Rural areas in the U.S. have faced a decline in hospitals that provide obstetric services for years, and the fate of one hospital in northern Idaho suggests that abortion bans could worsen the trend.
The Washington Post reported reported Tuesday, Bonner General Health in Sandpoint, Idaho has been forced to announce the impending closure of its labor and delivery department, citing staffing issues as well as the state's punitive abortion ban—one of the strictest in the nation—and threats from state Republicans to make the law even more stringent.
ban criminalizes abortion cases in almost all cases and threatens doctors who provide care with felony charges, suspension or termination of their medical license, and up to five years in prison. It includes potential exceptions for people whose pregnancies result from rape or incest and people who doctors determine face life-threatening pregnancy complications—but as Common Dreams has reported, such exceptions have led medical providers to withhold care until a patient is sufficiently ill, placing them in danger.
The threat of prosecution and pressure to withhold medical care from people who need it has contributed to the hospital's staffing shortage, said Bonner General Health in a statement late last week.
"Idaho's political and legal climate does pose as a barrier specific to recruitment and retention for OB-GYNs."
"Highly respected, talented physicians are leaving. Recruiting replacements will be extraordinarily difficult,"
said the hospital. "In addition, the Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care. Consequences for Idaho physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines."
Idaho Republicans have
proposed classifying abortion as "murder from the moment of fertilization" and have called for bans that extend to people whose pregnancies result from incest and rape.
"Idaho's political and legal climate does pose as a barrier specific to recruitment and retention for OB-GYNs," hospital spokesperson Erin Binnall told the
Patients in Sandpoint will now have to travel to Coeur d'Alene, about 45 miles south, to deliver their babies. The city now has the northernmost labor and delivery department in the state, and people living near the state's northern border may have to travel two hours to reach the hospitals there.
Bonner General Health announced its decision days after the podcast "This American Life" featured an interview with an obstetrician who has worked for several years at Bonner General Health but has considered leaving the state since Idaho's ban went into effect last June, after the U.S. Supreme Court overturnedRoe v. Wade.
"I was looking at social media and somebody was talking about a person who is completing their OB-GYN residency and was looking to come to the Pacific Northwest,"
said Dr. Amelia Huntsberger. "And I'm like, hey, there's all sorts of openings in Idaho. And then I'm laughing out loud because I'm like, who is going to be finishing their residency training and being like, I definitely want to go to the state with the super strict abortion laws that criminalize healthcare?"
Journal of the American Medical Associationpublished a report in 2018 showing that a lack of obstetric care in rural hospitals is associated with a rise in preterm births and more people giving birth in facilities where medical staff lack the proper training to assist with labor and delivery, such as emergency departments. High rates of maternal mortality are also associated with "maternity care deserts," which include nearly half of rural U.S. counties, according to the Commonwealth Fund.
Nearly 90 rural obstetrics units closed their doors between 2015 and 2019, with hospitals citing financial losses associated with high numbers of patients who use Medicaid as well as difficulty in recruiting and retaining doctors.
"This will be the beginning of a trend, I fear,"
said behavioral scientist Caroline Orr Bueno of Bonner General Health's decision. "We already have a maternal mortality crisis in the U.S.—we're the only country in the developed world where maternal mortality rates are increasing—and abortion bans are going to make it worse."