NSW parliament's lower house on Wednesday passed an amended bill put up by Greens MP Amanda Cohn to address "abortion deserts" in the state and remove barriers to women in areas outside major cities.
But the bill will need to return to the state's upper house, which does not sit again until May 27.
Sixty-five lower house MPs supported the change in a conscience vote, while 20 were opposed.
Political leaders lamented the "Americanisation" of the debate around increasing access.
Opposition Leader Mark Speakman alleged in parliament that a prominent campaigner threatened to derail his leadership if he supported the bill.
Anti-abortion activist Joanna Howe told him she would "lead a public campaign aimed at encouraging a grassroots opposition to you as Liberal leader", Mr Speakman told MPs under parliamentary privilege.
"I will not cave to brazen bullying like this, nor to the Americanisation of NSW politics," he said.
Mr Speakman supported the bill, calling it "a shadow of its former self".
"It can no longer be characterised as a 'radical Greens bill'," he said, noting it was narrowed along guidelines from the national regulator, allowing qualified nurses and midwives to prescribe abortion medication.
Premier Chris Minns backed his political rival, suggesting Dr Howe had spread an "enormous amount of misinformation and lies" on her social media channels.
"It's whipped up a lot of good people in the community believing that the legislative changes are far more extensive than they in fact were," Mr Minns said.
AAP FactCheck in March debunked the Adelaide Law School professor's claim the bill would "force the closure of all Christian and Catholic hospitals unless they perform abortions".
The pared-back bill allows nurse practitioners and endorsed midwives with appropriate training to prescribe abortion medication, known as MS-2 Step.
The ACT, Queensland, Western Australia and South Australia have also permitted nurses and midwives to prescribe abortion drugs following advice from the Therapeutic Goods Administration.
The push to expand abortion access came after revelations a woman was denied an abortion on the day of her planned procedure at Queanbeyan Hospital in August 2024.
Another public hospital in Orange restricted terminations for non-medical reasons, triggering Health Minister Ryan Park to intervene and reinstate abortions without restrictions in October 2024.
Abortion was permitted by the courts in NSW in 1971 and decriminalised in 2019, but is not always accessible, particularly in rural and regional areas.
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