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Montana Supreme Court: State can't block advanced practice nurses from performing abortions

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Posted at 12:12 PM, May 12, 2023

HELENA - The Montana Supreme Court has ruled the state cannot prevent advanced practice registered nurses from performing abortions.

In a unanimous decision released Friday, the court sided with two nurses who sued over a state law that said only physicians and physician assistants can perform abortions.

Advanced practice registered nurses (APRNs), have received advanced training, including at least a master’s degree. The plaintiffs argued they can be fully medically competent to perform abortions safely, and the state has no legitimate reason to exclude them.

In an opinion authored by Justice Laurie McKinnon, the court said the Montana Constitution “guarantees a woman a fundamental right of privacy to seek abortion care from a qualified health care provider of her choosing, absent a clear demonstration of a medically acknowledged, bona fide health risk.”

They said there was “overwhelming evidence presented to the District Court that abortion care is one of the safest forms of medical care in this country and the world, and that APRNs are qualified providers.”

“The State has failed to present any evidence that demonstrates abortions performed by APRNs include more risk than those provided by physicians or PAs,” the opinion continued. “The State has failed to identify any reason why APRNs should be restricted from providing abortions, and thus failed to articulate a medically acknowledged, bona fide health risk.”

The court’s opinion cited a 1999 ruling commonly known as the Armstrong decision, which established that the state constitution’s right to privacy protected access to abortion before a fetus is viable. In the Armstrong case, justices used similar legal justifications to overturn a law that prevented physician assistants from performing abortions.

The Montana Legislature then amended that law to the version at issue now.

The Montana Attorney General’s Office argued the state law was a reasonable regulation, intended to reduce health and safety risks from abortions. They suggested, without the law, it would be too easy for an APRN without the necessary experience to begin offering abortions.

Attorney General Austin Knudsen and Gov. Greg Gianforte have argued the Armstrong case was wrongly decided and asked the Supreme Court to reverse its precedent.

Helen Weems, one of the APRNs who filed this suit, operates All Families Healthcare, a clinic in Whitefish. Weems has been able to provide abortions since 2019 after the Montana Supreme Court allowed a preliminary injunction on the state law to remain in place. The other APRN is identified as Jane Doe in the court filings.

Read the full opinion: