Ambiguous Idaho abortion laws that misunderstand pregnancy care will cause harm to patients

Promoting health is the mission of my work as an obstetrician/gynecologist. Practicing medicine in Idaho, I fear for my patients and for my peers in the medical community. New government mandates restricting access to reproductive health care in Idaho will harm pregnant people and physicians.

Misconceptions abound in these laws.

Spontaneous abortion (more commonly called miscarriage) is unfortunately common; up to 1 in 5 pregnancies will end in miscarriage. A fetal heartbeat in the first trimester is no guarantee of a healthy baby. Pregnancy is not without risk. Some women will experience seizures due to pregnancy, some will have a stroke, some will suffer damage to their heart as a result of pregnancy. Some complications can be predicted and some cannot. Some women with high risk health conditions will do well in pregnancy and others will die.

Even medical experts cannot perfectly predict outcomes in pregnancy. How do lawmakers presume to make medical decisions for a patient without acknowledging or understanding the complexities of health care in pregnancy?

The Legislature has defined abortion as “the use of any means to intentionally terminate the clinically diagnosable pregnancy.” Treatment of incomplete abortion (more commonly called miscarriage), ectopic pregnancy and molar pregnancy are all “abortion” care as defined by Idaho law.

None of these pregnancy outcomes have anything to do with a mother’s intention or choice but will affect a mother’s ability to get high quality, evidence-based care in Idaho. Idaho’s abortion laws, as currently written, impede medical judgement, place pregnant patients’ health in danger and force doctors to decide between prompt appropriate medical care and potential prosecution.

These are untenable choices.

A recent decision in federal court was a helpful step in temporarily protecting a patient’s access to emergency health care.

What about the patient in clinic who learns the heartbreaking news that her long desired pregnancy is ectopic? An ectopic pregnancy implants outside the uterus, most commonly in the fallopian tube, and represents a potentially life threatening diagnosis to the mother. With the Total Abortion Ban in effect, doctors in Idaho wonder what care they can offer to a patient in clinic without risking felony charges and a minimum of two years in jail.

The recent ruling does little to protect the patient and doctor in this common clinical scenario. 

Some heart defects carry a very high risk for pregnancy complications and death. These complications may not occur until late in the pregnancy. What percentage risk of injury or death due to pregnancy confers the option of abortion if a patient so chooses? How should a doctor counsel and treat the patient to avoid jail time?

There are myriad ways that pregnancy can and sometimes will go awry. It is extremely difficult to legislate pregnancy care in a way that adequately captures the complexity and nuance that are present.

Imagine the government forcing patients to continue a pregnancy that may not result in a living baby and may threaten their future fertility and health. That is what is happening now in Idaho. Pregnant patients will bear increased risk of injury and death from these strict laws.

There is no room for the government between a patient and their doctor.