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Physician-only limit on abortion questioned again

(The Center Square) – Pennsylvania’s abortion laws turn providers into travel agents, advocates say, because of restrictions that prevent medical professionals other than doctors from performing the procedure.

Providers add that for those who are qualified, the influx of women from states with more restrictive bans leads to a delay in services that puts patients at risk.

“In order to provide this care, I actually drive an hour each way every day across state lines to Delaware,” said Kelly Nichols, associate medical director of Planned Parenthood of Delaware. The state lifted its physician-only requirement in 2022.

Nichols noted that the restrictions make the state a less desirable place for medical professionals to study and ultimately settle down, adding to the major medical staffing woes seen across the commonwealth.

One in four women receive abortions in their lifetimes for a broad spectrum of reasons, according to a survey from Guttmacher Institute, a non-profit research and policy organization that focuses on reproductive health rights.

Advocates say that for many, the right to an abortion is a matter of life or death. According to midwife Katrina Lipinsky, the maternal mortality rate is 83 per 100,000 live births in Pennsylvania. For Black women, the rate is even higher at 148 per 100,000 births. Adolescents see increased risks for complications like anemia, eclampsia and preterm birth. For abortion, the risk of death is just 0.45.

“We know that abortion is much more safe than continuing a pregnancy and delivering at full term,” she said.

During a recent hearing with the House Democratic Policy Committee, where lawmakers have considered loosening restrictions in the wake of a Supreme Court decision that tossed the question of constitutionality back to the states, Lipinsky argued that Pennsylvania’s physician-only requirement makes little sense.

She pointed out that she isn’t allowed to perform abortions in the state, even though she uses the same procedures and medications to assist women experiencing miscarriages in the early stages of pregnancy.

In the past, physicians have expressed concerns about the scope of care, particularly related to giving more treatment authority to certified nurse practitioners. This debate has never focused on abortion services, however.

The Center Square was unsuccessful in its attempt to contact the Pennsylvania Medical Society for comment on the issue.

Pennsylvania currently bans abortions after 24 weeks. Laws also require parental consent for minors, as well as a 24-hour waiting period. According to Chris Castro, senior attorney for the Women’s Law Project, the latter rule unfairly limits minors in the foster care system or those without a stable parental figure. For others, it’s redundant.

“The overwhelming majority of young people do involve a parent in their decision to have an abortion, regardless of whether the state mandates parental involvement,” she said.

Abortion is also regulated under the criminal code, a unique distinction amongst medical procedures. The classification means that even doctors who can provide abortion care may shy away from offering it in their practice, and pharmacies may choose not to stock the drugs required for medication-based abortions.

Medical providers opposed to abortion, including faith-based coalitions like the Christian Medical and Dental Association and the Alliance for Hippocratic Medicine, say that evidence is “clear” that abortions both increase the risks of preterm delivery in future pregnancies and the development of breast cancer in patients that do not complete a full-term pregnancy.

The alliance further argues that the 90% of OBGYNs who don’t perform abortions do so out of a moral responsibility rather than a “politically motivated lie that abortion is essential health care.”

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