What Blocking Emergency Abortion Care in Idaho Means for Doctors Like Me

Ideas

On April 24, the Supreme Court will hear arguments weighing whether Idaho politicians have the power to block doctors from giving emergency medical care to patients experiencing pregnancy complications—a case that will open the door for other states to prohibit emergency reproductive care and worsen medical infrastructure for people across the board. Once again, politicians have set up a case that could have devastating impacts on the ability of doctors to provide–and for pregnant women to receive–essential reproductive health care.

I’m a family physician who’s practiced medicine in rural Idaho for more than 20 years, where I’ve had the opportunity to guide hundreds of patients through their pregnancies. It’s no exaggeration when I say that my state’s health care system is in crisis, thanks in enormous part to our near-total abortion ban. Now, instead of trying to salvage what’s left, Idaho politicians are looking to hasten our downward spiral, making it even harder for doctors like me to provide care to patients in need. I can only hope that the Court will take into account that it’s not just abortion at stake in this case—it’s the future of emergency room care and medicine altogether.  

Rural health care has always faced challenges, but in the nearly two years since the overturning of Roe v. Wade, it’s gotten exponentially worse. In Idaho, we’ve lost nearly a quarter of our obstetricians since the state’s abortion ban went into effect—colleagues and friends who got into medicine to help people are being forced out of practicing obstetrics in our state. They realized it was impossible to provide adequate care while under the thumb of politicians more interested in advancing their extremist agenda than protecting the health of their constituents.

Idaho’s abortion ban makes it a crime for anyone to perform or assist with performing an abortion in nearly all circumstances. The ban does not even include an exception for when a person’s health is at risk—only for when a doctor determines that an abortion is necessary to prevent the pregnant person’s death. Ask any doctor and they’ll tell you that this “exception” leads to more questions than answers.

Read More: ‘Am I a Felon?’ The Fall of Roe v. Wade Has Permanently Changed the Doctor-Patient Relationship

Patients need an emergency abortion for a wide range of circumstances, including to resolve a health-threatening miscarriage. But there is no clear-cut legal definition under the ban of what exactly that looks like or when we can intervene, and doctors—operating under the threat of prosecution—have no choice but to err on the side of caution.

“Can I continue to replace her blood loss fast enough? How many organ systems must be failing? Can a patient be hours away from death before I intervene, or does it have to be minutes?” These are the callous questions doctors are now forced to think through, all the while our patient is counting on us to do the right thing and put their needs first.

As a result, pregnant patients sometimes make repeated trips to the ER because they’re told time and time again that nothing can be done for them until their complications get more severe. Imagine if someone you love had a 104-degree fever but you were told nothing could be done until it spiked to 106 and your organs were failing. Requiring patients to get right up to the point of no return before administering care is not sound medical policy—it’s naked cruelty, and it’s only going to get worse as long as we allow extremism, not science, to run rampant in our statehouses and trample over our safe system of care.

It also violates a longstanding federal law—the Emergency Medical Treatment and Labor Act (EMTALA)—that requires hospitals to treat emergencies before they become life-threatening. That’s exactly why the U.S. Department of Justice sued Idaho soon after the state’s abortion ban took effect. The lawsuit argues only that Idaho must allow doctors to provide abortions in medical emergencies when that is the standard stabilizing care, but even that proved too much for state leaders.

Instead, Idaho politicians fought the DOJ all the way up to the Supreme Court. How the Supreme Court rules will have broad implications that will reverberate throughout the country. If the Court holds that federal law no longer protects pregnant people during emergencies, it will give anti-abortion politicians across the country the green light to deny essential abortion care, push providers to leave states where the choices made with their patients can be second-guessed by prosecutors, and continue this cycle of inhumanity for patients. 

As we’ve seen in Idaho, policies guided by anti-abortion extremism make health care worse for everyone. This assault on abortion has not ended with abortion—rather, it has extended to more of our rights and health care, with birth control, IVF, prescription drugs, and now emergency medical care all at risk.  

This must stop. 

For nearly 40 years, federal law has guaranteed that patients have access to necessary emergency care, including when a pregnancy goes horribly wrong. The Supreme Court must uphold this law and ensure pregnant people continue to get the care they need when they need it most. The health of my patients in West Central Idaho—and millions of other Americans across the country—deserve nothing less.