On June 24, 2022, I was lying in bed febrile with COVID-19 when I saw the headline on my phone: “Supreme Court Overturns Roe.” I let out a loud groan. The reaction was so visceral because I live in Idaho, and I knew we had a trigger abortion ban waiting to go into effect. Also, I had moved here less than three years prior, and I knew my husband and I would have to start talking about whether we would need to uproot our family again.
It took only two weeks after the Dobbs decision for our first affected patient to arrive (though the trigger ban had not yet gone into effect). She was diagnosed with preterm prelabor rupture of membranes at 19 weeks of gestation, then denied abortion care at two other hospitals and forced to drive hundreds of miles to find a physician willing to provide the treatment she knew she needed. By the time she reached us, she was infected, then went on to hemorrhage and require a blood transfusion. Since then, we have treated patients in similar situations multiple times per month.
At least 13 reproductive health physicians have left Idaho, and two rural labor and delivery units have closed. We have lost four out of nine maternal–fetal medicine specialists. My hospital now has many gaps in maternal–fetal medicine coverage, which is distressing for my obstetrics hospitalist group given that we practice at a regional referral center. My group remains short-staffed without any applicants for open positions. There are only a few locum tenens obstetrician–gynecologists willing to come work in Idaho, and our hospital administrators are reluctant to pay the additional costs, increasing the stress on those of us who remain.
In the past year, I have become very involved in abortion-rights advocacy in the state. I have written declarations for the Department of Justice lawsuit, testified in the state legislature, written op-eds, been interviewed by national media, spoken at press conferences, created educational modules for hospital staff, attended countless meetings, and learned more about the legal and political systems than I ever cared to know.
Four of the dedicated physician advocates I have worked with closely have left Idaho after disappointing decisions by the Idaho Supreme Court and state legislature. We are now regrouping to continue the fight, and I have taken over as ACOG’s Idaho Section chair.
Despite the additional stress and time investment this advocacy work adds to my already busy clinical duties and family life, I know I cannot remain in Idaho without making my voice heard. Every day, I ask myself how much longer I can stay, and I worry what kind of health care will be available to Idahoans if more of us leave.
Disclaimer: Published submissions reflect the experiences of individual ACOG members and may not represent official organizational opinions of ACOG. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. It does not constitute legal advice; clinicians should be familiar with and comply with federal, state, and local restrictions on abortion, including medication abortion, and are encouraged to consult with a lawyer when navigating local abortion laws and regulations. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. It is not intended to substitute for the independent professional judgment of a treating clinician.
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