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Delaware Senate Democrats

Scope of practice bill expands access to reproductive health

April 7, 2022

DOVER — As legislatures across the nation continue to restrict access to abortion care, the General Assembly has just passed a bill that will expand Delawareans’ access to safe and legal medication abortions.

House Bill 320, sponsored by Rep. Debra Heffernan, Sen. Kyle Evans Gay and Senate Majority Leader Bryan Townsend, would allow physician assistants and advanced practice registered nurses to prescribe medication for the termination of pregnancy, including Mifeprex, Mifepristone, and Misoprostol. Medical abortions are the most common abortion regimen in the United States and are extremely safe, with less than .31% of patients reporting major complications.

Physician assistants and advanced practice nurses have the training and authority to prescribe nearly all medications, including controlled substances. However, despite their ability to provide safe, low-risk access to medication abortions, current state code allows only qualified physicians to prescribe and administer abortion medication.

“Supporting women means ensuring access to the medical services they need. House Bill 320 will make it easier for the women in our state to overcome the unnecessary restrictions that surround medically-induced abortions,” said Sen. Kyle Evans Gay, D-Talleyville.

Mifepristone, Misoprostol, and Mifeprex are subject to extremely stringent restrictions under the Risk Evaluation and Mitigation Strategy (REMS) issued by the FDA. REMS stipulates that the medication can only be administered in certain settings and must be taken under the supervision of a qualified prescriber. It also requires a provider to become a certified prescriber by completing and sending a Prescriber Agreement, and requires providers to obtain a signed Patient Agreement Form from the patient before dispensing the drugs. These requirements pose serious logistical challenges to individuals in medically underserved and rural communities, where reproductive health clinics are often difficult to find or inaccessible.

“Women deserve access to comprehensive medical care, which includes access to safe abortions,” said Senate Majority Leader Bryan Townsend, D-Newark/Bear. “In 2017, I sponsored the bill to codify Roe v. Wade in Delaware. This was a major accomplishment in the fight to protect women’s rights, but we always knew there was more to do. House Bill 320 will allow physicians assistants and advanced practice registered nurses to prescribe medication to terminate a pregnancy. The right to a safe abortion is meaningless if we cannot guarantee access to everyone.”

The bill passed the Senate on Thursday with a 14-7 vote along party lines.

“As we face the looming threat of the Supreme Court weakening or even overturning Roe, making it easier for individuals to obtain abortion services is more critical than ever,” said Planned Parenthood of Delaware President and CEO Ruth Lytle-Barnaby. “We are grateful that while many states are cutting off their residents from what has been a constitutional right for nearly half a century, Delaware is fighting for body autonomy thanks to bold leadership from legislators, advocates, and others. Medication abortions are highly safe and very common, and the procedure falls into the scope of practice for physician assistants and advanced practice nurses. In fact, 18 other states allow them to prescribe medication for abortions.”

“I’ve been proud to champion several key measures that protect women’s reproductive rights, including our 2017 legislation that codified the provisions of Roe in state law. Even with these protections in place, many in underserved and rural communities still have difficulty accessing reproductive healthcare due to medically unnecessary restrictions on medication abortion,” said Rep. Debra Heffernan, D-Brandywine Hundred South. “It’s time to remove the burdensome regulations that prohibit qualified medical professionals from delivering the type of care that is well within their scope of practice, and that’s exactly what we’re doing with this legislation.”

House Bill 320 now heads to Governor Carney’s desk.