North Carolina clinics want nurses to offer medication-induced abortions

With both abortions in North Carolina and the number of out-of-state clinic patients soaring after Roe v. Wade was struck down, judges should permit more trained health professionals to prescribe pills for medication-induced abortions, plaintiffs in a lawsuit wrote on Monday.

Abortion providers, medical workers and an abortion-rights group awaiting trial next year in their 2020 lawsuit challenging many state abortion rules asked a three-judge panel to act now and block a law limiting who can provide such medication from just certain licensed physicians.

Allowing physician assistants, nurse practitioners and certified nurse midwives who work at certified abortion clinics to prescribe these pills would immediately expand access to abortion in North Carolina, the plaintiffs said. These “advanced practice clinicians” already can prescribe the same two medicines used in medication-induced abortions for managing a patient’s miscarriage, according to a memo describing the legal grounds for a preliminary injunction.

The court should remove "an unnecessary barrier to care so that more North Carolinians can access a full range of reproductive health services, including time-sensitive abortion care, in their own state,” Anne Logan Bass, a nurse practitioner at Planned Parenthood South Atlantic, and a plaintiff, said in a news release.

North Carolina abortion clinic operators have said they've seen a marked increase in the number of women coming from other states that now have more severe abortion limitations following the U.S. Supreme Court decision in June.

The memo said Planned Parenthood South Atlantic — a leading abortion provider in the state and a plaintiff — performed 1,298 abortions in September, which is a 68% increase compared to September 2021. And in September 66% of abortion patients at its health center in Asheville — a short drive from parts of Georgia, South Carolina and Tennessee — were from out-of-state, compared to 31% in September 2021. Overall, 27% of the abortion patients at Planned Parenthood health centers last month came from other states, compared to 11% the same month the year before.

This “has exacerbated the long wait times experienced by North Carolinians seeking abortion — forcing them to remain pregnant against their will for longer periods, potentially pushing them past the gestational age limit for a medication abortion, and more,” the plaintiffs' attorneys wrote.

North Carolina restricts abortion after 20 weeks, with some exceptions for a medical emergency. Tennessee currently bans almost all abortions. South Carolina and Georgia ban abortions once an ultrasound detects fetal cardiac activity — typically six weeks after fertilization and before many patients know they’re pregnant. South Carolina's law was enforced briefly in the summer before the state's Supreme Court suspended its enforcement due to litigation.

Wait times between scheduling medication-abortion appointments at Planned Parenthood's health centers in Winston-Salem and Asheville and the actual appointment dates also have increased dramatically since July, the memo said. Physician staffing challenges at the six Planned Parenthood health centers in the state that perform abortions mean abortion appointments aren't always available, the court filing said.

Republican legislative leaders along with other government officials defending these and other abortion laws in the lawsuit will be able to respond to Monday's motion. A panel of three Superior Court judges is hearing the case because the lawsuit alleges the challenged laws violate the state constitution. The trial is scheduled for September 2023.

The lawsuit also challenges a 72-hour waiting period for a woman to receive an abortion; a ban on virtual appointments to receive a medication-induced abortion; requirements approved in 2011 that certain information be presented to a pregnant woman; and regulations placed upon clinics the plaintiffs say prevent abortion access.