No Doctors Required: California Pushes to Let Nurse Practitioners Perform Late-Term Abortions
A bill to expand who can perform late-term abortions in California drew a stark clash at the April 21 Assembly Health Committee hearing: a registered nurse described watching a full hospital unit scramble to save a woman’s life during a catastrophic obstetric emergency, while the committee chair, Assemblywoman Mia Bonta, responded by thanking the bill’s author for “finding opportunities for people to get the care they fully deserve.”
That collision, between frontline medical caution and legislative momentum, defined the hearing on AB 1973, a bill that would allow nurse practitioners, certified nurse-midwives, and physician assistants to perform second and third trimester abortions. The committee voted 11 to 4 to advance the bill to the Appropriations Committee, with Democrats voting yes and Republican members voting no.
What the Bill Does
Authored by Assemblywoman Cecilia Aguiar-Curry, AB 1973 removes current law restrictions that limit advanced practice clinicians (APCs) to first-trimester abortions. It also shields out-of-state providers from professional discipline for abortion-related conduct. Supporters say the bill simply aligns state law with the existing training and competency of nurse practitioners and midwives, particularly in rural areas where physician shortages are acute.
Opponents see it differently.
A Nurse’s Warning from the Delivery Room
Mindy Hertzel, a registered nurse with a certification in inpatient obstetrics and Director of Clinic Operations at Sierra Pregnancy and Health, testified in opposition, drawing on her direct experience with high-risk obstetric cases.
“Second and third trimester abortions are not simple procedures,” Hertzel told committee members. “Risks include hemorrhage, infection, uterine perforation, cervical laceration, amniotic embolism, and more, all of which are life-threatening. When complications occur, they escalate quickly and require immediate experienced interdisciplinary intervention.”
Hertzel described a case that shaped her understanding of how fast these emergencies move.
“I’ll never forget experiencing what it looks like to call a code on a patient experiencing an amniotic embolism,” she said. “It took our entire unit of nurses, anesthesiologists, the hospital rapid response team, and multiple physicians experienced in labor and delivery to perform the C-section, stabilize her, and transport her to critical care. The response was immediate and extensive. Had she not been in a facility equipped with teams of people prepared to respond to such emergencies, I hate to think of what the outcome would have been.”
Hertzel argued that expanding these procedures into less-equipped settings is not a compassionate expansion of access. “Expanding these abortion services into a setting less prepared than that would be catastrophic,” she said. “Vulnerable patients should not receive a lower standard of care. They deserve the highest level of medical expertise, not increased exposure to risk.”
CFC: Abortion Shouldn’t Get a Special Exemption
Greg Burt, Vice President of the California Family Council, challenged the committee to apply the same standard to abortion that it applies everywhere else in medicine.
“Every other area of medicine holds firm on surgical training requirements,” Burt said. “No one in this building would propose letting nurse practitioners perform cancer surgery to expand access to underserved communities. The legislature would reject that immediately. So why does abortion get special exemption?”
Burt pressed the committee on what he described as a double standard that ultimately harms the women it claims to help.
“What is it about this procedure that causes otherwise careful legislators to set aside their thinking and that they apply everywhere else in medicine?” he asked. “Why aren’t we demanding that underserved women receive care at the same standard as wealthier communities? Expanding access by lowering standards is not compassion. It is telling vulnerable women they deserve less.”
He then turned to the nature of the procedures being expanded. “Second and third trimester abortions,” he said. “Public opposition to abortion sharply grows worse as pregnancy advances because the humanity of the child is harder to deny. Organ systems are formed. Many of these babies can survive outside the womb. These are developed children and the methods are brutal. Expanding who performs them does not make it less troubling. It simply sears our consciences by normalizing what should normally horrify us.”
Burt closed by calling attention to what he says is a glaring gap in the legislature’s priorities. “Why is the preoccupation always with expanding abortion and not with supporting mothers who might choose differently with real help? There are more families wanting to adopt than children available. Where are the bills promoting adoption? The lopsidedness of this legislature’s attention should trouble all of us.”
The Vote and What’s Next
The committee passed the bill along party lines, with ayes from Assembly members Addis, Aguiar-Curry, Ahrens, Bonta, Caloza, Mark González, Patel, Rogers, Schiavo, Sharp-Collins, and Stefani. Chen, Johnson, Patterson, and Sanchez voted no. Carrillo did not vote.
AB 1973 now moves to the Assembly Appropriations Committee.
Call to Action
Contact your member of the Assembly today using the link below: