Montana Supreme Court says advanced practice registered nurses can provide abortions
In the order written by Justice Laurie McKinnon and signed by the other six justices, the court said the state “failed” to prove its arguments on several points.
That included not proving that abortions done by APRNs were riskier than those performed by physicians or physician assistants. The state also didn’t show why APRNs should be restricted from providing abortions or any associated health risks.
While the court in this decision recognized the state has general and inherent "police power" to regulate the health and safety of its citizens, the record showed no evidence APRNs providing abortion care presented any medical risk to women.
“The state’s argument is detached from the overwhelming evidence presented to the district court that abortion care is one of the safest forms of medical care in this country and the world, and that APRNs are qualified providers,” the order reads. “ ... There is no medically recognized bona fide health risk for APRNs to perform abortion care, much less one that is clearly and convincingly demonstrated.”
The court also pointed out that all parties in the case agreed managing a miscarriage is identical or nearly so to early abortion care, but the state did not argue it was unsafe for APRNs to provide that care.
"The court pointed to a logical fallacy in the state’s argument. … How can the state say it has a compelling interest to regulate abortion when identical procedures are not subject to the same onerous requirement?” Rate said.
APRNs also regularly provide care far more advanced than early abortions, the court noted, such as neuraxial anesthesia, central line insertions and intubations. They can also prescribe dangerous and addictive drugs that pose far more risk than abortion medications.
The court also pointed to studies showing the risk of early abortion complications ranging from minor at 1.32% to major at 0.05% is far less than other common procedures such as wisdom teeth removal at 7% and tonsillectomies at 8-9%.
The ruling also cited safety repercussions associated with a lack of abortion care, highlighting evidence that delays in accessing care can force women to seek later-term abortions, which can come with higher risks, more costs and possibly the inability to get a medication abortion.
“Access to abortion care in Montana is the difference between obtaining quality care or no care at all, especially for patients who might otherwise ‘time out’ of early abortion care because their pregnancy extended past a certain gestational age, which can result in safety repercussions for the patient,” the court wrote.