Know your options for medical care in Idaho for early pregnancy emergencies

If you are pregnant and confused about your current rights to medical care in Idaho, you are not alone.

Doctors, nurses, hospital administrators and lawyers have struggled to understand the many laws that now restrict medical care in our state. If trained professionals struggle to understand the ins and outs of providing care under the complex matrix of laws currently in effect, we can only imagine the burden that pregnant Idahoans and their families carry as they navigate the health system.

It is especially important for you to understand your rights early in your pregnancy, during the time that your baby cannot survive outside of your uterus. The earliest gestational age a Neonatal Intensive Care Unit in Idaho could offer resuscitation for your baby is 23 weeks. If you are suffering from a miscarriage, if you have an ectopic or molar pregnancy, or your baby dies before birth, you should be able to receive care in Idaho now without legal barriers as the updated Idaho Abortion Ban (called House Bill 374, The Defense of Life Act) signed by Gov. Brad Little on April 4 does not apply to those conditions.  

For other complications that occur in early pregnancy, such as your water breaking or bleeding, we recommend that you go to the largest hospital that is accessible to you. Do not go to an urgent care or emergency department that is not attached to a hospital unless that is the only option accessible to you.

If your gestational age is 20 weeks or greater, you should seek initial evaluation on labor and delivery instead of the emergency department because labor and delivery has the experienced staff and equipment needed to care for pregnancy complications at more advanced gestational ages. If you are diagnosed with ruptured membranes or another significant condition, ask to see an obstetrician-gynecologist or a family medicine physician who provides obstetrical care for consultation.

Even though current Idaho law only allows a doctor to offer you an abortion to prevent your death, federal law supersedes Idaho law when you have an emergency condition in your pregnancy. Federal EMTALA, or the Emergency Medical Treatment and Active Labor Act, law requires that your doctor offers you an abortion for treatment of an emergency medical condition if it is necessary to stabilize your health. Some complications, such as HELLP syndrome, preeclampsia with severe features, or your water breaking early, may necessitate early delivery to preserve your health or life even when your baby will not survive as these conditions cannot be cured while remaining pregnant.

A significant number of obstetricians have already left Idaho due to the fear of criminal charges for providing standard patient care. The physicians who have remained in Idaho are overworked because of the vacancies our colleagues have left behind. With no in-state obstetrics and gynecology residency training program to resupply our workforce, we have historically relied on attracting doctors trained in other states — doctors who are now not willing to move to Idaho to fill these open positions. 

Please have compassion for the physicians and midwives caring for you. Those of us who have stayed are doing our best to provide compassionate, ethical care amidst unprecedented legal constraints, uncertainty and fear.