State board OKs abortions by nurse practitioners

Nurse practitioners with special training can perform first-term abortions in Arizona, the state Board of Nursing voted Wednesday.

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The panel concluded that the act of “aspiration abortions,” where the fetus is vacuumed out of the uterus, is within the legal scope of practice of nurses with advanced training and experience. They rejected the contentions of an attorney for the anti-abortion Center for Arizona Policy that letting anyone other than a doctor terminate a pregnancy violates Arizona law.

Wednesday’s vote, which came with only one dissent, most immediately legalizes most of what Mary Andrews has been doing at a Tucson clinic of Planned Parenthood Arizona since 2001. But it also opens the door for other nurse practitioners to begin performing the procedure in the future.

In a separate vote, the board concluded nurse practitioners cannot legally do abortions beyond the 13th week of pregnancy. Carol Bafaloukos, a spokeswoman for Planned Parenthood, admitted Andrews has been terminating pregnancies using that same procedure through 16 weeks since 2001.

But board members chose to impose no penalty, saying they have never before ruled that second-trimester abortions should not be done by nurse practitioners. And Andrews said she stopped performing those abortions in March and will not do them in the future.

Wednesday’s action does not end the dispute.

The state House already has approved legislation sponsored by Rep. Bob Stump, R-Peoria, which would spell out that only a physician can perform an abortion. HB2269, which would overrule any board decision, awaits Senate debate.

And Deborah Sheasby, attorney for the Center for Arizona Policy, said even if Stump’s bill fails or is vetoed, she believes existing statutes already make it more than clear that nurse practitioners cannot perform abortions.

She said her organization may sue to get a judge to reach the same conclusion.

Nursing is generally regulated under state law. But the scope of what they can do generally is spelled out in regulations.

Nothing in those rules mentions abortions. Instead, they say only that nurses with certain advanced training may “perform therapeutic procedures that the registered nurse practitioner is qualified to perform.”

Wednesday’s board vote clarifies for the first time that “aspiration” abortions performed in the first 13 weeks of pregnancy fit that definition.

But Stump, the House Health Committee chairman, said it is the Legislature that should decide who gets to terminate a pregnancy, getting House members to approve on a 32-28 margin.

Even if the Senate goes along, however, the odds may be against the measure becoming law. While Gov. Janet Napolitano does not comment on pending legislation, she already has vetoed two measures this session designed to put some new restrictions in statute.

Sheasby said while Stump’s measure would “clarify” the law, she does not believe its approval is necessary to halt nurse practitioners from performing abortions.

She noted one state statute dealing with licensing abortion clinics refers only to doctors performing the procedure. But Sheasby acknowledged a federal court has barred the state from enforcing that law.

Sheasby said even if that law never takes effect, she believes it is clear the Legislature never intended for nurse practitioners to perform abortions.

She said lawmakers have recrafted laws about nurse practitioners over the years, often expanding what they can do, but never once decided they also can do abortions.

But Lawrence Rosenfeld, an attorney for Planned Parenthood, said he reads Arizona law the other way.

He said the fact that no law specifically prohibits nurse practitioners from performing abortions means the state Board of Nursing gets to decide the issue.