Women denied abortions tell court they were ‘made to feel like medical refugees’ as they sue Idaho

An Idaho woman who was denied an abortion in her home state felt like a “medical refugee” when she had to cross state lines to obtain abortion care, she has told a court hearing a case against the state.

Four Idaho women denied abortion care after experiencing pregnancy complications and physicians are suing the state of Idaho, which has two abortion bans in place and only allows abortions in the case of rape or incest or to save the pregnant person’s life with limited medical exceptions. The plaintiffs, represented by lawyers at the Center for Reproductive Rights (CRR), are seeking clarity on medical exceptions and when providers are legally allowed to provide life-saving care.

Jennifer Adkins, the lead plaintiff in the case, drove to Portland, Oregon in April 2023 after she was denied abortion care in Idaho after receiving “devastating news” when she was 12 weeks pregnant that her fetus had a fatal condition that could also threaten her health, Gail Deady, a CRR lawyer, said in the Idaho Fourth District Court on Tuesday.

“She knew she could miscarriage and hemorrhage on the road” but she had “no choice but to make that drive,” Deady said during opening arguments.

Adkins testified about her firsthand experience.

Already a mother to a young child, she got an ultrasound to check on her second pregnancy.

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During her ultrasound, “the baby looked different than my previous pregnancy,” Adkins testified. She said she saw fluid on the scan and noticed the technician was taking a lot of measurements — which she didn’t interpret as a good sign.

After a conversation with a genetic counselor and a maternal-fetal medicine specialist, she learned that her baby had fluid behind her neck — which turned out to be cystic hygroma — and was not going to survive the pregnancy, she testified.

Not only did she then understand she would likely suffer a miscarriage or have to leave the state for abortion care, Adkins testified that her own health seemed to be at risk: “The longer I remained pregnant with this condition, the higher my risk of developing mirror syndrome,” a life-threatening condition. She also faced a risk of hemorrhage or sepsis, should she miscarry without the assistance of a medical professional.

After this conversation, the specialists gave her a list of out-of-state providers, a bereavement pamphlet and a miscarriage kit.

She got another ultrasound which showed her fetus still had a heartbeat. “I felt devastated because no parent wants to wish that when they look at an ultrasound, they don’t want to see their baby’s heartbeat, and yet here I was. I wanted something to make the decision for us and end her suffering,” Adkins said.

She consulted with her husband and they found the “most compassionate option” was to get an abortion out of state.

Her procedure cost $850. But before she and her husband embarked on their six-hour drive to Portland, she and her husband needed to rent a car, book a hotel, and book childcare for her son, which totaled about $1,500. “We needed to come up with the money to do that,” she testified. They sought assistance from abortion funds and friends.

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“We were made to feel like medical refugees from our own state,” she said. At one point during the lengthy drive, they lost cell service, meaning there was no way to get in touch with someone if she had started to hemorrhage.

Thankfully, that didn’t happen. Her abortion at the end of April 2023 was successful: “It went as well as it could have.”

By October, she was pregnant again — but was “terrified.”

When asked if she considered leaving the state, she said it wasn’t an option, since she and her family have been in Idaho for generations, so leaving the state would also mean “leaving a huge array of support and family behind.”

Her third pregnancy resulted in a healthy and happy child, she told the court.

Kayla Smith, another plaintiff in the case, also gave an emotional testimony.

When asked whether she had come up with a name for her second child, she choked up and paused as she reached for tissues to wipe the tears from her face. His name was Brooks.

In August 2022, around 18 weeks pregnant, she went for a routine scan. Smith suspected things were off with her baby when “the sonographer was very quiet,” she recalled.

Her baby had “several anomalies,” Smith testified, and she saw a maternal-fetal medicine doctor. There, she learned that her baby suffered from critical aortic stenosis. A pediatric cardiologist further explained the widespread implications on the baby’s heart and the only option was a very risky surgery.

Still, Smith testified, she understood that “if executed perfectly, the outcome may not change.” He would most likely need a heart transplant before he turned 5, she said..

But no doctor would perform that surgical intervention, she said, so that was no longer an option.

Smith was told about palliative care but that was not an option she wanted to explore. Carrying her pregnancy not only put her own health at risk, Smith said on the stand, but “I was not willing to watch my son suffer and essentially gasp for air.”

Still, she sought more information from a genetic counselor. It was at that appointment at 20 weeks pregnant that she decided to terminate her pregnancy.

Two days before receiving her diagnosis, the trigger ban went into effect in Idaho, meaning she was unable to receive abortion care in her home state, Smith said while fighting tears.

So she, her husband, and her two-and-a-half-year-old drove eight hours to Washington. She received an induction abortion.

The couple got an autopsy for Brooks, which confirmed “his heart defect had progressed more than what we had seen even weeks prior,” she testified.

If it had been legal in her home state, she would have. She was comfortable with her physicians — and could have avoided distressing encounters in new medical settings. “Having someone come in and tell me ‘congratulations’ because they didn’t know the situation… I think that all could have been avoided” had abortion been legal in Idaho, Smith told the court.

She has since moved to Washington, where she now “feels safe,” she said. She delivered her third child there.

During cross examination, James Craig, a lawyer for the state, asked Adkins a few questions that required short responses, including whether she had experienced any severe medical conditions when she obtained her abortion. Adkins testified she had not.

Earlier in the day during opening arguments, Deady told the court that the current medical exceptions are “unworkable and they inhibit Idahoans’ ability to receive vital care.”

Each of the patients already had one child when they learned that their fetuses had been diagnosed with fatal conditions.

The witnesses will demonstrate that “the narrowness of the exceptions are precluding physicians from providing care” to patients with high-risk conditions, she argued.

The lawyer for the state argued the state’s law is clear: “the killing of an unborn child through abortion is illegal in most circumstances.” He added: “Idaho has a right to protect these precious lives.” He said the plaintiffs are trying to “rewrite the law” and add exceptions that the legislature did not include.

Craig argued that the plaintiffs’ amended definition of “emergent medical condition” is too broad, claiming it includes “any issue a pregnant woman could face, no matter how minor,” before using the example of a pregnant woman stepping on a rusty nail and getting Tetanus.

“There is no right to an abortion in Idaho’s constitution,” he argued.

He called D&C, a common procedure, “barbaric and gruesome” and entails the baby being ripped apart “limb by limb.”

The testimony begins one week after Donald Trump won the presidential election, sparking fears around the future of reproductive health care. The president-elect has bragged about the reversal of Roe v Wade in 2022 after appointing half of the Supreme Court justices who decided to overturn the constitutional right to abortion and has provided murky messaging around whether he would enact a federal abortion ban.