Planned Parenthood of Northern New England and civil liberties groups are challenging a Maine law that prohibits nurse practitioners and nurse-midwives from performing abortions, a case that could have national implications and result in improved access to abortion services.
The lawsuit, filed Wednesday in U.S. District Court in Portland, contests a law enacted in 1979 requiring that abortions be performed only by doctors. Most abortions in Maine are done at three women’s health centers – Planned Parenthood in Portland and clinics in Augusta and Bangor.
Zachary Heiden, legal director for the ACLU of Maine, said Wednesday that if the Maine lawsuit is successful, legal challenges could be mounted in the 41 other states that have similar laws. Heiden said that when many of the laws were passed, there were far fewer nurse practitioners and nurse-midwives, so although the original intent may not have been to restrict access to abortion, over time that has become the practical effect.
The health care landscape has changed dramatically since the 1970s, and access to health care in rural areas is challenging.
“Maine is a large, rural state, and much of the year travel can be difficult, so laws like these can be especially harmful,” Heiden said, explaining why the ACLU chose Maine for a test case.
Nurse-midwife Katie Riley, who works at Planned Parenthood’s Portland clinic and also a clinic in Manchester, New Hampshire, said nurse-midwives can perform abortions in the latter state.
“The fact that I can provide this service in New Hampshire, and when I step across the border into Maine I can’t, is simply ridiculous,” said Riley, one of the plaintiffs in the lawsuit.
Other plaintiffs include nurse practitioners Julie Jenkins of Belfast, Alison Bates of Portland, Stephanie Small of Topsham, and Maine Family Planning, a health care provider in Augusta that offers abortion services. The lead attorneys supporting the suit are the American Civil Liberties Union and the ACLU of Maine.
“This law significantly restricts patient access to abortion services in Maine, and prevents some Maine women from receiving an abortion from their regular primary and gynecological care provider,” Planned Parenthood said in a written statement Wednesday. “Today, while medication abortion is available via telemedicine in some cases, there are only three publicly accessible health centers in Maine where a woman can get an in-clinic abortion.
“If this medically unjustified restriction (in Maine law) is blocked, that number will increase to at least 18 locations across this large, rural state,” the statement says. “Today, some women living in northern Maine have to make a more than six-hour round-trip to Bangor for an abortion, even though there is a qualified, experienced (nurse-midwife or nurse practitioner) in their community ready to provide this care.”
Amy Cookson, a Planned Parenthood spokeswoman, said a 2016 U.S. Supreme Court decision that struck down Texas laws restricting abortion access paved the way for the Maine lawsuit. The Texas laws caused dozens of abortion clinics to close.
“Since the Supreme Court ruled in ‘Whole Woman’s Health’ that laws restricting access to abortion must be grounded in protecting the health and safety of women, there’s now precedent to challenge medically unnecessary abortion restrictions like Maine’s physician-only law,” Cookson said.
Bates said that if it’s successful, the lawsuit will benefit women’s health care on many fronts. She pointed to studies that show abortions performed by nurse practitioners and nurse-midwives do not compromise patient safety.
“This is definitely a skill that’s within my scope of practice,” Bates said. “For me, this would be a victory (by) establishing much better access for our patients. It would be a victory for all of my colleagues.”
But Teresa McCann-Tumidajski, executive director of Maine Right to Life, an anti-abortion group, said abortion is an “elective procedure,” so there should not be easy access. She said the group opposes the lawsuit.
“We are against violence inside and outside the womb,” McCann-Tumidajski said. “We don’t want to open up new avenues of access to abortion.”
Overall, abortion rates have declined dramatically in the U.S. and Maine. Despite Maine’s relatively stable population, 1,836 abortions were performed in the state in 2015, compared with 2,653 in 2005, according to the Maine Center for Disease Control and Prevention.
Health experts cite improved birth-control methods as one of the major factors in declining abortion rates.
Listed as defendants in the lawsuit are the Maine Attorney General’s Office and district attorneys in the state’s 16 counties. The AG’s Office declined to comment Wednesday.
Nicole Clegg, vice president of public policy for Planned Parenthood of Northern New England, said there’s a shortage of doctors, especially in rural Maine, who provide abortion services, so ending the prohibition on nurse practitioners and nurse-midwives would expand options for women.
Clegg said nurse practitioners, for instance, could offer abortions at their clinics. Also, Planned Parenthood would expand abortion services beyond the Portland health center to its clinics in Biddeford, Sanford and Topsham. The lawsuit could also make it easier to prescribe medications that can induce abortions for those who are pregnant less than 10 weeks, she said.
Clegg said Planned Parenthood’s Portland clinic, the Mabel Wadsworth Women’s Health Center in Bangor and Maine Family Planning in Augusta perform about 90 percent of all abortions in the state, and many women travel long distances for the service.
About 25 percent of patients who have abortions in Portland, Clegg said, are traveling more than an hour each way.
“They’re coming here from every county in the state,” she said.
Joe Lawlor can be contacted at 791-6376 or at:
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