A matter of access: State Senate committees consider bill that would let APRNs perform abortions

Legislation that would allow advanced practice registered nurses to perform abortions passed through the state House and is now before the state Senate.

House Bill 576 will be heard at 9:30 a.m. today by the Senate’s Health and Commerce and Consumer Protection committees.

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The legislation would permit an APRN to provide medication or aspiration abortions in the first trimester of pregnancy — as long as they have prescriptive authority, practice within their specialty and have a valid and unencumbered license. The bill also requires the procedure to be performed in a hospital licensed by the state Department of Health or operated by the federal government, in a clinic or APRN’s office.

Currently, only physicians can provide abortion services.

But according to the legislation, residents in West Hawaii as well as those who live on Kauai, Molokai and Lanai do not have access to local physicians who can provide such care.

“These residents are therefore forced to travel long distances to access care, increasing costs for travel, lodging and child care,” the bill reads. “Travel to reach care is an insurmountable barrier for people who already face systemic barriers to health care, including people with low incomes, young people, survivors of intimate partner violence and people in rural communities.”

The ongoing COVID-19 pandemic has highlighted existing challenges of the physician shortage and exacerbated current barriers to care.

According to the legislation, studies have found no differences in safety when the procedure is performed by qualified providers other than physicians.

Allowing licensed APRNs to provide abortion care would allow residents to stay in their communities to receive care with fewer financial and logistical barriers, the bill states.

The bill passed its final House committee — the Judiciary and Hawaiian Affairs Committee — and third reading in that chamber earlier this month.

Kona Councilwoman Rebecca Villegas was among the numerous individuals and organizations who provided written testimony in support of the measure prior to the committee hearing..

“Our constituents in my district, as well as constituents on the islands of Kauai, Molokai and Lanai, do not have access to a local care provider unless we travel two hours or fly to another island,” she wrote. “The outer islands should have the same access to health care that Oahu and Maui residents have, and COVID has compounded the financial and logistical barriers to care for the outer islands.”

A number of others opposed the measure.

“Expanding the number of people who can provide abortion will increase the number of unborn children being killed,” wrote Janet Hochberg, executive director of Hawaii Life Alliance, in submitted testimony. “We strongly urge you to prevent this from happening by making it clear that it is not within the scope or independence of practice of lower health care professionals to provide abortion

“Abortion proponents have long touted that abortion should be safe, legal and rare!” she continued. “Although we choose life over abortion, let’s keep it that way and work toward serving our most vulnerable communities with resources and life-affirming programs that will help prevent and mitigate the fall out from unplanned and difficult pregnancies.”

Puna state Sen. Joy San Buenaventura, a member of the Senate health committee, said Thursday that she expects a contentious debate today.

She said that conversations surrounding the issue shouldn’t be controversial more than 40 years after Roe v. Wade, the 1973 the U.S. Supreme Court ruling that protected a woman’s right to choose, but with other states restricting access, “it still is a hot topic as to whether or not a woman still has a right to have control over her own body.”

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The legislation does not expand access but rather allows access in an area with limited health care professionals, she said, giving women in their first trimester the right to choose “a safe option, without having to fly Oahu.”

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.

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