Last week, the Maryland General Assembly overrode Governor Larry Hogan’s veto, enacting an affirmatively pro-abortion law, a law so pro-abortion that even the avowedly pro-abortion Hogan wouldn’t sign it. The law makes Maryland the 15th state in the country to allow non-physicians, including nurse practitioners, nurse midwives, and physician’s assistants, to perform abortions. It also requires Maryland insurance providers to cover the entire cost of abortion procedures and requires the state to spend $3.5 million annually on abortion-procedure training.
Naturally, the Washington Post editorial board is thrilled with this development, calling the law “a significant step to increase access to abortion statewide.” Left unstated is the main reason why this policy change will “increase access”: Less than 15 percent of OB-GYNs are willing to perform abortions, and permitting non-physicians to do so will increase the pool of abortion providers. Unlike what the Post claims, this move does not come without attendant risks.
The editorial asserts that “women in Maryland [will] benefit from the forward-looking legislation that lifts outdated barriers on who can perform abortions.” In defense of the assertion that the new law won’t harm “the quality of reproductive care,” the editorial cites only one study, authored by six researchers affiliated with the University of California, San Francisco, including its Bixby Center for Global Reproductive Health, one of the most pro-abortion institutions in the country. The seventh author, Jeff Waldman, served for more than three decades as medical director for Planned Parenthood Shasta Pacific, where he was employed at the time the study was produced. While this alone doesn’t discredit the study, a review of its findings suggests that the picture isn’t as rosy as the authors claim.
The study concludes that abortion complications were “clinically equivalent” between physicians and newly trained nurse practitioners, nurse midwives, and physician’s assistants, as well as that “the care provided by newly trained” non-physicians was “not inferior” to the quality provided by doctors. But one critique of the study, prepared by Mary Davenport of the American Association of Pro-Life OB-GYNs (AAPLOG), notes several major flaws in its methodology and outcomes, including a financial conflict of interest due to the involvement of Planned Parenthood employees and its abortion clinics and a failure to obtain proper informed consent from participants. Perhaps most important, the accuracy of the study’s complication statistics wasn’t verified by a review of medical records.
A more serious look at non-physician abortions suggests they pose at least some added risk to women’s health, for obvious reason. In order to become an OB-GYN in the U.S., aspiring doctors must complete a four-year medical-school program, followed by a four-year postgraduate residency program, during which they offer supervised clinical care in women’s reproductive health. Residents participate in surgical procedures and learn to deal with the natural variations and complications that arise in women’s health-care scenarios. Even the American Board of Medical Specialties, meanwhile, recognizes that abortions, especially late in pregnancy, are not a simple procedure; it recommends that abortion providers complete an additional two-year subspecialty training program after residency.
In contrast to this significant amount of training, nurse practitioners have completed a four-year undergraduate nursing degree and a two-year master’s program. Physician’s assistants likewise study for only six years. “When these complications occur, it is unlikely that these minimally trained technicians will have the skills and experience to manage the complications,” AAPLOG has said in a policy statement on the topic. “This will lead to more adverse outcomes in women who have entrusted their health to the abortionist’s care.”
Once again, “women’s rights” cheerleaders — including those on the Washington Post editorial board — have proven themselves willing to overlook or downplay the possibility that expanded abortion access might come at a cost to women’s health and safety.