Advocacy groups aiming to improve access to abortions are taking their fight to court in Maine.
The Maine chapter of the American Civil Liberties Union and Planned Parenthood on Wednesday filed a lawsuit in federal court over a state law that permits only physicians to provide abortions. Maine is among 41 states that have such a requirement, which the groups argue “severely restricts access to abortion care” in rural areas with no abortion clinics and sparse physician coverage.
The groups want to lift the provision to allow qualified nurse practitioners and nurse midwives, who often serve as women’s primary and gynecological care providers, to perform abortions. That would include abortion procedures in a clinic as well as terminating pregnancies with medication, known as the “abortion pill.”
While the first goal is to improve the lives of women in Maine who are harmed by the law, “we’re also hoping that if we’re successful it will set a good precedent for the rest of the country,” Zachary Heiden, legal director of the ACLU of Maine, said.
Maine is home to three publicly accessible health centers where women can get abortions in a clinic setting: Planned Parenthood’s location in Portland, the Mabel Wadsworth Center in Bangor, and a Maine Family Planning clinic in Augusta. If the provision is lifted, that number would increase to 18, the groups said.
Maine’s law “causes women to delay their abortion while they save money and arrange for transport, time off work, and child care — if they can access an abortion at all,” the groups said in a joint statement announcing the lawsuit. “These barriers are 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.”
Some women living in northern Maine, for example, travel more than six hours round trip to Bangor for an abortion, even though a qualified advanced practice registered nurse in the community is ready to provide that care, the groups said.
Julie Jenkins, a nurse practitioner with Maine Family Planning in Belfast, said some women must spend the night away from home and their children to access an abortion.
“The law singles out abortion care with no medical justification, and that harms women who can’t get abortion care from qualified providers in their communities,” Jenkins, one of four advanced practice clinicians named as plaintiffs in the suit, said.
Advanced practice nurses already provide a range of health services of equal or greater complexity than first-trimester abortion, the groups said, including a procedure used to manage a miscarriage. The procedure, which involves using suction to empty the uterus, is the same used to terminate an early pregnancy in a clinic setting.
Nurse practitioners also already administer the medications used to induce an abortion in cases of miscarriage, Jenkins said.
Maine Family Planning offers the abortion pill, a combination of two medications, at its centers throughout the state. As of last year, Maine Family Planning provides the service by connecting doctors with patients virtually through telemedicine.
New Hampshire and Vermont already allow advanced practice registered nurses to perform abortions.
The advocacy groups pointed to a 2013 study of more than 11,000 abortion patients in California over four years, which found an equivalent low rate of complications resulting from abortions performed by doctors versus those performed by newly trained advanced practice clinicians.
Several medical authorities, including the World Health Organization, the American College of Obstetricians and Gynecologists, and the American Public Health Association, support allowing advanced practice clinicians to perform abortion services in early pregnancy.
Wednesday’s court filing comes more than a year after the Supreme Court struck down abortion restrictions in Texas, finding that states may not impose undue burdens on women seeking an abortion.