Only doctors can perform abortions in Alaska, according to a 50-year-old law. That means advanced practice clinicians, such as physician assistants, nurse practitioners, and nurse midwives can’t perform abortions in the state, even when they have the proper training. And non-physicians aren’t allowed to prescribe pills to induce abortion, either.
Planned Parenthood’s Alaska chapter argues that this restriction limits access to abortion. So, the chapter filed a lawsuit against the state in 2018 to challenge the law.
Superior Court Judge Josie Garton heard arguments in the case the week of Nov. 13 in an Anchorage courtroom.
Camila Vega is an attorney for Planned Parenthood Federation of America.
“All major medical organizations agree that these providers can provide this care, and Alaska restricts it,” Vega said. “And you can’t do that in a state where there’s a fundamental right to abortion and so, that’s why we brought this case.”
22 states allow advanced practice clinicians to provide abortions. At the moment, Alaska is among them because two years ago, a state judge temporarily blocked the 1970s-era restriction. So, while the case is pending, a wider range of clinicians is allowed to provide medication abortions.
But if the law isn’t overturned, Vega said patients will have to go back to vying for scarce appointments with doctors. Or if they live in a rural area, they might have to wait to travel to a city. And Vega said timeliness is crucial for people who decide to end a pregnancy.
“When people need abortions, they need them when they need them,” Vega said. “And, they don’t need them based on a physician’s schedule.”
Vega said not everyone is impacted by this law equally; some people are more vulnerable to it interfering with their lives.
“It’s low income people,” Vega said. “It’s people who have caregiving responsibilities, who have inflexible work schedules, who have issues with transportation, who are victims of intimate partner violence. It’s young people who may not want their parents to know about their decision.”
Margaret Paton Walsh is an attorney for the state of Alaska and defended the case. She said Planned Parenthood did not show in court that this law is a burden to patients. They presented no data that abortion rates went up after the provider restriction was temporarily lifted, nor, she said, did they have any testimony from pregnant women who had trouble scheduling an abortion when the restriction was in effect.
“The inability to quantify it all makes the whole case completely speculative,” Paton Walsh said. “It’s all just based on this sort of hypothetical feeling about what must have happened because of how things are. But the reality is that women are delayed in accessing abortion care for a variety of reasons.”
Paton Walsh said that people do experience barriers to medical services all the time, but not necessarily because of this law.
“A lot of them have to do with the personal realities of their life like trying to get time off work, or childcare,” Paton Walsh said. “Those problems exist, regardless of who’s providing the care. And to show that the law creates a problem, they have to show that the law, the lack of physician appointment availability, is what causes delay.”
And she said without clear proof the law is a burden, it’s not something the courts should decide.
“Who gets to provide what service, licensing, those sorts of rules, those are legislative decisions, policy decisions, and they’re not decisions that should be made by courts of law, in the absence of evidence that there is a burden on a constitutional right,” Paton Walsh said.
Judge Garton’s decision is likely months away. Whichever side loses could appeal to the Alaska Supreme Court.
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Rachel Cassandra covers health and wellness for Alaska Public Media. Reach her atrcassandra@alaskapublic.org. Read more about Rachel here.
