I came to provide care for complicated pregnancies; I’m leaving because of Idaho’s abortion bans

A couple suffers the loss of their unborn baby and are sent to me for help. In the clinic room the emotional pain is palpable. As a maternal-fetal medicine physician I’m here to help them through this unimaginable circumstance. At the end of our time together they’re hopeful for another child someday. They tell me that in a future pregnancy they hope I can care for them because they trust me and feel safe. Sadly, when they are pregnant again I will no longer be here. I am leaving Idaho because of the abortion bans. 

I came to Idaho to work as a maternal-fetal medicine physician, someone who cares for the most complicated pregnancies. I was excited and optimistic to use my expertise to make an impact in the lives of others and to improve reproductive health care and pregnancy outcomes in the state. I made Idaho my home but then the abortion bans took effect. These laws have impacted the management of pregnancy complications and lowered the standard of care. 

My life as a physician has been turned upside down. How do I keep my patients safe? How do I stay safe? The total abortion ban does not have exceptions, only affirmative defenses. An affirmative defense means that the burden of proof lies with the physician to prove their innocence. In court the physician must prove that the procedure was necessary to avert death or was due to rape or incest. There is no defense to protect the health of the mother which is the most common scenario we face. I need to be able to protect my patients’ lives, their health and future fertility without fear of becoming a felon. This fear is why I’m leaving Idaho.

Idaho’s maternal and infant health is worsening, mothers are dying at an increasing rate. A lack of physicians and access to care are major contributors. These bans make it difficult to attract physicians to the state. The loss of health care providers due to the criminalization of medicine will only further these health disparities. These factors made my decision to leave an immensely difficult one, but I cannot continue to practice in a place where I do not feel safe. 

I wish lawmakers could spend a day in my shoes, see the things I see, deliver the news I have to deliver, touch the hands that I hold. If they did, they would have an appreciation of the difficult choices that people and their physicians must make. 

I’m not giving up on Idaho. I want to do what I can to help make it a safer place for pregnant people. I have great respect for health care providers in Idaho who are doing their best every day to provide care and keep people safe.  

To all my former patients, I want to thank you for sharing your stories, your fears and hopes and struggles with me. It’s been a privilege to care for you.