In every state, the term “scope of practice” describes what that state’s laws allow individual health care providers to do. Licensed physicians always have the broadest scope of practice, but most states also allow “advanced practice” providers to perform significant clinical tasks and to prescribe drugs. The type of advanced practice provider most people are familiar with is the nurse practitioner (the type of provider most likely to treat you in a drug-store or Walmart-based health clinic), but there are many others such as physician assistants, certified nurse midwives, certified registered nurse anesthetists and so on.
A 2013 study published in the American Journal of Public Health confirmed that advanced practice providers can safely provide aspiration abortions:
Conclusions. Abortion complications were clinically equivalent between newly trained NPs, CNMs, and PAs and physicians, supporting the adoption of policies to allow these providers to perform early aspirations to expand access to abortion care.
In the picture above, taken from the very handy AP Toolkit, the green coloring indicates states where advanced practice providers are able both to perform aspiration abortions and to prescribe drugs needed for medication abortions. The states in blue allow their advanced practice providers only to prescribe drugs for medication abortions, but not to provide aspiration abortions. The states in orange (appropriate color I guess . . .) don’t allow their advanced practice providers to do either.
This is an important area of political advocacy. If you live in a green state, your state is already doing well. If you live in a blue state, advocate for your state’s scope of practice for advanced practice providers to be expanded to include the ability to perform aspiration abortion (such efforts already underway!).
If you live in an orange state . . . do your best. In many of the orange states I think there’s not much chance of changes in this area, but it may be possible in some of them.
As access to abortion is shut down in much of the country, women needing this health care service will be travelling to states where it remains legal. It could very well be that the primary limiting factor to this activity is a lack of health care providers rendering this service, even in states where it is legal.
Advocating for expansions to your state’s scope of practice for advance practice providers is admittedly not the most exciting aspect of the fight we find ourselves in. In my opinion at least, it is a critical part of doing what we can to maintain reproductive freedom.