{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T16:51:13Z","timestamp":1780073473827,"version":"3.54.0"},"reference-count":41,"publisher":"American Public Health Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2013,3]]},"abstract":"<jats:p> Objectives. We examined the impact on patient safety if nurse practitioners (NPs), certified nurse midwives (CNMs), and physician assistants (PAs) were permitted to provide aspiration abortions in California. <\/jats:p><jats:p> Methods. In a prospective, observational study, we evaluated the outcomes of 11\u2009487 early aspiration abortions completed by physicians (n\u2009=\u20095812) and newly trained NPs, CNMs, and PAs (n\u2009=\u20095675) from 4 Planned Parenthood affiliates and Kaiser Permanente of Northern California, by using a noninferiority design with a predetermined acceptable risk difference of 2%. All complications up to 4 weeks after the abortion were included. <\/jats:p><jats:p> Results. Of the 11\u2009487 aspiration abortions analyzed, 1.3% (n\u2009=\u2009152) resulted in a complication: 1.8% for NP-, CNM-, and PA-performed aspirations and 0.9% for physician-performed aspirations. The unadjusted risk difference for total complications between NP\u2013CNM\u2013PA and physician groups was 0.87 (95% confidence interval [CI]\u2009=\u20090.45, 1.29) and 0.83 (95% CI\u2009=\u20090.33, 1.33) in a propensity score\u2013matched sample. <\/jats:p><jats:p> Conclusions. Abortion complications were clinically equivalent between newly trained NPs, CNMs, and PAs and physicians, supporting the adoption of policies to allow these providers to perform early aspirations to expand access to abortion care. <\/jats:p>","DOI":"10.2105\/ajph.2012.301159","type":"journal-article","created":{"date-parts":[[2013,1,17]],"date-time":"2013-01-17T20:59:04Z","timestamp":1358456344000},"page":"454-461","source":"Crossref","is-referenced-by-count":118,"title":["Safety of Aspiration Abortion Performed by Nurse Practitioners, Certified Nurse Midwives, and Physician Assistants Under a California Legal Waiver"],"prefix":"10.2105","volume":"103","author":[{"given":"Tracy A.","family":"Weitz","sequence":"first","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Taylor","sequence":"additional","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Desai","sequence":"additional","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ushma D.","family":"Upadhyay","sequence":"additional","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff","family":"Waldman","sequence":"additional","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly F.","family":"Battistelli","sequence":"additional","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor A.","family":"Drey","sequence":"additional","affiliation":[{"name":"Tracy A. Weitz, Sheila Desai, Ushma D. Upadhyay, and Molly F. Battistelli are with Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, and the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco. Diana Taylor is with ANSIRH, Bixby Center for Global Reproductive Health, and the School of Nursing, University of California, San Francisco. Jeff Waldman is with Planned Parenthood Shasta Pacific, Concord, CA...."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.1363\/4000608"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1363\/4304111"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000189095.32382.d0"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000116260.81570.60"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2006.04.010"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.10.012"},{"issue":"15","key":"bib7","first-page":"1","volume":"60","author":"Pazol K","year":"2011","journal-title":"MMWR Surveill Summ"},{"key":"bib8","volume-title":"The Vital Role of Community Clinics and Health Centers: Assuring Access for All Californians","author":"Schacht J","year":"2008"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1370\/afm.49"},{"issue":"4","key":"bib10","first-page":"719","volume":"80","author":"Grimes DA","year":"1992","journal-title":"Obstet Gynecol"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1016\/S1049-3867(05)80250-6"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jmwh.2008.09.003"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2012.03464.x"},{"key":"bib15","volume-title":"Taskforce on Health Care Workforce Regulation. Reforming Healthcare Workforce Regulation: Policy Considerations for the 21st Century","author":"Finocchio LJ","year":"1995"},{"key":"bib19","volume-title":"Defending Life 2010: Proven Strategies for a Pro-Life America: A State-by-State Legal Guide to Abortion, Bioethics, and the End of Life","author":"Burke DM","year":"2010"},{"key":"bib20","author":"Rough G","journal-title":"Arizona Republic"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.76.5.550"},{"key":"bib22","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.94.8.1352"},{"key":"bib23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69742-0"},{"key":"bib24","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.08.010"},{"key":"bib25","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2003.08.017"},{"key":"bib29","doi-asserted-by":"publisher","DOI":"10.1191\/0962280203sm314ra"},{"key":"bib30","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1521-4036(199905)41:2<149::AID-BIMJ149>3.0.CO;2-E"},{"key":"bib31","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.10.1172"},{"key":"bib32","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.10.1152"},{"issue":"1","key":"bib33","first-page":"129","volume":"76","author":"Hakim-Elahi E","year":"1990","journal-title":"Obstet Gynecol"},{"key":"bib34","doi-asserted-by":"publisher","DOI":"10.1370\/afm.1051"},{"key":"bib35","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109147.23082.25"},{"key":"bib36","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.108228"},{"key":"bib37","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2002.123898"},{"key":"bib38","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.7.6.559"},{"key":"bib39","doi-asserted-by":"publisher","DOI":"10.1162\/003465302317331982"},{"key":"bib40","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/87.3.706"},{"key":"bib41","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/70.1.41"},{"key":"bib43","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1984.03340400036021"},{"key":"bib44","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(83)92464-9"},{"key":"bib45","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/16.5.875"},{"key":"bib46","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000115511.14004.19"},{"issue":"5","key":"bib47","first-page":"230","volume":"29","author":"Newhouse RP","year":"2011","journal-title":"Nurs Econ"},{"key":"bib48","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2010.0026"},{"key":"bib50","volume-title":"(U.S.). The future of nursing: leading change, advancing health","year":"2011"}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.2012.301159","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,10]],"date-time":"2022-05-10T00:49:37Z","timestamp":1652143777000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.2012.301159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,3]]}},"alternative-id":["10.2105\/AJPH.2012.301159"],"URL":"https:\/\/doi.org\/10.2105\/ajph.2012.301159","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3]]}}}