the insertion of medical instruments into the uterus. Though many doctors agree that non-physicians could provide medications with few risks, the idea that a non-physician would perform an invasive procedure such as aspiration strikes many as rife with risks.
Debate about AB 154, which was introduced by California State Assembly Majority Leader Toni Atkins (D-San Diego), has been muted in a state that pro-choice advocates see as sympathetic to their cause. The Los Angeles Times came out strongly in favor of the measure in an editorial on September 3, arguing that it does not pose safety risks and that it could increase access to abortion services for women early in pregnancy:
In underserved urban areas, women face delays in getting medical appointments at clinics. When a woman can’t get an abortion in the first trimester, she may end up getting one in the later stages of pregnancy, which can mean a more complicated and more expensive abortion.
Advocates of AB 154 also argue that other states have allowed non-physicians to perform abortions safely, including in Planned Parenthood clinics.
Opponents describe AB 154 as an effort by Planned Parenthood and other groups to profit from Obamacare, since the legislation will expand the number of patients eligible for the state Medi-Cal program, and Medi-Cal pays for abortion. They also dispute assurances about the bill’s safety for women, arguing that there has been inadequate monitoring of California abortion clinics even prior to the passage of the new legislation.