No, You Don’t Need a Doctor to Perform an Abortion

The number of U.S. abortion providers has decreased dramatically since clinics hit their peak in the 1980s. And that erosion of options continues to decline, even after the Whole Woman’s Health v. Hellerstedt ruling in 2016 blocked states from using admitting privileges and hospital transfer agreements to stop doctors from providing terminations.

But the closures of some clinics over an inability to find doctors who can offer care has many people questioning the very premise that a doctor needs to perform an abortion in the first place.

That’s just the question we should be asking, too.

In many ways, it’s ironic that abortion has been delegated to the professional wheelhouse of doctors. After all, it was the physician’s movement that worked to make abortion illegal in the United States from the beginning.

As History.com reports:

During the second half of the 19th century, American physicians intent on overseeing women’s reproductive health campaigned to criminalize abortion, sending a common practice underground.

Noting that abortion was not criminalized, fairly abundant and primarily the work of midwives and herbalists, the site explains that professional men wanting to elevate their own status and legislate their morality brought about the first laws against terminating a pregnancy.

The site explains:

This infuriated those who felt that abortion was immoral—and created troubling competition for physicians,” they write. “At the time, medicine was becoming an actual profession instead of the realm of homegrown practitioners, and the rise of medical schools and accreditation created a class of professional doctors. These physicians were suspicious of the midwives and self-styled “doctors” many women relied on for abortions, and as soon as the American Medical Association formed in 1857, its members began to agitate to make abortion illegal.

Later, doctors wanting to be able to offer abortion helped drive the effort in the 1960s and ’70s to make abortion less restricted — primarily to protect themselves legally for when they chose to perform the service. And it has stayed that way, even as the states began using the “doctor” issue as an increasingly narrow designation to restrict who could provide care at all.

Physicians turned into OB-GYNs, then board-certified OB-GYNs, then board-certified OBGYNs with hospital admitting privileges, as red state legislatures weaponized the profession’s own specialties to restrict care and close down clinics.

The reality is that a first trimester non-medication abortion is an extremely safe procedure, and one that has become increasingly so with the introduction of manual vacuum aspiration. And, of course, a medication abortion — which simply involves handing a patient the proper pills — doesn’t need any medical training at all.

Despite this fact, far too many states hold onto antiquated requirements that all abortion must be performed by doctors. But with doctors — and access — disappearing, a handful of states are now trying to make a change.

Legislators in the state of Maine are now hoping to expand the pool of medical professionals who can offer abortion care by allowing nurse practitioners and physician assistants to provide.

The Portland Press Herald reports:

Denise Tepler, D-Topsham, one of the bill’s co-sponsors, said in a floor speech that many women support the bill because it allows them to seek abortion services from the primary health care providers with whom they already have a longstanding relationship.

“A provider who may have delivered her baby, counseled her on test results or helped her determine a course of action to improve her health,” Tepler said.  “I think we can agree that a woman should be able to seek medical care, including an abortion, from a provider she trusts and with whom she has an established relationship.”

If Maine’s bill passes, the state will join neighbors New Hampshire and Vermont, which also allow more medical professionals to terminate pregnancies.

Minnesota isn’t passing legislation to expand the provider pool; instead they are doing it via the courts. A new lawsuit by providers, reproductive rights activists and clergy is challenging a number of state abortion restrictions, ranging from two parent parental consent to a mandatory 24-hour wait for a procedure.

In the bevy of antiquated and medically unnecessary restrictions is one that says only doctors can offer abortions — a rule that certified nurse midwives hope to change so they too can offer terminations. This is the same tactic being launched in Virginia, where the state’s court is also looking at potentially striking down a “doctors only” abortion rule.

The simple truth is that any medical professional could be trained to perform early abortions — especially if those abortions are nothing more than providing medication to a patient. That’s one of the reasons that so many primary care doctors are now looking into how to integrate medication abortion into their own practices and offer that care to their own patients should unwanted pregnancies arise.

Do you really need a doctor to have an abortion? Not at all. Now hopefully we can all work together to make our laws reflect that reality.

Photo Credit: Robin Marty/Flickr

44 comments

William T
William T4 days ago

thanks for this

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Elaine W
Elaine W5 days ago

Noted. thanks.

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Lesa DiIorio
Lesa D6 days ago

thank you Robin...

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Leo C
Leo Custer7 days ago

Thank you for sharing!

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Freya H
Freya H8 days ago

Anti-choice activists and politicians will never stop abortion; outlaw the procedure, and it moves underground, to secret rooms, to the private offices of doctors (for the rich), to bathtubs and bedroom floors. Women will seek out back-alley butchers, or risk fatal injury self-aborting. Meanwhile, where are the "defenders of human life" AFTER the babies are born? (You still reading, Anne M?) Where will they be for the hungry, the homeless, the neglected, the abandoned, the abused? And what are they doing to save the planet so we'll all have a place to live in the first place?

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pam w
pam w9 days ago

Guess what? RU486 works most of the time but not ALL of the time! Abortions are sometimes needed to correct an incomplete result of RU486! And--this article is correct--you do NOT need a medical degree to provide a safe, effective abortion! My Planned Parenthood clinic uses nurses, trained by our medical doctors. All vital signs are carefully monitored, anesthesia is administered by carefully trained nurses/nurse practitioners/midwives, etc. People like myself spend quality time with patients, helping them prepare for the procedure, helping them to relax (careful breathing) holding their hand and speaking for them whenever necessary. This is PP's goal....a woman-friendly, safe, effective procedure which sends her on her way with a (relatively) happy experience.

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Leanne K
Leanne K9 days ago

Free not greetings, my below comment was auto corrected

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Leanne K
Leanne K9 days ago

In fact, if I was living in America I would be stockpiling RU486 and dispensing them greetings whoever needed them. Eff that

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Leanne K
Leanne K9 days ago

Just make RU486 readily available

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Mark T
Mark Turner9 days ago

Ty.

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