Nurses, Midwives, and PAs ‘Fill Gap’ as Abortion Providers

When physician is removed, does risk increase? California now permits non-physicians to perform abortions, a move that supporters say guarantees access, while opponents claim is bad medicine. Over the last 4 years 30 states passed legislation aimed at restricting access to abortion, a trend that California bucked when the state passed Assembly bill 154 in 2013, enabling mid-level providers to offer medication and surgical abortions. Mary Davenport, MD, FACOG, an obstetrician-gynecologist practicing in the San Francisco area and a medical director of the Magnificat Maternal Health Program in Nigeria, called the state’s decision “bad policy” based on “bad research.” Davenport promotes a technique to reverse medical abortions that use RU-486 — www.abortionpillreversal.com and http://www.medpagetoday.com/OBGYN/GeneralOBGYN/50164 At the American Association of Pro Life Obstetricians and Gynecologists here last month, Davenport critiqued a study by Tracy Weitz, PhD [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3673521/ see Abstract and excerpts below], published in the American Journal of Public Health, which compared safety outcomes among physicians and non physicians performing surgical abortions, also known as aspiration or “vacuum” abortions. Davenport argued that Weitz had a predetermined conclusion before even beginning her research. “She’s a brilliant woman. She had a firm ideology about abortion access, and then she did a study that was instrumental in getting this law passed in the legislature,” Davenport said. Weitz’s prospective observational study was designed to measure the safety among women whose abortions were administered by either nonphysicians — nurse practitioners, physicians assistants or nurse midwives — or physicians. The researchers chose a noninferiority design because “we anticipated a slightly higher number of complications among newly trained NPs, CNMs, and PAs than among the experienced physicians,”...