North Carolina’s Senate Bill 20 Threatens Reproductive Access

SB 20, a bill that bans abortion after 12 weeks of pregnancy with narrow exceptions and harsh restrictions, went into effect on July 1, 2023, in North Carolina. Somechangesinclude a hospital requirement, making it less accessible to people in rural areas and simultaneously more expensive, requiring patients to make three in-person appointments, and possibly forcing clinics to shut down.

Jill Sergison (she/her), a certified nurse-midwife, who has done global reproductive clinical research & sexual health advocacy, submitted the following op-ed.

Jill co-owns Points True North Consulting and is currently engaged in the implementation of pharmacist-initiated contraception in NC.  Jill recently founded North Carolina Nurses for Reproductive Rights (ncnrr.org) and co-developed reprohealthnc.org, dedicated to providing reproductive health access information to NC residents. She is tri-chair of NC’s Reproductive Life Planning Group, C4 Chair of Pro-Choice North Carolina, and is a PhD student at Duke University.

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The passage of SB 20 has sent ripples of shock and devastation throughout the North Carolina medical community. Abortion is often spoken about as a decision that is made between “a woman and her doctor,” and on a micro level that is true. However, to reduce abortion provision to this simple dyad is to ignore that restricted access to abortion care is both a societal and healthcare systems issue.  

Advanced-practice clinicians (nurse practitioners, certified nurse-midwives, and physician assistants) are prohibited from performing abortions in North Carolina, although they are licensed to do so in 20 other states. However, nurses at all levels are essential care providers in the provision of abortion services. Nurses are often the clinicians who are with a patient at the time of a pregnancy diagnosis and skillfully offer pregnancy options counseling including referrals for care. At abortion clinics, nurses prepare patients for their procedure, perform post-abortion care and provide psychosocial support.Many nurses are reproductive rights advocates, advisors, scholars, and allies.

While most nurses are not directly involved in abortion care, every nurse who cares for families and people of reproductive age will feel the impact of this law. Legislation that restricts a clinician’s ability to provide evidence-based care to their patients is demoralizing and undermines their training, skills, and experience. Essentially, abortion access has an impact on entire healthcare systems and many providers working in that system. We must widen the lens on North Carolina's abortion restrictions to acknowledge the many ways it impacts entire healthcare systems and providers, including nurses, who are critical to the safe and crucial provision of abortion and reproductive health care.