Improving Abortion Access by Easing Doctor Oversight Rules – Marin Independent Journal


I will never forget my first positive pregnancy test. My stomach knotted, my breath hitched. I was flooded with shame – a feeling that took me by surprise. I was 23 years old and worked as a physician assistant and counselor for an OB/GYN at a practice in San Francisco. For me, having an abortion was not a choice, it was obvious.

I was not ashamed to have an abortion. I was embarrassed to put myself in a situation where I needed to. I had sex and used birth control since high school. I was proudly HIV-positive, but I had method failure.

I was fortunate to work for an abortion provider who was knowledgeable, non-judgmental, and able to help me. I had the same procedure that I had seen other patients do hundreds of times. I left work that day relieved.

I had my second positive pregnancy test five years later, while living in Merced and working as a women’s health nurse practitioner. This time my options were much more limited. Access is a real barrier for far too many people, especially the tens of thousands of women who live in the 40% of California counties without a clinic offering abortions.

Unlike before, the two OB/GYN doctors I worked with did not perform abortions. There were no options nearby, and the San Francisco doctor who performed my first abortion couldn’t fit me into his schedule. Fortunately, a nurse practitioner friend from San Francisco General Hospital asked the doctor she worked for if he could help me, and he said yes.

Most women are not so lucky.

There is a solution in the works that would help take luck out of the equation: more abortion care providers.

California already has a large number of highly skilled and skilled nurse practitioners whom many patients trust and see for their primary and reproductive care needs. Although state law allows nurse practitioners to perform first-trimester abortions under the supervision of a doctor, with a shortage of doctors in the state and an expected increase in need now that the US Supreme Court- United overturned Roe v. Wade, it is essential to allow qualified nurse practitioners to perform this care without the supervision of a physician.

Nurse practitioners, nurse midwives and physician assistants can offer first-trimester vacuum aspiration abortion procedures under a doctor’s supervision under a law passed in 2013. This law has been a huge step forward in the health care industry, and I was proud to be the first nurse practitioner in the state legally trained to perform abortions.

We’ve since learned that requiring physician oversight is a barrier to abortion access because it doesn’t address California’s physician shortage.

California lawmakers have an opportunity to remedy that by passing Senate Bill 1375, authored by pro Tempore Senate Speaker Toni Atkins, which would clarify the law and allow nurse practitioners to perform first-trimester abortions and other non-physician reproductive care services.

To qualify, nurse practitioners must have at least the equivalent of three years of full-time experience under the direction of a physician and must meet other standards to ensure the quality of care remains high. Patient health and safety is and always will be the top priority.

Lawmakers have the opportunity to raise a workforce ready to meet demand and help more patients. Pregnant women don’t have time to wait for their appointments, and many may be unable to make the time to travel to clinics hours away. Luck should not be a factor in a person’s ability to have an abortion. Nurse practitioners should.

Debbie Bamberger, Nurse Practitioner, has been providing sexual and reproductive health care for nearly 30 years. Distributed by


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