Proposed Rules to Enhance Access to Reproductive Care and Repeal Outdated Restrictions

 In Nurses Weekly

The State Board of Medical Examiners today published a rule proposal that, if adopted, will expand access to reproductive health care and repeal outdated regulations that place medically unwarranted restrictions on abortion in New Jersey.

Today’s publication in the New Jersey Register follows the Board’s unanimous vote in September 2020 to propose several changes to its regulations to remove barriers to care that do not offer corresponding health benefits.

Key aspects of the proposed new rule, amendments, and repeal include:

  • repealing the Termination of Pregnancy rule, N.J.A.C. 13:35-4.2, that singles out abortion care for targeted regulation by, among other things, requiring that all terminations of pregnancy be performed only by a physician, and barring office-based terminations beyond 14 weeks gestation;
  • clearing the path for Advanced Practice Nurses, Physician Assistants, and Certified Nurse Midwives and Certified Midwives to perform early aspiration terminations of pregnancy (in addition to medication-based termination of pregnancy, which is already permitted) and clarifying that these providers are authorized to provide miscarriage treatment; and
  • updating the regulations to integrate reproductive care within the generally applicable rules designed to ensure the safety of patients who undergo surgery or special procedures in an office setting.

Members of the public are invited to provide input on the proposal during a 60-day comment period.

“The Board of Medical Examiners’ evaluation of the medical evidence will modernize New Jersey’s outdated regulations and barriers to reproductive health care in New Jersey,” said Governor Phil Murphy. “I thank the Board of Medical Examiners for their thoughtful and deliberative examination of the rules and work to repeal antiquated regulations and expand access to reproductive care for all New Jerseyans.”

“I thank the Board of Medical Examiners for taking steps to expand access to reproductive health care, based on its careful consideration and assessment of the medical evidence,” said Attorney General Gurbir S. Grewal. “The Board’s evidence-based modernization of its rules will bring New Jersey into line with states across the country that have already taken action to increase access to quality care.”

“For many patients, lack of access to authorized providers and facilities close to home results in increased risks and costs when seeking reproductive health care services,” said Director of Consumer Affairs Paul R. Rodríguez. “The Board should be commended for taking the lead to remove medically unnecessary restrictions and to ensure New Jerseyans have safe and timely access to essential reproductive health care services.”

By clearing the path for certain healthcare providers other than physicians to perform a termination of pregnancy, the Board’s proposal may significantly expand access to reproductive care in New Jersey. Currently, there are approximately 11,024 Advanced Practice Nurses, 4379 Physician Assistants, 363 Certified Nurse Midwives and 15 Certified Midwives in the State who may be authorized to perform the procedure in the future.

The Board’s decision to propose regulatory changes to the enhance access to reproductive care and repeal outdated restrictions on abortion followed the recommendations of a Board subcommittee empaneled in 2018 to study the Board’s current regulations in light of advances in the field of abortion care.

In developing its recommendations, the Board’s subcommittee reviewed nationally recognized medical and public health studies, which demonstrated that general rules governing health care procedures are sufficient to secure the health and safety and that certain early abortion procedures can safely be performed by non-physician clinicians. Studies also indicate that medically unnecessary over-regulation of abortion itself creates public heath harms by disrupting access to essential care. Based on this evidence, other states have moved to similarly expand access to reproductive health services.

The Board’s proposal is now subject to public comment. The proposed rules, amendments, repeal and information on how to submit a comment by March 5, 2021 can be viewed here.

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