Editor’s note: This story contains graphic details of pregnancy loss.
The early weeks of Rebecca Vincen-Brown’s pregnancy were filled with excitement: pulling her toddler’s old items down from storage in the attic; sharing the news with family and friends; explaining to her 2-year-old daughter, Winter, that she’d soon have a baby brother or sister. At that point, in November 2022, she and her husband had tried conceiving for nearly a year.
But by February, the excitement had turned to anxiety. Routine genetic testing indicated Vincen-Brown’s baby likely had a chromosomal abnormality that would almost certainly be fatal, the 31-year-old Kuna woman told the Idaho Statesman in an interview.
“And that’s when the tone of the conversation started getting a little bit more serious and grim,” she said.
She waited a month for an anatomy scan that confirmed the worst: Her baby had severe developmental issues and would likely die soon after birth. What’s more, Vincen-Brown could develop life-threatening preeclampsia or hemorrhaging.
Vincen-Brown and her husband made the decision to terminate the pregnancy. As the reality of the situation hit them, another realization emerged. Idaho’s abortion laws prevented the couple from having the procedure in state.
Almost all abortions are banned in Idaho. The only exceptions are when the pregnancy risks death of the patient, or was due to reported incest or rape. Earlier this year, the Idaho Legislature also passed an exception to the abortion ban that clarified the prohibition doesn’t apply to ectopic or molar pregnancies. But lawmakers blocked an effort to include exceptions when a pregnant patient’s health is at risk.
Vincen-Brown, who was 17 weeks pregnant, traveled to Portland with her family for the abortion. Around midnight the day doctors induced dilation, she began experiencing painful contractions that were 30 seconds apart. Vincen-Brown said she stifled her cries to avoid waking her daughter, who was sleeping in the family’s hotel room. The contractions continued until her water broke. She gave birth to a stillborn baby on the floor of the bathroom, she said.
They had called the clinic’s on-call doctor only to learn he was in Seattle. They had several hours until the Portland clinic opened.
Their car had been parked off-site by the hotel valet, and Vincen-Brown said she was bleeding too heavily for her husband to retrieve it. An ambulance would cost thousands of dollars since they were out of state.
“We sat there with one baby sleeping in the Pack ’N Play on the other side of the wall and my other baby laying on the bathroom floor,” she said. “And for four hours, there was nothing that we could have done about it any differently. … The whole thing was barbaric.”
Months after Vincen-Brown and her family traveled to Oregon for the abortion, she joined three other women to sue the state of Idaho over its restrictions.
The lawsuit, filed in September, seeks to clarify what circumstances qualify for emergency exceptions to Idaho’s abortion law. Next week, a court will hear arguments over the state’s motion to dismiss the case entirely.
Health problems spur terminations of pregnancies
Like Vincen-Brown, the other three women named in the lawsuit terminated wanted but unviable pregnancies, according to the lawsuit. The lawsuit provided details into what they experienced:
Jennifer Adkins, a 31-year-old Caldwell woman and the lead plaintiff, sought an abortion in Portland after doctors told her she would likely miscarry and, if she continued the pregnancy, develop a life-threatening condition. Her trip to Oregon put so much financial strain on the family, they were unable to pay their mortgage for a month.
Kayla Smith, a 31-year-old former Nampa resident, found out her baby had one of the most severe genetic heart conditions pediatric cardiologists had ever seen and was unlikely to survive. She was 19 weeks pregnant. Her family took out a $16,000 loan to travel to Washington for her procedure, where she delivered a stillborn baby.
Jillaine St. Michel, 37, of Meridian, sought an abortion after learning her baby had severe developmental conditions affecting multiple organ systems and was unlikely to survive. St. Michel traveled to Seattle for the procedure, which wasn’t covered by her insurance because it was considered out-of-network.
Doctors feared they could be prosecuted under Idaho’s abortion ban for referring patients to states where abortion is legal. Idaho Attorney General Raúl Labrador in March issued a legal opinion that said referrals were illegal under the law. Two Idaho family doctors sued, and a federal judge in August blocked Labrador from seeking criminal penalties for referrals.
The Idaho Academy of Family Physicians (IAFP), a trade organization with 656 members and a plaintiff in Adkins’ lawsuit, said many members are “afraid to have open and frank conversations” with patients about the options available to them, including when there’s a pregnancy complication.
Adkins told the Statesman that once during her pregnancy, her mother accompanied her to a doctor’s appointment. After the appointment, Adkins’ mother told her that she couldn’t follow the “bizarre” conversation that took place.
Adkins later said she explained to her mom what happened: Her doctors were hinting that, if she wanted to terminate her pregnancy, she would have to leave the state, and they could not provide any more help.
“They had to be extremely careful about how they were speaking to me,” Adkins said. “It was almost like we were talking in code.”
With new pregnancies, women worry about health care
Idaho’s restrictive abortion laws have been the catalyst for an exodus of reproductive health care providers from the state.
Of the nine maternal fetal medicine specialists who practiced in Idaho before the state’s abortion ban took effect, only four are left, according to the Idaho Medical Association. Two rural hospitals have closed their labor-and-delivery centers, and medical leaders say they’re struggling to recruit new staff.
More doctors may follow. A physician survey conducted by the Idaho Coalition for Safe Reproductive Health Care found that half of obstetrics and gynecologists surveyed were considering leaving Idaho. Ninety-six percent of those said they would reconsider if a health exception was added to the state’s abortion laws.
The impact has rippled to pregnant patients across the state. Dr. Julie Lyons, another plaintiff in the lawsuit, said it now takes longer to get patients a diagnosis, and even routine procedures like ultrasounds are delayed.
Lyons said the federal block on criminal penalties for abortion referrals hasn’t alleviated health care providers’ concerns around abortion. Without a health-based exemption, treating pregnant patients becomes a minefield of separating life-threatening risks from otherwise severe conditions.
Lyons noted that abortion isn’t just an elective procedure. She said in the case of many pregnancy complications, it’s the medically necessary option.
“I think people understand what abortion means in a very different way,” Lyons said. “And our values may shift when we realize that it’s more complicated than just a decision.”
Three of the women suing Idaho are pregnant again, according to the lawsuit, including Vincen-Brown.
For Vincen-Brown, the experience has been vastly different from her two previous pregnancies. Though genetic testing confirmed her second baby had triploidy, which is not hereditary, she said she has approached this pregnancy with restraint. She didn’t step into the nursery in her home until 20 weeks into her pregnancy, she said.
Her baby girl is due in March. Vincen-Brown said she’s also concerned for the reproductive health care her daughters will need in the future. Another plaintiff, Kayla Smith, moved to Washington out of concern for her daughters’ future health care, according to the lawsuit.
Adkins said she hopes to become pregnant again, but she’s afraid that there won’t be specialists in Idaho to care for her if she experiences complications again.
“Who’s going to be left to care for us?” Adkins said. “That’s the part that scares me the most about having another baby here.”