Session's last days focus on women's health

The expected end of the session (March 24) has come and gone. It appears we have considerable work to complete next week. Perhaps nothing is more important than hearing legislation on some proposed amendments to the state's abortion laws.

Last week, the board of directors and senior leadership of Bonner General Health went public with their plans to discontinue obstetrics care at BGH in May. This news spread quickly to Boise. However, the issue of women’s healthcare has been on the dashboard of many here.

The Idaho Medical Association, members of the Idaho Legislature, the Attorney General staff, and the right-to-life community have been talking about amendments to the state abortion statutes for several months.

The women’s health medical community has been impacted by the state abortion statutes. I understand the Idaho maternal mortality rate is approximately twice that of the U.S. average.

Idaho has a low number of OB/GYN physicians per capita. We have a very limited number of maternal-fetal-medicine specialists as well. These specialists have three more years of training than a typical OB/GYN physician. Most recently, a few of these MFMs have given notice they plan to leave Idaho.

The problem of retention of these healthcare specialists is exacerbated by the low numbers of medical residents interested in coming to Idaho for their training.

Issue one for the medical community is the "affirmative defense" clause in the Idaho abortion statutes. This clause puts the burden of proving innocence on the physician rather than the presumption of innocence that we all have in most legal matters. Guilty verdicts carry hefty fines and felony charges. The end of a medical career would also be likely.

The effects of limited access to OB/GYN care are not limited to just women and small communities. In the case of Bonner and Boundary counties, if a woman was to have an emergency problem with a pregnancy, the EMS responders would have to decide if the best care would be to deliver the patient to the local emergency room or the specialty facility in Kootenai County (50-90 minutes away). Not only is it a long ride in the ambulance, but it also takes one of our ambulances out of our area for a few hours.

Members of the medical community and the Legislature met recently to hear about a draft bill to address some of the concerns noted. The proposed bill would include language to eliminate the "affirmative defense" part of state statute. Other clarifications were also included to address ectopic and molar pregnancies, care for a woman who is no longer pregnant, the health of the mother and more. These changes were a correction many had hoped would give some level of confidence to medical providers.

Last week, the proposed bill (HB342) was introduced. The State Affairs Committee voted to "print" the bill for a hearing the next day. Before the hearing could commence, many of the committee members backed away from their support of the hearing. The hearing was canceled.

The next day I began to get emails from many encouraging my "no" vote on HB342.

Since then, there have been a considerable number of meetings and negotiations regarding a re-draft of the bill. As I write this (March 25) the parties involved are meeting to draft one or more bills for an introduction on Monday. I’m told the bills will cover the "affirmative defense" clause and give some clarifications for allowable procedures. How far the amendments of the bills will go is unknown.

Most legislators I speak with have concerns about leaving Boise without getting something done on our women’s Health situation. We know we need to provide some certainty and clarity for our medical community, and equally important, for our communities.

When I met privately with Speaker Moyle yesterday afternoon, I let him know how important it was for us to get something done on the abortion issue this session. I remain hopeful we can accomplish something on this important matter.

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Mark Sauter represents Bonner and Boundary counties in the Idaho Legislature in District 1A. He can be reached at msauter@house.idaho.gov.