In the past four years, states have enacted 231 restrictions on abortion care, severely limiting women’s access to this legal and safe procedure. Under the guise of protecting women’s health, state legislatures, particularly in the South and Midwest, have been actively introducing and passing bills that are neither evidence-based nor backed by science—effectively placing politicians in the consultation room with patients. For instance, there is only one clinic where abortion care is provided in each of the following four states: Mississippi, Missouri, North Dakota, and South Dakota. And while the courts have not yet made final rulings on Texas’ H.B. 2, a comprehensive package of restrictive abortion laws, women’s access to abortion care in Texas has already been severely curtailed. At the same time, the number of abortion providers and locations where abortion care is available has been steadily decreasing, and fewer clinicians are willing or able to deliver abortion care due to these new restrictions.
However, states have increasingly begun to introduce legislation that protects access to abortion care and, in some cases, expands access. California has been a leader in protecting and expanding access to abortion care. In 2002, the state passed a law that allows advanced-practice clinicians, or APCs—including nurse practitioners, or NPs, certified nurse midwives, or CNMs, and physician’s assistants, or PAs—to provide medication abortions. And in 2013, after rigorous study, evaluation, coalition building, and advocacy, the legislature passed a law to allow these health care professionals to provide aspiration abortions in the first trimester as well. The law went into effect on January 1, 2014. Other states should consider following California’s example by expanding abortion access rather than restricting it.
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