Bill Would Allow Certified Midwifes to Perform Abortions Without Doctors

On Friday, the Assembly Business and Professions Committee will hear a bill that would allowed certified nurse-midwifes to perform abortions without doctor supervision.

Certified nurse-midwives close to getting expanded rights and duties

Senate Bill 1237, authored by Senator Bill Dodd (D-Napa), would also require written permission of a patient before such a midwife-only abortion is performed, with the midwife getting the required training and certification to perform an abortion by themselves before any solo abortions. Certification itself would come from a board to be comprised of other certified midwifes and certified doctors.

Midwifes would also be able to furnish certain drugs for their new duties, but would need a physician to sign off on the drugs beforehand. They would also need to register under the Controlled Substance Utilization Review and Enforcement System (CURES) for administering drugs.

SB 1237, also known as the Justice and Equity in Maternity Care Act, also affects births, with midwifes being responsible for registering any births they attend outside the hospital, especially in low-risk births. Data regarding midwifes actions would also need to be sent into the state.

Senator Dodd and supporters of SB 1237 have said that health care costs, a shortage of obstetricians, 9 California counties having no OB/GYN units, and racial disparities in birth and abortions are major factors affecting pregnant women in California. The lack of abortion access for women in rural areas and minorities in many areas has also been noted by supporters as a main reason to allow midwifes to perform abortions without extensive supervision.

“I appreciate the support for this proposal, which will improve access to high-quality maternity care and help resolve inequities in treatment for women of color,” said Senator Dodd last month. “The current gap is completely unacceptable. By increasing access to nurse-midwives, we can improve outcomes for mothers and babies, especially those in rural or inner-city settings.”

Mid-wife organizations also noted many of the same conclusions.

​”The burden of morbidity and mortality falls largely on Black and indigenous women and those from marginalized communities who cannot receive the care they need and desire,” explained California Nurse-Midwives Association Kathleen Belzer. “This is unacceptable. SB 1237 will improve access to maternal health care by removing physician supervision which is extremely difficult to attain. This will be especially impactful in the community, out of hospital setting. This bill allows certified nurse-midwives (CNMs) to work independently with low risk women, and creates a collaborative framework for CNMs to work with physicians when necessary in a team based model to ensure the safest and highest quality care available.”

Despite a majority in support of SB 1237, opposition remains strong

Opponents have included family groups and medical professionals, with family and religious groups focusing on fetus removal as a main objection.

“It is horrific enough that California funds the killing of children through all nine months of pregnancy and leads the country in abortions with over 132,000 each year,” said California Family Council president Jonathan Keller. “But the radical abortion lobby and the politicians they support seem hellbent on making it easier for unborn children to be killed, even if it means lowering health and safety standards for all women.”

Physician and medical groups have said that the issue is more of medical and safety issue.

“Anything can go wrong when a woman is giving birth,” explained gynecologist Dr. Jaya Kanda. And anything can go wrong during an abortion. Disregarding the abortion debate, you need medical professionals on hand for that, as you need medical professionals during birth.”

“During births there may be complications. This can result in a lot of quick decisions, including an emergency c section. At home with a mid-wife, the odds go up in health risks by not having a doctor there. Some people only see the cheaper cost and don’t put what a life is worth in that equation. Any doctor will tell you that a hospital is the safest place.”

“The same goes for abortions. Abortions are a safe procedure, but there is still a chance of complications. And when you only have a midwife there, that percentage rises because medical professionals can see a lot more that’s happening than those who haven’t been trained.”

“We need safety in these procedures, not a greater chance of things going wrong.”

Despite concerns over midwifes performing such duties, the state Senate nearly unanimously passed SB 1237 in June 35-1, showing a large amount of support for the bill.

Should SB 1237 be passed this session, California would join 10 other states in allowing non-physicians to perform abortions.