Idaho’s ambiguous abortion laws that misunderstand pregnancy care will hurt 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 hurt pregnant women and doctors.

Misconceptions abound in these laws.

Spontaneous abortion (more commonly known as miscarriage) is unfortunately common; up to 1 in 5 pregnancies will end in miscarriage. A fetal heart rate 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 experience a stroke, some will experience heart damage as a result of pregnancy. Some complications can be predicted and some cannot. Some women with high-risk health conditions will do well during pregnancy, and others will die.

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

The Legislature defined abortion as “the use of any means to intentionally terminate a clinically diagnosable pregnancy.” Treatment for incomplete abortion (more commonly known as 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 obtain high-quality, evidence-based care in the Idaho. Idaho’s abortion laws, as currently written, fetter medical judgment, put the health of pregnant patients at risk, and force doctors to choose between appropriate medical care and potential lawsuits.

These are untenable choices.

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

What about the patient at the clinic who learns the heartbreaking news that her long-desired pregnancy is ectopic? An ectopic pregnancy implants outside the uterus, most often in the fallopian tube, and is a life-threatening diagnosis for the mother. With the total abortion ban in effect, doctors in Idaho are wondering what care they can provide to a patient in the clinic without risking felony charges and a minimum of two years in prison.

The recent decision does little to protect the patient and physician in this common clinical scenario.

Some heart defects carry a very high risk of 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 wishes it? How should a doctor advise and treat the patient to avoid a prison sentence?

There are a myriad of ways pregnancy can and sometimes will go wrong. It is extremely difficult to legislate pregnancy care in a way that adequately reflects the complexity and nuances that are present.

Imagine the government forcing patients to continue a pregnancy that might not result in a live baby and threaten their future fertility and health. This is what is happening in Idaho right now. Pregnant patients will bear an increased risk of injury and death because of these strict laws.

There is no place for government between a patient and his doctor.

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