Exodus

The beginning of the letter from the Idaho Coalition for Safe Reproductive Healthcare

The Washington Post reported last week that some hardline antiabortion states are finding difficulties recruiting Ob/Gyn doctors. I doubt Idaho’s rabid posture will affect our already low ranking for physicians per capita. We trail the country in this one. There are just so many reasons for doctors not to come here.

Instead of a welcome mat, the Idaho Legislature voted last year to enact a ball and chain incentive. If you get your medical education from the Idaho supported WWAMI program, you will now owe Idaho four years of professional service. So, either you find a place somewhere within our borders to pay back, or you will owe the State Treasurer the cost of what the state paid for your medical education. That indenture might move us above Mississippi in the national rankings, despite the abortion issue.

There are probably only half a dozen medical providers in the state who provide abortion services. The number of abortions in Idaho has been decreasing for years now. These providers will go elsewhere.

But there are probably a dozen or more who care for high-risk pregnancies. This is a very vital service for Idaho with our high birth rate.

These specialist doctors will need to have a lawyer on staff to figure out just what the Idaho statutes allow for treatment. Maybe the new Attorney General can staff a position to provide this sort of advice. If a woman’s water breaks at 18 weeks, can we induce the delivery, or does she need to be septic, near death? If the fetus has a nonviable malformation can labor be induced? These questions come up commonly in the care of complicated pregnancies.

All these nuances, and so little clear direction from the Idaho Legislature. It turns out some states are trying to help doctors figure this out. Louisiana has a laundry list of reasons a pregnancy would be “medically futile”. Idaho has no such mercy in our abortion ban.

I delivered babies as a Family Doc here in Idaho. I’m not a Perinatal Specialist, though I trained with some good ones in my residency. I knew right away that I would be referring most complicated pregnancies to such specialists, though I did care for a few of these women in their and my home town. I expect there will be a few more of these women sent out of town, maybe out of state, on to the specialists for such care after August 26th.

It has always made sense to me that the people closest to these brutal decisions should have the most say. But the Idaho Legislature thinks otherwise. We’ll soon find out what the Idaho Supreme Court thinks. And a Federal Judge will get to weigh in too.

I am sorry my profession, medical doctors, have not made their opinion known on this. The Idaho Medical Association is supposed to speak for its members, and they claim about 80+% of Idaho doctors as dues paying members. I’m sorry, mine have lapsed.

It’s probably because we doctors have strongly mixed feelings. Many of my colleagues strongly oppose any abortion. And some might be supportive of Idaho’s draconian laws. But we have avoided this painful discussion amongst ourselves. We do not welcome confrontation in this business of medicine.

I have always considered abortion, of any kind, to be best considered between the patient and their family, the father if he is involved, and the medical counselor. But our representatives in the Idaho Legislature and the laws they have passed now say otherwise.

Idaho will not lose a bunch of doctors because of this. But some highly skilled Perinatal specialists might not want the legal hassles our laws have enacted. They may choose a different place to practice. We, our state, and our pregnant neighbors with complicated situations will suffer. Maybe that’s what you want for them. I wish it were different.

Post Script:

After I wrote this, a news article came out about a coalition of Idaho doctors asking for some legislative relief. Good for them. Maybe a legislator or two will listen. This important personal issue deserves nuanced consideration, not just edicts.

About ddxdx

A Family physician, former county coroner and former Idaho State Senator
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