September 25, 2024
Amanda Rodgers, MPH
My home state of Idaho implemented an abortion ban two months after the U.S. Supreme Court overturned Roe vs. Wade. Idaho has one of the most extreme abortion bans in the country, which includes felony charges for providers performing abortions and adults helping teens under age 18 get abortions in neighboring states. All states should pay attention to the consequences of abortion bans by watching what is happening in places like Idaho. Since there are no longer any federal abortion protections, we are the “canaries in the coal mine” of what our nation may become with state-initiated abortion laws.
Idaho’s abortion ban has had incredibly negative effects on health services, families, and the statewide economy since its implementation in 2022.
Following the ban, Idaho saw a mass exodus of providers from every medical discipline, but especially OB-GYNs and maternal health specialists. In a 15-month span, Idaho lost 22 percent of its obstetricians, and now women in only half of the state’s 44 counties have access to an OB-GYN. Fewer licensed physicians also contribute to Idaho’s dwindling medical residency programs. Doctors of all experience levels don’t want to work in a place where doing their jobs could land them in prison.
Unfortunately, Idaho had been experiencing provider shortages before the abortion ban. In fact, Idaho ranked 50th for the number of active physicians in 2022, meaning the state had a 98.2 percent primary care provider shortage. With over two-thirds of the state classified as rural and frontier, access to healthcare is difficult for many Idahoans. Thanks in part to the abortion ban, a labor and delivery ward in Idaho’s rural panhandle closed after losing providers, which forced an entire region of women to travel between 50 and 100 miles to get necessary maternal health services.
The ban’s impact on women’s health is grave, but Idaho doesn’t have a systematic way to track some health outcomes. Despite pregnancy-related death rates doubling between 2018 and 2020, the state legislature dissolved the Maternal Mortality Review Board (MMRB) after abortion ban implementation, leaving Idaho as the only state in the country without any review of maternal death data. After a year without any oversight agency developing recommendations to avoid these preventable deaths, Idaho’s legislature passed a law to reinstate the MMRB.
The abortion law is costing our healthcare system more money as the state’s hospitals are using more flight services for out-of-state emergency abortions (to preserve the health of mothers). The Idaho abortion ban allows an exception only if mothers are at risk of death, placing doctors in an untenable position of watching their patients suffer from serious conditions like organ failure while waiting until women are critically ill before they legally can perform life-saving abortions.
In addition, the abortions ban strains the healthcare systems of neighboring states, which now care for more out-of-state patients in addition to their own residents.
Throughout 2024, the Supreme Court has been reviewing Idaho’s abortion law to decide if it supersedes a federal law requiring emergency abortion services. By dismissing the case on procedural grounds, the Court failed to address the conflict between Idaho’s abortion ban and the federal Emergency Medical Treatment and Labor Act (EMTALA), which requires all people, regardless of pregnancy status, to have access to emergency healthcare.
Instead, it referred the case back to lower courts, leaving legal questions surrounding the state’s abortion ban unresolved. Until the case is settled, Idaho OB-GYNs legally can provide emergency abortions under the EMTALA. Not knowing if they will face legal exposure or other retributions after the judicial system makes a determination about the legality of the ban, many providers are reluctant to provide any abortion services.
While the abortion ban allows an exception for rape and incest, it requires victims to have a police report in hand before receiving abortion services. This requirement completely ignores the fact that a vast majority of sexual assaults go unreported (in 2018 the National Sexual Violence Resource Center estimated 75 percent of all sexual assaults were not reported to law enforcement). A 2015 Idaho State Police Sexual Violence Report demonstrated that only 25 percent of reported sex crimes resulted in an arrest, and only 4 percent produced a guilty disposition. Knowing facts around reporting and conviction rates, the new law provides very little protection or motivation for victims to report sexual assaults to local police. Moreover, a woman may not even realize she is pregnant for 8-10 weeks.
A key factor in preventing unwanted pregnancies, sexual assaults, and abortions is comprehensive sex education in public schools. The legislature created a statute that allows local school boards to eliminate all sex education except abstinence-only curricula. This new policy also shuts down and dissolves the statewide Adolescent Pregnancy Prevention program.
For those who, sadly, care primarily about the “bottom line,” the abortion law also hurts Idaho’s economy. Losing current and prospective providers is detrimental to both the physical well-being of our residents and our state’s fiscal health. Companies like Lyft, Yelp, Levi’s, and Tinder have said that Idaho’s abortion ban has created an environment where businesses can’t thrive.
As a woman in her 30s who has a partner and chooses not to have kids, it’s a challenging landscape to live in. Despite my background in sex education, and access to nearby medical services, as well as material and social resources, I personally struggled finding a reproductive healthcare provider.
Based on my symptoms, my primary care doctor said I could have a potentially fatal ectopic pregnancy. Thankfully, a simple test ruled out this dangerous condition, but it took a while to get an endometriosis diagnosis because fewer Idaho OB-GYNs accept non-pregnant patients.
After this nerve-racking experience, I often wonder: what if I did suffer from an ectopic pregnancy – would I have enough time to arrange out-of-state care to save my life? I also think about my fellow Idahoans who have fewer resources and/or live in rural or remote communities, like the small town where I grew up. For them, any barrier to reproductive healthcare could mean life or death.
Knowing I’d be working within a conservative environment, I decided to return to Idaho because I love the land and its communities. However, the government’s overreach into our personal healthcare has endangered the state’s residents. Abortion is healthcare, and banning it destabilizes the medical community’s ability to provide adequate care
As more states consider abortion bans, we face a nationwide reproductive healthcare crisis that is easily preventable — allow women the right to choose and doctors the right to practice.
