BOISE, Idaho — For an expectant mother, finding out her pregnancy needs to be terminated due to severe health complications is “probably one of the most devastating things that’s going to happen” in her life.
But doctors say it’s become even more devastating in Idaho, where a strict ban on abortions — which are allowed to save a woman’s life, but not to preserve her health — prevents them from providing such care unless someone is on the brink of death.
Under threat of jail time and loss of their medical licenses, doctors say they now sometimes have no choice but to send a woman across state lines by helicopter or advise her to otherwise get to another state for treatment.
“People are definitely surprised,” Stacy Seyb, a physician specializing in maternal-fetal medicine at St. Luke’s Hospital in Boise, said of these conversations. “They’re like, ‘What are you telling me? Not only am I losing my pregnancy, but now I’m going to have to travel somewhere else?’”
Depending on their location, doctors have sent some women to Washington and Oregon – reliably blue states that the Center for Reproductive Health says have “expanded access” for abortion since the U.S. Supreme Court overturned Roe v. Wade in 2022.
But other women are being transported to Utah, a red state where abortion remains legal up to 18 weeks of pregnancy while a stricter ban moves its way through the courts.
"Salt Lake is probably one of the places we’ll tend to call first,” said Seyb, noting the city’s proximity by both air and road to Idaho’s capital.
St. Luke’s, Idaho’s largest health care provider, said recently that it had airlifted six patients to other states for abortion care since January, when the U.S. Supreme Court lifted an injunction protecting emergency abortions in Idaho. That number doesn’t account for women who may have crossed state lines on their own.
A spokeswoman for St. Luke’s said in an email to FOX 13 News that she didn’t have a “specific breakdown of how many of the six patients were specifically transported to Utah.” The University of Utah also said it did not have information available about the number of women who had been transported to Utah from Idaho for abortion care.
Idaho Senate Minority Leader Melissa Wintrow, a Boise Democrat, said she thinks it’s a “crime” that laws passed by her Republican colleagues have pushed patients out of the state for care.
“I think it’s abhorrent,” she said in a recent interview from the steps of the Idaho State Capitol. “Think of the cost, think of the trauma – and think of how to get somebody all the way to Salt Lake City from here.”
WHY ARE PATIENTS BEING TRANSFERRED?
Under Idaho code, doctors say they can provide an abortion to any woman with emergency health complications who is clearly on the brink of death.
But the state’s law doesn’t carve out an exemption when the woman’s health is at risk. And that can raise thorny legal questions when patients come in with health complications, such as early term high blood pressure or when water breaks early on in pregnancy, a condition that carries high risk of infection.
Exactly how close to death does a woman need to be before an abortion would be legal? And what should doctors do when a medical emergency puts a patient at risk of severe health complications – including stroke, loss of kidney function or infertility — but doesn’t imminently risk her life?
“Unless that mom has proceeded all the way to the brink, there’s no way to clearly say, ‘Hey, my judgment is this patient is going to eventually die if she’s not treated with the definitive treatment that at times is ending the pregnancy,’” Seyb said.
An air transfer generally happens when doctors feel someone isn’t close enough to death to be treated under Idaho law but still faces an imminent health risk. In less immediate circumstances, patients are sometimes advised that they can book a flight or drive themselves to another state – or choose to wait it out at home.
“We have had people stay in the state and kind of hang out or, you know… keep their fingers crossed that nothing bad is going to happen,” Seyb said. “We also know of several cases where patients have stayed home too long because they feel like, ‘Well, they can’t do anything for me.’ You know, the whole idea of traveling, etc. is onerous.”
Seyb said some women have stayed home long enough that they end up qualifying for care under Idaho’s law.
“We haven’t had anybody die completely yet,” he said, “but certainly they should have had medical attention before they did.”
In the video below, fetal maternal medicine Dr. Stacy Seyb explains the pregnancy complications that can impact women’s health:
Idaho doctors want to see clarifications to the state’s law, which is currently under consideration at the U.S. Supreme Court. That body will ultimately decide whether a federal law known as the Emergency Medical Treatment & Labor Act (EMTALA) allows doctors to provide abortions in emergency situations even in states where the procedure would otherwise be illegal. An opinion on that case is expected later this summer.
In a separate review of the state’s abortion ban last year, the Idaho Supreme Court rejected doctors’ arguments that the law was too vague, ruling instead that it was understandable to any person of “ordinary intelligence."
The court said Idaho’s law gives latitude to providers to use their “good faith medical judgment” to determine whether an abortion is necessary to save a woman’s life, and it said there was no requirement that a woman be imminently at risk of death to do so.
Blaine Conzatti, a lobbyist with the Idaho Family Policy Center who helped push for some of the state’s anti-abortion laws, points to that ruling as evidence that doctors can provide needed care. He believes Idaho doctors are transferring patients because they’re operating on bad legal advice from their hospitals.
"From our perspective, many of these conditions are being used as straw man arguments when in fact a woman could indeed get an abortion because that condition very well would endanger that mother’s life,” he said.
But the court’s ruling did little to quell fears among doctors that they could be jailed – with the prospect of up to five years in prison – or lose their medical license if they make the wrong move when providing an emergency abortion.
Under the law, any physician could be “charged, arrested, and confined until trial even if the physician initially claims they did it to preserve the life of the mother, or based on reported rape or incest,” the court noted. “Only later, at trial,” could the physician argue that it was "a justifiable abortion that warrants acquittal and release.”
“It can end up in a big legal battle,” Seyb said. “And most people didn’t go into medicine to be involved with those types of things.”
That's why some doctors are electing to transfer patients to neighboring states where abortion laws are clearer.
Other Idaho obstetricians have chosen to leave altogether. The state lost 22% of its practicing obstetricians in the 15 months after the abortion ban went into place, according to a February report from the Idaho Physician Well-Being Action Collaborative. And three hospital obstetrics programs have also closed their doors, impacting access to prenatal care even outside of emergencies.
“All those OBGYNs who left also do primary care, and that’s why we have waiting lists – that’s why we have people who aren’t pregnant trying to find physicians as well,” Wintrow said. “I think we’re going to see the repercussions here for a long time.”
WHAT'S NEXT FOR UTAH?
Kathryn Boyd, president of the Planned Parenthood Association of Utah, sees what’s happening in Idaho — and in other states across the country — as a warning sign of what could be next here.
While abortion remains legal up to 18 weeks in Utah, a near-total ban is currently on hold pending a ruling from the Utah Supreme Court. And if that trigger law is allowed to take effect, Boyd worries there will be “chaos.”
“Having lived in a state that had a near total abortion ban, having worked in a state that did have a total abortion ban, I’ve seen the effects up front of what this kind of restriction can do to people,” she said.
Utah’s trigger ban would prohibit abortion at “any stage of a pregnant woman’s pregnancy,” except under narrow circumstances. Like Idaho’s law, Utah has carved out exceptions for ectopic pregnancies, when the woman’s life is in danger, and in cases of rape and incest when there’s a police report.
And while Utah’s trigger ban also doesn’t mention the “health” of the woman, it does allow for abortion in emergencies where there’s “serious risk of substantial and irreversible impairment of major bodily function.”
If the new restrictions go into effect, Boyd forecasts that "people will have to seek care outside of the state of Utah, just like they’re having to do in Idaho right now.”
That would almost certainly be true of elective abortions. But Rep. Karianne Lisonbee, R-Clearfield, said she doesn’t think Utah women would face problems obtaining emergency pregnancy terminations under the state’s trigger law like Idaho residents are now.
The exemptions for impairment of bodily functions are already in effect in the state, even as the stricter abortion ban moves through the courts. And Lisonbee said the fact that Idaho doctors feel comfortable airlifting patients here is a good sign for access to emergency abortion care in Utah.
“We worked really closely with doctors and hospitals on that language to make sure that women in life-threatening situations were not having to be life flighted out of the state in order to have their lives saved,” said Lisonbee, who sponsored the abortion ban in the House.
“Because of the work that we did on those exceptions, I think we’re in a good spot,” she added. “And it’s telling that those women are being transferred here for life saving care.”
While the future of abortion access is in flux in Utah — as well as in Idaho and across the country — one thing is clear: both sides are gearing up for a long fight through the courts.
“It’s a very, very long road to get to the point where it’s done, all of the court cases are over, all of the appeals are over, there’s a decision,” Boyd said.
But "if it’s a decision that falls on our side and abortion remains legal, you can bet your bottom dollar they will be up on that Hill at the very next session,” she said of her opponents. “If it goes in favor of the state, you can bet your bottom dollar that we will be seeking out ways to change our [state] constitution.”
Watch as three generations of Boise women explain why they oppose Idaho’s abortion ban: