Medical leaders paint grim picture for maternal health unless Idaho alters abortion law

BOISE, Idaho — Nampa OB-GYN Dr. Megan Kasper recently saw a young pregnant patient who, in her second trimester, was experiencing painful contractions. Her cervix had dilated 5 centimeters. Still, she was several weeks away from the earliest gestational age where a premature infant is viable.

Kasper said all she could offer was expectant care, meaning she closely monitored the patient but wouldn’t intervene unless her condition changed or worsened.

“My care of that patient did not change based on the (abortion) laws that went into effect in August 2022,” Kasper said Wednesday at a presentation about women’s health care challenges at the state Capitol. “But the things I needed to manage in the background were different.”

“What did I need to do to keep myself and the whole health care team out of trouble? ... What was going to be my threshold for her health status? If she started bleeding, how much bleeding was I going to tolerate? At what point would her bleeding be enough that I would feel confident in saying, ‘OK, this is life threatening'?"

As lawmakers seek to finish the 2024 legislative session any day now, Kasper and several other doctors and medical leaders urged legislators to add a maternal health exception to the state’s strict abortion ban. The only exceptions the law provides are for rape, incest and to “prevent the death of the pregnant woman.” There are no exceptions for the health of the pregnant patient.

Democrats want the standard eased, but the overwhelmingly Republican Legislature has not obliged.

Doctors in Idaho who provide abortions, even to stabilize a pregnant patient with a complication, face a felony punishable by up to two to five years in prison. They could also have their medical licenses suspended for a minimum of six months for a first offense and permanently revoked upon a subsequent offense.

Idaho doctors say the law has had a chilling effect on recruitment and retention of the state’s already slim body of physicians, particularly those working in obstetrics.

In late February, a report released by the Idaho Physician Well-Being Action Collaborative said dozens of Idaho’s obstetricians stopped practicing in the state in the first 15 months after the law took effect in August 2022. Over the same period, only two obstetricians moved to the state to practice.

And of the nine maternal-fetal medicine specialists working in Idaho before the ban was enacted, only four are left. Maternal-fetal specialists are obstetricians who undergo three additional years of training to manage the most complicated and high-risk pregnancies. Obstetricians in Idaho often seek their guidance on a case-by-case basis. But as their ranks dwindle, that’s becoming harder to do.

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