У Connecticut and Maryland, lawmakers passed bills this spring that allow certified nurses, midwives and paramedics to perform medical and procedural abortions. У Delaware, lawmakers recently passed a bill that allows nurses and midwives to prescribe pills to terminate a pregnancy. У Washington Statelawmakers have codified the Attorney General’s report, which allows those known as “advanced clinicians” to perform abortions.

While this policy was developed in anticipation of the expected decision of the Supreme Court Rowe vs. Wade this term, more efforts are currently being made due draft conclusion POLITICO published two weeks ago.

New Jersey Gov. Phil Murphy pushes legislators create a “reproductive health access fund” with grants to train abortion providers and enact legislation that enshrines existing rules that allow advanced clinicians to perform abortions. And California Gov. Gavin Newsom published a proposal for budget amendments on Wednesday, which includes an additional $ 57 million to prepare state clinics to increase the number of patients seeking an abortion.

Lawyers believe that such a policy will allow states that support abortion to begin strengthening their supplier networks.

But a number of problems remain.

Anti-abortion organizations such as Students for Life of America and the American Association of Life Obstetricians / Gynecologists have mobilized to combat these state laws by sending people to testify against them and lobbying the legislature to oppose them.

In Maryland recently Republican Gov. Larry Hogan vetoed a bill that allows non-therapists to perform abortions, arguing that the policy “endangers the health and lives of women” and “risks reducing high levels of reproductive health services”. When the legislature overcame that veto, Hogan withheld $ 3.5 million allocated to a new training fund for abortion providers, which hampered efforts to begin training for non-doctors when the law is implemented this summer.

The Connecticut Medical Society also criticized the state’s move, telling lawmakers in March that such a policy would have “unintended consequences.”

“We are descending a slippery slope to allow those procedures that are actually surgical to make mid-level providers, creating patient safety concerns and a significant amount of problems from practice,” they wrote.

However, many individual physicians and medical groups have adopted an extension of who can perform abortions, including the World Health Organization, the American Public Health Association, and the American College of Obstetricians and Gynecologists.

“I’ve been training for 10 years to be where I am today, but I also recognize that most abortions in the United States happen in the first trimester and go without complications,” said Lauren Tuxton, an abortion researcher and researcher at the University of Texas. in Austin. “We also have a lot of data to say that the outcomes of health care in people who have best practices of doctors who provide abortion care are similar to those who have doctors.”

Approximately 10 percent of national abortion providers practice in 23 states that are willing to immediately ban most, if not all, abortions if Caviar canceled, according to the last abortion census of the Gutmacher Institute in 2017.

Of the remaining states, 18 allow non-therapists to perform abortions in accordance with the law, ordinance, court case, opinion of the Attorney General or a decision of the Board of Nurses, according to Gutmacher and POLITICO Public Policy Review.

While many low-income patients may not be able to travel for the procedure if the Supreme Court allows strong bans, Tuxton and other researchers are worried that not enough states are willing to handle the number of patients who can and will travel.

For example, Planned Parenthood reported that after Texas ’six-week ban took effect in September, there was 800 percent growth in patients wishing to have an abortion in neighboring states. Now many of the same states are going to impose bans.

“I’m worried about what it will look like if care is limited in more states than in one,” Tuxton said. “How will all this patient care be absorbed? I am worried that this will lead to delays in providing assistance that is dangerous. “

Longer waiting time

These delays will affect residents of blue states as well as those traveling from states that ban abortions, especially those living in rural areas where clinics are few or non-existent. If the provider’s workforce is not expanded rapidly, progressive proponents fear they may push patients out the window where they can legally undergo the procedure. Abortion pills are FDA-approved only for use during the first 10 weeks of pregnancy, as well as several blue states, including California and New York. only procedural abortions are allowed up to fetal viability, which usually occurs around 24 weeks gestation.

Washington State, for example, expects a 385 percent increase in the number of patients wishing to have an abortion from Idaho and other nearby states if Caviar canceled, according to Gutmacher Institute.

“If we are not prepared for what will happen, the inequality we see when access to reproductive care is not for everyone will deteriorate, and this has historically excluded communities,” said Kia Guarina, executive director of Pro-Choice, Washington.

In addition to the crisis, states like Maine and Kansas have book laws that say only a doctor can have an abortion. Others, such as Pennsylvania and New Jersey, have laws that allow nurses to work only under a doctor’s supervision – not only for abortions, but for many types of procedures.

https://www.politico.com/news/2022/05/17/states-expand-abortions-flood-of-patients-00032815

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