TESTIMONY OF THE MAINE MEDICAL ASSOCIATION

IN SUPPORT OF

L.D. 1261, AN ACT TO AUTHORIZE CERTAIN HEALTH CARE PROFESSIONALS TO PERFORM ABORTIONS

Joint Standing Committee on Health Coverage, Insurance & Financial Services
Room 220, Cross State Office Building, Augusta, Maine
Wednesday, May 1, 2019, 10:00 a.m.

Good morning Senator Sanborn, Representative Tepler, and Members of the Joint Standing Committee on Health Coverage, Insurance, & Financial Services.  My name is Dr. Norma Dreyfus and I am a retired pediatrician from Arrowsic and I am pleased to be here to testify in support of LD 1261, An Act to Authorize Certain Health Care Professionals to Perform Abortions on behalf of the Maine Medical Association.  I am a long-term member of the MMA Legislative and Public Health Committees.

The MMA is a professional organization representing more than 4300 physicians, residents, and medical students in Maine whose mission is to support Maine physicians, advance the quality of medicine in Maine, and promote the health of all Maine citizens.

Unfortunately, as others have testified, women in a large swath of rural Maine lack abortion providers, requiring women who are able, to travel long distances, losing time from work and family.

A number of states have helped alleviate this situation by training advanced practice clinicians other than physicians to perform medical and aspiration abortions thus increasing their workforce.  The American College of Obstetricians and Gynecologists (ACOG) endorses this and studies, some abstracts of which are attached, show that the results of the practice of abortion by advanced practice clinicians are comparable to those of physicians¹.

Advanced practice nurses are a qualified work force who already perform services of complexity that is equal to or greater than abortion, including miscarriage management which is identical to the procedure used for the aspiration abortion procedure.

Medical and aspiration abortions are safe procedures, indeed are many times safer than childbirth which has been attended to by nurses, as midwives, for centuries.  A study in the journal Obstetrics and Gynecology² concluded that childbirth is associated with 11 times the mortality of safe legal abortion.  The overall morbidity associated with childbirth exceeds that with abortions as well.  Advanced practice clinicians may readily be trained to perform medical and aspiration abortions which have less morbidity and mortality than childbirth.

L.D. 1261 would remove the restriction that only physicians can perform abortions and would allow advanced practice clinicians to do so.  According to ACOG, “access to safe abortion hinges upon the availability of trained abortion providers.”³ This bill would move Maine closer to that goal.

The alternative, unsafe illegal abortions, is unacceptable.  I was a medical student in the 1960s prior to the Roe v. Wade decision and will never forget the “septic” abortion ward.  As Dr. David Bingham, a colleague of mine, wrote, “when we made rounds, there was a whole ward full of (septic abortion) patients with varying degrees of infection and hemorrhage, complications from quacks, beatings, poisonings, and potions.  Most of these patients would be left sterile, some would not survive, all survivors would be traumatized.”

I ask that you vote “Ought to Pass” on L.D. 1261.

Thank you and I would be happy to respond to any questions you may have.

¹Freedman, MA, Jillson, DA, Coffin RR, Novick LF. Comparison of complication rates in first trimester abortions performed by physician assistants and physicians. Am J Public Health 1986; 76:550-4 Weitz TA, Taylor D, Desa S, Upadhayay UD, Waldman J, Battistelli, MF,et al. Safety of aspiration abortion performed by nursing practitioners, certified nurse midwives, and physician assistants under a California legal waiver.  Am J Public Health 2013; 103:454-61

²Raymond, Elizabeth and Grimes, David, The Comparative Safety of Legal Induced Abortion and Childbirth in the United States; Obstetrics and Gynecology: Feb 2012; 119; Issue 2, 215-219

³ACOG 2014, Committee on Health Care for Underserved Women; Number 612, Nov 2014