After an Idaho hospital closed its obstetrics department, pregnant women in the county have been left without nearby care. Their OB-GYNs fled the state.
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ABORTION RIGHTS
Pregnant with no OB-GYNs around: In Idaho, maternity care became a casualty of its abortion ban
After an Idaho hospital closed its obstetrics department, pregnant women in the county have been left without nearby care. Their OB-GYNs fled the state.
Laura Olin and her newborn daughter at City Beach Park in Sandpoint, Idaho, on Sept. 26, 2023.Margaret Albaugh for NBC News
Sept. 30, 2023, 7:00 AM EDT
By Julianne McShane
If you’re pregnant in Bonner County, Idaho, you’ll likely spend a lot of time on Route 95.
Bonner General Health, a 25-bed hospital,
discontinued obstetrics, labor and delivery services this year. So for residents, Route 95 is the way to the closest in-state hospital with obstetrics care, which is at least an hour’s drive south — or longer in the snowy winter.
The hospital, which staffed the county’s only OB-GYNs,
cited the state’s “legal and political climate” as one of the reasons it shuttered the department. Abortion has been banned in Idaho, with few exceptions, since August 2022.
Laura Olin, 32, lives in the city of Sandpoint, where Bonner General is, and gave birth to her twin boys at the hospital in 2020. When she became pregnant again, she opted to deliver her daughter in Spokane, Washington — 90 minutes away — in August.
As the reality of doing the drive while in labor set in, she said, “it was very scary those last few weeks of pregnancy.”
It made her think differently about her previous birth experience, Olin added. “To go into labor at home and arrive at the hospital five minutes later was a blessing that I didn’t know was a blessing,” she said.
Laura Olin at City Beach Park in Sandpoint on Sept. 26. Margaret Albaugh for NBC News
The four OB-GYNs who previously worked at Bonner General, meanwhile, have left Idaho to practice in states where abortion is legal. All four told NBC News that the state’s ban contributed to their decisions to move.
As a whole, the situation has left mothers-to-be in Bonner County to contend with an unexpected consequence of their state’s abortion policy: reduced access to medical care for women whose pregnancies are very much wanted.
Olin is one of a half-dozen pregnant or recently pregnant women who spoke to NBC News about how the closing of Bonner General’s maternity department upended their birth plans and disrupted their lives. They say further travel times have introduced logistical burdens, financial difficulties, stress and anxiety.
“I really feel like it’s inevitable that there will be poor outcomes for women and babies who now have to travel longer to care in those emergency situations,” said Elizabeth Smith, 35, a lactation consultant in Bonner County who has opted to deliver her baby — due in December — at a nearby birth center with a midwife. Delivering with a midwife is the only local option left in Bonner County.
Smith said that as a former neonatal intensive care nurse, she would have preferred a hospital but that traveling for appointments and labor would require someone to watch her four children.
“I don’t feel like that was an option for me given my large family and the need for child care,” she said.
Bonner General Health Hospital in Sandpoint, Idaho, on Sept. 26.Margaret Albaugh for NBC News
Research has shown that women who lack access to hospitals with obstetrics care are more likely to face health consequences, including
a higher risk of preterm birth, which is
associated with asthma, hearing loss, intellectual disabilities and other
lifelong impacts for children. An
analysis published in 2019 found that rural residents had a 9% greater chance of maternal morbidity and mortality compared to urban residents, in part because of limited access and longer travel times to obstetrics care. (Women of color had at least 33% higher odds of those negative outcomes than white women regardless of where they lived, according to the research.)
Olin, a supporter of abortion rights, said the ripple effects of Idaho’s policies still caught her by surprise. She decided to cross state lines to deliver her daughter, she added, out of fear that abortion restrictions could affect her care
if complications arose.
“When it actually affected my pregnancy, I couldn’t believe that that was happening,” Olin said.
Her former OB-GYN at Bonner General, Dr. Morgan Morton, who now practices in Washington, said many of her former patients — including those with opposing political views to Olin’s — shared that reaction.
“I definitely have patients that I know would’ve been in support of these laws and now are very surprised at the downstream effects,” she said.
‘In case of an emergency, what do I do?’
Bonner General
announced the closing of its obstetrics department in March, citing a lower patient volume and the loss of pediatricians as factors in the decision, alongside what a spokesperson recently described as “some of the most restrictive reproductive laws in the country.”
Idaho law prohibits abortion at any stage, with exceptions only to save the life of the mother, ectopic or molar pregnancies and cases of rape or incest in which the incidents were reported to police and the pregnancies are terminated within the first trimester. In April,
the state also became the first to criminalize some out-of-state travel for abortion, with a law that makes helping a minor cross state lines for that purpose punishable by two to five years in prison.
In a statement to NBC News, the Bonner General spokesperson said that the services were eliminated with “a heavy heart” and that hospital providers worked with patients to coordinate alternative plans and make the transition “as easy as possible.”
“We hear the community and want desperately to meet their needs,” the spokesperson said.
Many former Bonner General patients now go to Kootenai Health in Coeur d’Alene, which is the closest in-state hospital with OB-GYNs on staff. It is more than 40 miles from Sandpoint. In June, Kootenai Health recorded its highest number of births ever, according to Kim Jorgensen, the hospital’s director of women’s and children’s services.
“When this closure was announced, we were getting a lot of calls from women asking, ‘What do I do?’” Jorgensen said.
Candice Funk, 34, is one of those patients. She moved from California to Sandpoint — and got pregnant — around the time Bonner General stopped providing obstetrics care.
Funk developed
HELLP syndrome — a rare and life-threatening form of pre-eclampsia — during her last pregnancy, so this one is high-risk. That means she most likely would have had to go to Kootenai for her delivery and some appointments anyway. Even so, she said, there’s a persistent worry: “In case of an emergency, what do I do?”
Candice Funk is in her second trimester of a high-risk pregnancy.Margaret Albaugh for NBC News
During her previous pregnancies in California, Funk was a 20- or 30-minute ride from the hospital, she said. This time, she’s prepared to stay at the Ronald McDonald House — or an affordable hotel — in Coeur d’Alene if she needs more frequent monitoring.
“I know how drastic my conditions can be,” she said. “Hopefully it won’t be a surprise if something happens overnight.”
Sandpoint resident Lauren Sanders, 34, who’s due to deliver her second child in November, faced the type of situation Funk fears this summer: For a few days, she didn’t feel fetal movement.
So Sanders got in the car for a “really intense” 45-minute ride to Kootenai. Throughout the drive, she said, she kept wondering: “Is my baby still alive?”
The drive to Bonner General would have taken five minutes.
The Kootenai doctors determined that everything was fine and released Sanders after some monitoring. But if something goes wrong during her planned home birth with a midwife, she might wind up on another agonizing ride.
“I’ve had to get comfortable in the discomfort in having a ‘riskier’ birth at home,” Sanders said.
Lauren Sanders, six months pregnant, holds her 2-year-old daughter.Courtesy Madison Sanders
Chronic, elevated stress and anxiety during pregnancy are
associated with a higher risk of high blood pressure and heart disease for the pregnant woman,
preterm birth, and
asthma and
behavioral problems in young children, studies suggest.
Financial burdens further impede access to care
Katie Bradish, 36, said she shells out hundreds of dollars to go to prenatal appointments in Spokane, 90 minutes from her home. Each trip requires her to take time off her job as a vice president at a grilling supplies company, she said, and pay $200 for a babysitter to watch her 2-year-old daughter, plus gas money.