Idaho’s abortion bans put women at risk and don’t work. Here’s something that could | Opinion

Maternal mortality has been rising across the country in recent years, as the push to restrict abortion access has advanced. For years preceding the reversal of Roe v. Wade, there have been mounting efforts to clamp down on abortion at the state level — and those efforts were often more visible in the maternal mortality statistics than in the abortion statistics.

A growing body of research suggests harsh abortion laws, like those in place in Idaho, are a key driver of rising maternal mortality. A recently released brief by the Commonwealth Fund found that maternal mortality was 62% higher and was increasing nearly twice as fast in states that have heavy abortion restrictions. Infants were also 15 percent more likely to die shortly after birth in abortion restriction states.

The driver seems to be that maternity care providers are driven out by abortion restrictions, possibly because they fear criminal charges for things like treating miscarriages or ectopic pregnancies, which often involve nearly identical procedures to abortion or, as a federal judge found is likely in Idaho, are legally defined as abortions. Losing those services has real effects — reproductive health care is health care, in spite of what deniers would like us to believe.

Idaho seems to fit this broad, national pattern, though the sample size is small so the data is noisy. As Kelcie Moseley-Morris of the Idaho Capitol Sun recently reported, measures of maternal mortality Idaho have been trending sharply upward.

“All of the deaths (in 2020) were deemed preventable with more knowledge and continuity of care, according to the report, with six (of the 11 deaths) having a good chance of altering the outcome with proper monitoring and treatment,” Moseley-Morris wrote.

We can only await the data for 2022 — during which Roe v. Wade was overturned and one of Idaho’s three Planned Parenthood clinics closed — with grim anticipation. Research from the University of Colorado Boulder released in June predicts maternal mortality might rise by 25% where abortion bans go into effect, a prediction based only on how many more dangerous pregnancies would have to be taken to term.

Perhaps those who want to restrict abortion rights think that if this is the cost of stopping abortions, it’s worth it.

But state-level bans do not seem to be drastically reducing the overall number of abortions that take place, according to data from the Society for Family Planning. The abortion rate dropped in states that banned abortion but rose in nearby states that permit it, indicating that lots of women are simply crossing state lines to get abortions. In all, the national abortion rate moved from about 14 per 1,000 live births before Dobbs to 13 per 1,000 after — and that data doesn’t include the growing number of medication abortions performed outside clinical settings, so the true change is even smaller than that.

In the Mountain region, which includes Idaho, the overall number of monthly abortions increased from about 5,610 to 5,760, according to the Society for Family Planning data. So we have the worst of all possible outcomes: the abortion rate and maternal mortality rising in tandem.

All of this flows from the bad assumption that the best way to reduce the number of abortions is with harsh criminal penalties, something most Idahoans oppose.

If the objective is to reduce the number of abortions that take place, why not start with what we know has worked — which has reduced the abortion rate by half over the last 40 years?

What’s been the clearest driver for reducing the number of abortions? Far and away, it’s the long-term reduction in the teen pregnancy rate, which has steadily plummeted by about 75% in the last 30 years. There’s pretty good reason to believe this startling decline was driven, at least in part, by the greater use of contraceptives.

There have been lots of opportunities missed for policies like these, that might substantially reduce the number of abortions in Idaho without sending anyone to jail.

During the 2018 legislative session, Idaho Republicans refused to even hold a hearing on a bill, authored by Sen. Cheri Buckner-Webb, that would have required insurance companies to cover a full year of contraceptives, rather than just a few months.

That bill would have taken effect in 2019 if it was passed and signed into law. Instead, the major abortion policy of 2019 was a bill that required women seeking medication abortions to receive a brochure about a highly untested procedure referred to as “abortion reversal.”

So what happened in 2019? Idaho experienced a 19% year-over-year increase in its abortion rate, erasing six years of steady declines.

But lawmakers haven’t suffered political consequences for ignoring serious solutions and selling fairy dust instead. Solving these problems matters less, politically speaking, than what you can brag about in a closed GOP primary.

So many lawmakers will seek to outdo one another during the coming legislative session. They’ll try to see who can impose the most draconian penalties on women who seek abortions — including potential murder charges, an idea that’s been introduced more than once. They may try to limit the right of travel to seek an abortion in another state.

Why not, just this once, put policy ahead of politics, and focus on solutions like Buckner-Webb’s contraception bill that make everyone better off?