“The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’” – Matthew 25:40
Perhaps one of the most contentious words in the American political lexicon is the A word… Abortion. The word elicits strong emotions across the political spectrum, and perhaps that is because all sides of the debate are concerned with the preservation of life. Debating abortion in the public square often requires the debater to assume the worst of their opposition, and I’m not interested in that. One side will accuse the opposition of hating babies and wanting to eliminate them out of hedonistic convenience. The other side will accuse their opposition of hating women and wanting them to suffer or die in preservation of those who may never live beyond their first minutes outside of the womb.
Can I call a truce for the duration of this piece? I don’t believe that those who desire strict family planning are opposed to children and wish them eliminated from society. I also don’t believe that those who err on the side of life hate women and want to rule their bodies. I hope we can find common ground on the sanctity of humanity and not dismiss political opposition out of convenience, which makes it easier to demonize our opposition.
Idaho has a long history of opposing the practice of elective abortion. Before Idaho was even a state, the territorial legislative body banned the practice in the winter of 1864. Idaho’s ban remained in place until 1973, when Roe v. Wade placed jurisdiction at the federal level. In 2022, the Supreme Court overturned the 1973 Roe v. Wade ruling in Dobbs v. Jackson, which ruled that the Constitution does not confer a right to abortion. As a result, states like Idaho, which had trigger laws in place to revert to their prior position, saw those laws take effect. Idaho, once again, has a near-total ban on abortion with express exceptions for cases of rape, incest, and to preserve the life of the mother. It should be noted that all discussions of abortion deal in viable pregnancies and not non-viable pregnancies like molar or ectopic pregnancy. Idaho law expressly defines those separately.
As a result of Idaho’s near-total abortion ban, opponents sued, lost in court, and have taken their message directly to the public in pursuit of a ballot initiative creating a right to abortion. This initiative will appear on November’s ballot as Proposition 1: The Reproductive Freedom and Privacy Act (RFPA). Proponents of Proposition 1 state that it’s necessary to establish rights to medical privacy, protect women from dangerous healthcare that operates in the shadows, indemnify doctors who provide abortion, and keep Idaho’s obstetric infrastructure intact. I would like to argue that even if these were good-faith objectives of the RFPA, it does not accomplish those goals.
First, let’s address the idea of a right to medical privacy. The RFPA would extend that right to privacy to minors, who are not legally permitted to make nearly any medical decision for themselves, let alone a right to highly specialized and dangerous medical procedures. It is not hard to see why a rapist or a pimp would support such a right. Imagine the ability to hide the indiscretions of your illicit sex trade by sending your victims for regular abortions.
Second, would the RFPA bring black market healthcare out of the shadows and into a legitimate space? Certainly some of it would end up in an OBGYN office, but the RFPA permits any licensed healthcare provider to perform abortions. You don’t have to be an OBGYN or even a physician to perform abortions. Any licensed healthcare provider could be an acupuncturist or chiropractor. The danger here is that abortion care clinics could be opened up by anyone, and regulatory oversight is eliminated.
Third, does the RFPA indemnify doctors who perform abortions? Yes. It provides almost blanket immunity to abortion providers and eliminates a patient’s ability to seek damages in the case of medical malpractice. With abortion open to any licensed healthcare professional, does this sound like a law working in the best interest of women and babies?
Finally, does the RFPA protect Idaho’s fragile obstetric infrastructure? The answer is no. Before Dobbs, numerous articles covered the shrinking obstetric care industry, driven by factors ranging from low birth rates to low Medicaid reimbursement. This is a nationwide problem, with approximately 60% of rural maternity wards shuttering since the inception of the Affordable Care Act. This is a problem across all specialties in Idaho and not limited to obstetric care. We’re too rural, and we have too many patients on Medicaid.
A study published in JAMA out of Boise State suggested that Idaho lost 35% of its practicing OBs since Dobbs in 2022. The study was riddled with errors, dishonest, and didn’t look at Idaho’s medical licensing information. A review of Idaho Occupational Licensure showed that Idaho has grown by 20% in doctors identifying as obstetricians. Many have argued that locums are filling in for those who have left, and there is validity to that argument. But the question at the end of the day is access. Without permanent OBs, is Idaho backfilling access? The answer, in part, is yes.
All of these points don’t begin to touch on the accusations that our laws force women to other states to have abortions. I overheard a recent conversation in which a physician said they wanted the Idaho legislature to trust doctors. Idaho trusts doctors. The legislature gave physicians the broadest statutory discretion, only requesting that good-faith medical judgment be applied in the preservation of life. They asked that the medical community remember that we wish to treat all life as sacred, and that we do our best for both patients, baby and mom. Idaho doctors have delivered. Reports from the March of Dimes and the Idaho Maternal Mortality Review Board show that both fetal and maternal mortality are down in Idaho. In 2024, the last year of reporting, Idaho had a single pregnancy-related death. Our laws work, and no doctor has been prosecuted for exercising their good-faith medical judgment.
Just yesterday, I read that for the first time in recorded human history, adults 65+ outnumber children <5. We are in the throes of a catastrophic population collapse, and our entire safety net, which relies on a replacement population, is nearly non-existent. When Social Security passed in the 1930s, the worker-to-drawer ratio was 42:1. Today that number stands at 3:1 and is dropping. Can I ask that we re-evaluate our national priorities? Can we start to place an emphasis on the sanctity of family, and encourage young adults that no role we play is more important than fostering the next generation?
The RFPA would be catastrophic for Idaho. Many providers have simply asked for revised language that gives them the comfort of liability protections for doing their job in preserving life. The RFPA is catastrophic and unnecessary to accomplish that goal. Vote NO on Prop 1.
Photo by Hollie Santos on Unsplash
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