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Committee debates AB 1973 expansion to "procedural abortion" language; no recommendation taken
Summary
Committee members and public commenters discussed AB 1973, a bill that would authorize nurse practitioners, midwives and PAs to perform "procedural abortions," potentially including some second-trimester procedures. Members and commenters disagreed about competency, gestational limits, and safety; the committee did not take a formal position and recorded the item as information-only.
The committee discussed AB 1973, which would change statutory language from "abortion by aspiration" to "procedural abortion," potentially covering first-trimester aspiration and some second-trimester dilation-and-evacuation procedures.
Marissa Clark summarized that the bill would authorize nurse practitioners, nurse midwives and physician assistants to perform procedural abortions after completing approved competency-based clinical and didactic training, and would require those clinicians to maintain procedures for consultation, referral and transfer to a physician for complex cases.
Committee exchanges focused on whether the bill should include second-trimester procedures. One committee member opposed that portion, saying, "second trimester termination or procedures are a real surgical procedure should be done in the hospital and I don't think it's in the scope of practice of a midwife." Other members and public commenters pushed back that competency-based training and appropriate hospital settings can address safety concerns; CNMA's Holly Smith highlighted international and state-level evidence that advanced practice clinicians can perform second-trimester abortion with outcomes comparable to physician care where adequate clinical training exists.
Public commenters spoke in support of competency-based training and urged the committee and the board to consider evidence and proposed amendments that define training expectations and clinical settings. Committee members asked for more granular definitions of gestational limits (for example, whether the bill would cover up to 14, 16 or 24 weeks) and said that stakeholder engagement and clarified training standards would be necessary before the board could make a position recommendation. The committee did not make a motion and will forward the discussion and public comments to the board for consideration.
