ACPs to perform abortions in California, maybe

[rcdavis]

Here is the new clip

 

 

Home | America

Tags: california | senate | nurses | abortions

California Senate Passes Bill to Let Nurses Perform Abortions

Monday, 26 Aug 2013 06:47 PM

*

 

*

 

California’s Senate passed a bill to permit nurse-midwives and others to perform some types of abortions now done only by doctors.

 

The measure by Assembly Majority Leader Toni Atkins, a San Diego Democrat, passed the Senate 25 to 11. The bill now goes back to the Assembly, which passed it in May, to ratify amendments before going to Governor Jerry Brown, a Democrat.

 

If signed, California would allow abortions by midwives, physician assistants and nurse practitioners in the first 12 weeks of pregnancy. Four others states permit non-physician abortions: Montana, New Hampshire, Oregon and Vermont, according to a University of California, San Francisco, study. Thirty-nine states require a licensed physician.

 

“All women should have timely access to reproductive health care regardless of whether they live in urban or rural areas and without excessive expense or travel,” Atkins said in a statement. The bill “will help fill the gap created by the fact that over half of California’s counties lack an abortion provider.”

 

The California bill bucks a national trend as states such as Texas and North Carolina have passed restrictions on abortion providers.

 

While the U.S. Supreme Court’s 1973 decision in Roe v. Wade struck down many state laws restricting abortion, statutes vary across the U.S. A flurry of new restrictions have been added in the past three years.

 

States Opposed

 

In Kansas, Governor Sam Brownback, a Republican, signed legislation April 19 that bans abortions on the basis of fetal gender, declares that life begins at fertilization and prohibits public funding for abortions.

 

In North Dakota, Republican Governor Jack Dalrymple signed a law in March making it a felony for a doctor to perform a nonemergency abortion once a fetal heartbeat can be detected, as early as six weeks into a pregnancy, with no exceptions for victims of rape or incest.

 

North Carolina Governor Pat McCrory, a Republican, signed a law passed in July to make clinics meet structural requirements similar to those for outpatient surgical centers. Republicans said the measure would make clinics safer while opponents said it was an effort to deny access.

 

Texas Republican Governor Rick Perry signed a law last month that bans abortions after 20 weeks of pregnancy and requires the state’s 42 abortion clinics to meet standards similar to those for outpatient surgical centers.

*

 

 

© Copyright 2013 Bloomberg News. All rights reserved.

[AREID]

When do you suppose this will all be allowed in California?

 

 

Sent from my iPhone using Tapatalk - now Free

[EMEDPA]

if they are going to allow this I would like to see PAs get easily credentialed for tubal ligations and vasectomies as well. less risk and this way we could affect both sides of the pipeline as it were and maybe prevent the need for later abortions.

[just_nelle]

EMEDPA - I wholeheartedly agree with you re: BTLs and vasectomies...I've felt that way for some time now. As a PA who had previously moonlighted (out of passion for reproductive medicine) at a reproductive health clinic in California where my duties occasionally included prepping, assisting during procedures, and providing follow up for AB/vasectomy/BTL patients, I feel that if provided proper additional training, each of these procedures could be safely performed by a non-physician provider in order to increase access (and hopefully eventually decrease the need for terminations).

 

I'm just curious how California would go about ensuring standardization and quality assurance of this additional training, given the fact that it would affect ACPs that fall under different governing bodies (PA, NP, CNM).

 

Also, what does ACOG think about this?

[mdebord]

I read a slightly different version of this article (can't find now or I'd post) that included the fact that since a 2007 grant, nearly 8000 such procedures have already been performed by non-physician providers with a complication rate of about 2% (similar to physicians). Seems to provide great evidence to support the bill (and future expansion such as the vasectomies mentioned above).

[EMEDPA]

no scalpel vasectomies are already done by nurses in africa. training is like 2 days.

I did open btl's as a student with an ob looking over my shoulder. probably also a 2 day course for solo procedural mastery in all but morbidly obese pts. BTL can be done just with local or local + IV procedural sedation.

[gleannfia]

if they are going to allow this I would like to see PAs get easily credentialed for tubal ligations and vasectomies as well. less risk and this way we could affect both sides of the pipeline as it were and maybe prevent the need for later abortions.

I agree. I would like abortion to be safe, legal and RARE.

[gleannfia]

Coincidentally, or perhaps not so coincidentally, Rick Perry's sister has what you might call a personal stake in this legislation in Texas.

[Lexapro]

Yes, the study to allow CNMs and over providers to perform early abortions was piloted by UCSF. It's been a while now that they've had the data to show it's not a safety concern. I'm glad to hear they're finally moving forward on the legislation.

[Guest JMPA]

pas should also be able to perform euthanasia and lethal injection for convicts

[Gordon, PA-C]

if they are going to allow this I would like to see PAs get easily credentialed for tubal ligations and vasectomies as well. less risk and this way we could affect both sides of the pipeline as it were and maybe prevent the need for later abortions.

 

I seriously doubt NPs or PAs are going to do abortions in any significant number. Hell they literally throw money at MDs to do it and cant find many takers. Only 10 percent of ob/gyns do them. Every provider who does surgical abortions is quickly going to be publicly villified with their home address and phone number lsited on the internet. Who wants to drive home every day to find protesters outside your house?

 

The only way I could see it working is if a PA flies into a state to do a few quick abortions and then flies home in another state so nobody knows where he lives.

 

Now, medical abortions are a different story. Many states allow remote scripting for mifepristone and therefore it could be done remotely by PAs.

 

Secondly, not only should PAs do tubals and vasectomies, we should put c sections in that mix. It is a very straightforward procedure. Hell even FP docs can get credentialed to do them!

[EMEDPA]

Secondly, not only should PAs do tubals and vasectomies, we should put c sections in that mix. It is a very straightforward procedure. Hell even FP docs can get credentialed to do them!

c-section with vertical midline incision is a fairly starightforward approach and misses the ureters. I took the optional "emergency c-section lab" in the adv. life support in obstetrics course. That + the probably 20 c-sections I first assisted as a pa student 18 years ago and I think I could do one in a pinch if I had to.

[uscbigdawg]

Heck...as a medic, I assisted on a few vasectomies while deployed to Afghanistan when I would rotate through the aid station. Local anesthesia and the two doctors leading were non-surgical. Super simple procedure and had no complications.

 

With a little training and practice, I don't see why this can't be done outpatient like similar procedures.

[LT_Oneal_PAC]

They do credential PAs for vasectomies in the military. FlexSig scopes too.

[medic25]

Heck...as a medic, I assisted on a few vasectomies while deployed to Afghanistan when I would rotate through the aid station. Local anesthesia and the two doctors leading were non-surgical. Super simple procedure and had no complications.

 

With a little training and practice, I don't see why this can't be done outpatient like similar procedures.

 

Do I want to know why they are doing vasectomies at an aid station in the middle of Afghanistan? Doesn't seem like a typical procedure in a combat situation.

[uscbigdawg]

So you can complete post op recovery before the return home party comenses. It happens all the time. Everyday in a combat zone is not combat related. Gotta go, to know I suppose.

[medic25]

So you can complete post op recovery before the return home party comenses. It happens all the time. Everyday in a combat zone is not combat related. Gotta go, to know I suppose.

 

Gotcha, thanks. My buddies who served as PA's over there always said most of their work was non-combat related, but I didn't think about elective stuff like a vasectomy.