By Drs. Amelia and Vince Huntsberger
The Idaho Legislature has enacted some of the strictest abortion laws in the country. The “total abortion ban” went into effect on Aug. 25, 2022 and bans all abortions. There are no exceptions. None. No exception for the life of the mother. No exception for rape or incest. No exception for a pregnancy complicated by a lethal fetal diagnosis.
The ban does allow a doctor to bring an affirmative defense in court. The affirmative defense can be that the doctor acted to save the life of the mom or that the pregnancy was the result of an incident of rape or incest that was reported to the police, and the doctor was given a copy of the police report. Legally, this is extremely different from an exception. An affirmative defense means the doctor faces a felony charge in court and has to provide convincing evidence that will negate criminal liability.
In other words, the burden of proof is on the doctor to prove their innocence.
There is another law in effect that allows family members to sue a doctor who provides an abortion after a fetal heartbeat is present. This law incentivizes vigilante legal threats for any pregnancy terminated after a heartbeat is present.
Consider a clinical situation that occurs not uncommonly at our local hospital: a woman with a ruptured ectopic pregnancy with a heartbeat presents to the ER for care. She may initially appear stable with normal vital signs, and yet may have more than a liter of blood in her abdomen with ongoing active bleeding found at the time of surgery.
According to the Idaho Legislature, treating the ectopic pregnancy is an abortion. That abortion also saves her life. If all of her family members don’t understand the life threatening situation she faced, each of them could choose to sue the doctor for a minimum of $20,000.
To be clear: An ectopic pregnancy implants outside the uterus, most commonly in the fallopian tube, and represents a potentially life threatening diagnosis that will not result in a living baby. It is the leading cause of death of pregnant women in the first trimester.
Maybe you think, like many, that abortion should be restricted to some degree. Please understand the language of the laws in Idaho. The law defines abortion as “the use of any means to intentionally terminate the clinically diagnosable pregnancy of a woman with knowledge that the termination by those means will, with reasonable likelihood, cause the death of the unborn child.”
That definition is much more broad than the definition that most people would assume. That definition includes clinical situations that most would not consider abortion. That definition could include miscarriage, ectopic pregnancy, molar pregnancy or a pregnancy complicated by a fetus with a diagnosis that will be fatal after birth, just to name a few examples. That definition means that doctors like us could face potential felony charges, suspension and/or loss of our medical license, and spend a minimum of two years in jail for providing treatment of miscarriage or ectopic pregnancy.
None of those clinical situations have anything to do with a mother’s intention or choice, but will affect a mother’s ability to get high-quality, evidence-based, potentially life-saving care in Idaho. Can you imagine the government forcing a woman to continue a pregnancy with a grim prognosis that threatens her future fertility and her very life? That’s what is happening now in Idaho.
As you may know, termination of pregnancy without a medical indication has not been available in Sandpoint — or in most of Idaho — for more than a decade. Yet, with these laws in place, we worry about how to practice medicine that safely treats patients while avoiding legal prosecution.
Legislators in Idaho have codified a broad definition of abortion, encompassing care that most would not think applied. Doctors in Sandpoint and across the state are facing an impossible situation. One of the frightening aspects of the laws in Idaho is the ambiguity. When can a doctor intervene with evidence-based medical treatment without facing legal action? Does a patient have to be at the brink of death? Who decides what level of risk to a pregnant patient’s health and life is enough?
One of the impacts of these extreme bans is the delay in care that results from doctors navigating what the conflicting laws allow. Meanwhile, a patient is experiencing a medical emergency. In addition to facing felony charges, doctors in Idaho will be forced by the state government to ignore their medical training and defer care until it is necessary to prevent the death of the patient.
Withholding evidence-based treatment options until a patient deteriorates and death is imminent is cruel, inhumane and it is bad medicine. Patients may experience serious complications, have negative impact on future fertility, require additional hospital resources including blood transfusion and some patients may die as a result of delays in care.
Promoting health is the mission of our work in medicine. We cannot stand by while our patients and our health care teams face the criminalization of evidence-based, life-saving reproductive health care. This assault on the patient-doctor relationship must be stopped. Do you want the government making your medical decisions? We must block government interference in health care. These laws give the government power over your privacy and your personal medical decisions. Don’t let politicians take away your freedoms.
With all of this at play in Idaho, voting becomes essential. Vote as if the lives of the women you care about depend on it. They do.
Amelia Huntsberger, M.D., is an obstetrician/gynecologist with Sandpoint Women’s Health and Vince Huntsberger, M.D., is an emergency medicine expert at Lake Pend Oreille Emergency Medicine.
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