Outdated Law Banning Advanced Practice Clinicians from Providing Abortion Care Restricts Patients’ Ability to Get Health Care
Augusta – Reproductive rights advocates and providers today voiced their support for a bill to end Maine’s outdated ban on advanced practice clinicians (APCs) providing abortion care in Maine. Gov. Janet Mills and Speaker of the House Sara Gideon introduced the bill, LD 1261, which would allow qualified APCs such as nurse practitioners, physician assistants and certified nurse-midwives to provide abortion care.
The ACLU of Maine, Mabel Wadsworth Center, Maine Family Planning and Planned Parenthood of Northern New England said the bill will greatly expand access to needed health care, especially in rural parts of the state.
There are only three publicly accessible health centers in Maine (in Augusta, Bangor and Portland) where a patient can get an aspiration abortion or any abortion care after 10 weeks. Some people in rural parts of the state have to travel as far as eight hours round trip for an abortion – even if there is a qualified health care provider in their community who could perform one. While medication abortions are available in some cases via telemedicine at clinics throughout rural Maine, the APC ban makes delivering abortion care via telemedicine unnecessarily onerous.
As a result, some people must delay their abortion while they save money and arrange for transport, time off work, and child care, or forgo having an abortion at all. These barriers fall hardest on people who already face systemic barriers to health care, including people of color, people living in rural areas, young people and people with low incomes.
Currently, APCs provide a wide range of health services of equal or greater complexity than abortion, including miscarriage management – which is identical to the procedure used for an early in-office abortion. Numerous health organizations, including the World Health Organization, American College of Obstetricians and Gynecologists and the American Public Health Association support allowing APCs to perform abortions in early pregnancy.
In 2017, the ACLU and Planned Parenthood filed a federal lawsuit on behalf of Planned Parenthood of Northern New England, Maine Family Planning, and several health care providers challenging Maine’s APC ban. That suit is currently pending in the U.S. Court for the District of Maine.
The State has conceded in that litigation that APCs “are highly-skilled, compassionate, and trusted medical providers who, if properly trained, are competent to provide abortion services,” and that there are “strong public policy reasons for repealing” this ban, including making abortion care more accessible and less costly.
The following quotes can be attributed as noted:
Oamshri Amarasingham, ACLU of Maine advocacy director: "Enough is enough. Limited transportation options, brutal winters, and a shortage of health care providers – Mainers face more than enough obstacles to accessing needed health care without having medically unjustified laws piled on top. We're thankful to Gov. Mills and Speaker Gideon for introducing this bill, which would dramatically improve Mainers' access to safe abortion care in their own communities."
Andrea Irwin, Mabel Wadsworth Center executive director: “As the longest-serving abortion provider in Maine and the only provider north of Augusta to offer abortion care after 10 weeks, we know there are real barriers preventing rural folks from getting needed health care. By ending this outdated ban, more rural folks will be able to access care and make their own decisions about pregnancy and parenting. Any bans that limit Mainers’ access to abortion should be repealed.”
Leah Coplon, MPH, RN, Program Director at Maine Family Planning: “Maine’s APC ban is an unnecessary restriction on safe and legal abortion care. While we strive to expand access at clinics in rural Maine through our telemedicine abortion program, the APC ban makes providing those services needlessly burdensome for both patients and providers.”
Alison Bates, Nurse Practitioner, Planned Parenthood of Northern New England: “The APC ban makes it harder for my patients to access the care they need, is medically unnecessary, and contributes to abortion stigma. It does not protect patient health or safety and in fact harms patients by limiting access to time-sensitive medical care — care they may otherwise receive from their provider of choice, in their community of choice.”
