Morrison

Our neighboring state of Idaho has passed laws which make abortion illegal except for pregnancies resulting from rape or incest or which are “necessary to prevent the death of the pregnant woman.” Some of Idaho’s most prominent politicians seek to make Idaho a state “where life is fully and unconditionally protected” by eliminating even those narrow exceptions.

But Idaho’s new law has caused unanticipated problems.

About 15% of all pregnancies involve complications which could become life threatening, including common conditions like high blood pressure, diabetes, or obesity. But the Idaho law doesn’t say what risks are life-threatening enough that an abortion is allowed.

Can a pregnant woman who develops pulmonary hypertension get an abortion if she has merely a 64% chance of dying?

What about 72%?

Or does a doctor need to wait to perform an abortion until the patient’s death is imminent?

If a woman who is on dialysis becomes pregnant, does her increased risk of kidney failure allow her to have an abortion?

What if she’s waiting for a transplant?

Idaho law leaves it to doctors to figure out the answers.

About 15% of pregnancies end in miscarriage. A miscarriage can last a few days or a few weeks, and can cause life-threatening infection or bleeding. But the treatments used to stop heavy bleeding or an infection from an incomplete miscarriage, or to perform an abortion, are the same: “dilation and curettage” and the medications misoprostol and mifepristone are used for both purposes.

Even with advanced technology, it can sometimes be hard to know whether a woman has miscarried.

What if a doctor treats a patient who may have miscarried and is hemorrhaging severely, and the district attorney decides that the patient hadn’t miscarried?

Some physicians, fearing prosecution, have refused treatment for life-threatening bleeding or infections because they couldn’t be absolutely certain that the women had actually miscarried.

Medical ethics require practitioners to prioritize the safety of their patients and to treat a patient’s medical conditions before acute decompensation occurs. But the treatment for rheumatoid arthritis, lupus, and cancer — medication, radiation and chemotherapy — can cause a miscarriage.

Should a doctor provide treatment and risk criminal prosecution if a miscarriage occurs? Or delay treatment — risking ethical charges or a medical malpractice lawsuit for failing to provide standard care?

When the cost of getting it wrong might be a five-year prison sentence, what doctor wants to find out?

Idaho has been one of the nation’s fastest-growing states, but even before its abortion ban went into effect, it had the fewest active physicians per resident of any state. And when doctors can lose their medical license or face prison for providing care that is standard elsewhere, the effect of Idaho’s abortion ban has been predictable.

OB-GYNs have been leaving Idaho since the abortion ban took effect, and new doctors are reluctant to go to a place where they could face felony charges for providing medical care that is widely considered standard. Idaho’s loss of obstetricians has forced two hospitals to close their labor and delivery units. Both hospitals cited their inability to attract obstetricians as a reason. And a survey by the Idaho Coalition for Safe Reproductive Health Care found that 75 of Idaho’s 117 remaining OB-GYNs were considering leaving the state. Almost all said that Idaho’s new law was the reason.

The flight of women’s health care specialists from Idaho doesn’t affect only women who seek abortions. The providers who are leaving Idaho also provide prenatal care, giving advice and services to help women have healthy pregnancies. They deliver babies, and provide women with essential after-birth health care. They screen women for uterine, cervical and breast cancer. They treat women’s sexual issues and prescribe contraception for women who don’t wish to become pregnant. Idaho’s loss of trained providers leaves all Idaho women in search of care for the entire spectrum of women’s health issues.

A substantial number of rural Oregonians think that joining Idaho is the answer to all their problems. But because of limited prenatal care and the long travel times to reach medical care, rural women already face higher risks of pregnancy complications, preterm births, and pregnancy-related death. Becoming Idahoans would cause the entire host of problems faced by Idaho women to rain down upon the women of Eastern Oregon.

For women, becoming Idahoans would be the beginning of a nightmare.