A nurse practitioner can give you a complete physical, order diagnostic tests, stitch up a cut – even prescribe medication.
Along with other advanced-practice clinicians, like nurse midwives and nurse anesthetists, they can deliver many of the same services that a doctor can, often working in places where there is no doctor available.
But in Maine, they can’t watch you take a pill – if that pill is part of a medically induced abortion. A law that’s been on the books longer than the procedure has existed says that only doctors can do that here, and, as a result, women in this sparsely populated state sometimes can’t access the care they need.
This problem is the subject of a lawsuit, filed last year in federal court by the American Civil Liberties Union. It’s also the subject of a bill submitted by Maine Attorney General Janet Mills. Lawmakers should pass the bill and not wait for the courts to straighten this out.
When the current law was passed in 1979, just six years after the U.S. Supreme Court legalized abortion, the doctors-only requirement was intended to protect women’s health and safety from back-alley abortionists. Today, however, instead of protecting patients, the law has the effect of denying women access to health care.
What’s changed is the invention of the medically induced abortion, which has been used in this country since 2000. The patient takes one pill in the presence of a health care provider, and takes doses of a second medication at home.
It is almost always effective, especially in the first weeks of a pregnancy. It’s not a surgical procedure and is clearly not what lawmakers had in mind when they passed the law in 1979.
Passage of Mills’ bill, L.D. 1763, would do two things. It would make abortion services available to women who live in parts of the state that aren’t near one of the three clinics where abortions are performed: Maine Family Planning in Augusta, the Mabel Wadsworth Women’s Health Center in Bangor and Planned Parenthood in Portland. And approval of the proposal also would render moot the pending lawsuit that would unnecessarily run up the state’s legal bills.
Allowing advanced-practice clinicians to supervise women who take the abortion pill is not some wild idea. It’s the practice in nine states, including New Hampshire, where there are similar problems with access to health care in rural areas.
Mills’ sponsorship of the bill has drawn criticism from Republican lawmakers, led by Rep. Ellie Espling, assistant floor leader for House Republicans, because Mills is a candidate for the Democratic nomination for governor. But Mills’ position on the provider bill would be an asset to her campaign only if the bill were something that voters wanted the state to do. Public officials should not be discouraged from promoting policies that most Mainers would consider to be good ideas.
A legislative outcome on this issue would be better than a judicial one, because lawmakers will listen to testimony from experts and have the ability to build in specific protections.
Nurse practitioners are highly trained professionals who are more than capable of delivering this service. We shouldn’t let political barriers create legal barriers between these providers and their patients.
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