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Idaho鈥檚 OB-GYN Exodus Throws Women in Rural Towns Into a Care Void

Idaho鈥檚 OB-GYN Exodus Throws Women in Rural Towns Into a Care Void

Bonner General 国产精品视频 is a 25-bed critical access hospital, meaning it receives financial help from the federal government to maintain essential services, in Sandpoint, Idaho. More than a year ago, OB-GYNs left the hospital and Bonner General announced it was closing its labor and delivery unit. (Jazmin Orozco Rodriguez/KFF 国产精品视频 News)

SANDPOINT, Idaho 鈥 The ultrasound in February that found a mass growing in her uterus and abnormally thick uterine lining brought Jonell Anderson more than anxiety over diagnosis and treatment.

For Anderson and other patients in this rural community who need gynecological care, stress over discovering an illness is compounded by the challenges they face getting to a doctor.

After that initial ultrasound, Anderson鈥檚 primary care provider referred her to an OB-GYN nearly an hour鈥檚 drive away in Coeur d鈥橝lene for more testing.

Getting care for more serious gynecological issues, like a hysteroscopy, endometriosis, or polycystic ovary syndrome, has become much more difficult in Sandpoint, a town of about 10,000 people in Idaho鈥檚 panhandle region. A state law criminalizing abortions drove multiple OB-GYNs to leave town about a year ago.

The effects have been far-reaching. The OB-GYNs who left Sandpoint were also providing care to patients in nearby outlying areas, like Bonners Ferry, a roughly 40-minute drive into Idaho鈥檚 northernmost county. Doctors about not feeling safe practicing medicine where they could face criminal charges for providing care to their patients. Republican lawmakers in Idaho contend doctors in an effort to roll back the ban, and they declined to amend the law this year.

According to the Idaho Coalition for Safe 国产精品视频care, a group advocating for a rollback of the state鈥檚 strict abortion ban, at least two hospitals, including Bonner General 国产精品视频 in Sandpoint, ended labor and delivery services in the 15 months after the state criminalized abortion in 2022. During that same time period, the number of OB-GYNs practicing in Idaho . The report鈥檚 authors noted that many rural residents rely on consultations from medical specialists in urban parts of the state that are already struggling to provide care.

Those departures have expanded care deserts and added obstacles between patients and care, including for Anderson, 49.

A portrait of Jonell Anderson, who is sitting on a wooden bench by a large body of water on a partly-sunny day.
Jonell Anderson drove nearly two hours round trip from Sandpoint, Idaho, to Coeur d’Alene to receive testing for a mass found in her uterus this year. The burden of traveling outside her community for care adds to the emotional roller coaster of the experience, she says. (Jazmin Orozco Rodriguez/KFF 国产精品视频 News)

Anderson鈥檚 car broke down when she was on the way to see an OB-GYN in Coeur d鈥橝lene a few weeks after her initial ultrasound. Her husband took off work to drive her to a rescheduled appointment the same day. After hours of mishaps, she arrived for the visit, which lasted about 15 minutes. There, the doctor told her she鈥檇 need to come back for a hysteroscopy 鈥 an exam that shows the inside of the cervix and uterus 鈥 a few weeks later, followed by another appointment to go over results.

Four months later, in June, early results showed that the mass in Anderson鈥檚 uterus did not appear to be cancerous. She鈥檚 relieved, she said, but still concerned about nearing menopause and not having the support of an OB-GYN nearby to help her manage any symptoms or health issues that could come up.

鈥淚t sure was a whole level of stress that just added on because I had so much further to transport,鈥 Anderson said. 鈥淭hree years ago I would have been 10 minutes away from my appointment, not 60 minutes away.鈥

Those hardships patients face weigh heavily on the specialists who left.

Amelia Huntsberger, an OB-GYN, said that she and her husband are still grappling with a feeling of grief after being 鈥渇orced out of Idaho鈥 last year. They had lived in the state for more than a decade and practiced in Sandpoint. While leaving was a difficult decision, she said, she has no doubt it was the right one for her; her husband, who was a doctor in the emergency room at Bonner General; and their children.

鈥淚 think about things like who we are as a people,鈥 Huntsberger said. 鈥淲hat do we value, and do our actions reflect our values?鈥 Limiting access to care for women, pregnant or not, and their infants suggests lawmakers do not consider them important, she said.

Usha Ranji, an associate director for Women鈥檚 国产精品视频 Policy at KFF, said she has heard anecdotally about providers leaving states with strict abortion bans like Idaho鈥檚. Some recent medical graduates are also in states restricting abortion, making it harder to replace the outgoing providers, Ranji said.

Sandy Brower, a spokesperson for Bonner General, said the hospital is working to hire a gynecologist and is focused on building out its family provider team. She said other providers at the hospital are still treating women before and after pregnancy, but not during delivery unless it鈥檚 an emergency and the person cannot be transported.

Susie Keller, CEO of the Idaho Medical Association, said there鈥檚 a growing number of doctor vacancies in the state and that the number of applicants has 鈥渁bsolutely plummeted and those jobs are taking about twice as long as normal to fill.

鈥淲e are witnessing the dismantling of our health system,鈥 Keller said.

A photo of two posters on a wall. The poster on the left reads, "How would you architect women's healthcare?" and is further broken down into sections that say "legislation," "healthcare," "social/moral," "insurance," and "financial." Below, it continues to say, "If you could design it yourself, what would you choose? / How should we approach reproductive rights and social support for families in Idaho?" followed by an informational section about some specific individuals. The poster on the left says, "I want to live in an Idaho where... / What do you want to see for the future of women and healthcare in the state of Idaho? Tell us, and tell the world. Let's start a conversation. Choose your prompt from the collection below."
Posters in the “Worth of a Woman” exhibit explore different women’s health issues. (Jazmin Orozco Rodriguez/KFF 国产精品视频 News)

As more community members feel the effects of a strained health system, some are following in the path of the doctors 鈥 they鈥檙e considering leaving. Anderson is among them.

Local education issues play a large part in that decision-making process, she said, as she considers her 9-year-old daughter鈥檚 future. But access to women鈥檚 health care is another piece of the puzzle.

鈥淚f I don鈥檛 have the care I need and she doesn鈥檛 have the care she needs,鈥 Anderson said, 鈥渋s that really somewhere we want to live?鈥

Ranji said polling indicates health care is a priority for people, so it could play into decisions about where they want to plant roots. And that leads into another way community members could respond to the changes in local care 鈥 by voting in state elections.

Primary election results from May in northern Idaho, where Sandpoint is located, showed signs of voters backing Republican candidates who hold more moderate views on abortion. Former state Sen. Jim Woodward Sen. Scott Herndon, a fellow Republican who sought reelection to his seat in the legislature.

Woodward, a self-described pro-life candidate with a stance against elective abortions, supports efforts to include exceptions for the health of the mother and removing the threat of felony charges against doctors who perform abortions. Herndon, on the other hand, provoked strong reactions during last year鈥檚 legislative session when he that would have removed the already strict law鈥檚 current narrow exceptions for rape and incest.

A portrait of Kathryn Larson, who sits in an office overflowing with plants.
Kathryn Larson, a Democrat running for a seat in the Idaho House of Representatives, saw a doctor in the eastern Washington city of Spokane, more than an hour’s drive from her community, to treat her prolapsed bladder. Before OB-GYNs left Sandpoint, she might have been able to receive care locally.(Jazmin Orozco Rodriguez/KFF 国产精品视频 News)

Kathryn Larson, 66, has been campaigning as a Democrat for a seat representing most of Boundary and Bonner counties, the two northernmost in the panhandle region, in the state鈥檚 House of Representatives. She also has had recent firsthand experience falling into the care gap created by the exodus of OB-GYNs in Sandpoint.

In January, Larson went to the emergency room at Bonner General, a 25-bed critical access hospital, with severe chest pains. A cardiologist suggested an infection could be to blame. Larson said she also experienced vertigo and rapid heartbeat and later developed symptoms of a urinary tract infection. She was given rounds of antibiotics to treat the infection, but the symptoms returned.

More testing finally revealed the crux of the issue 鈥 Larson was dealing with a prolapsed bladder, which is not life-threatening but causes discomfort or pain and women in their 60s.

After about five months of back-and-forth communication with providers in Post Falls and the eastern Washington city of Spokane, she scheduled an appointment for surgery in early June in Spokane, more than an hour鈥檚 drive from Sandpoint. Following surgery, during which doctors implanted a mesh structure to support her bladder, Larson is spending six to eight weeks recovering before heading into the final stretches of election season.

She said the November election will help others in her party tell if it will be possible to work across the aisle to loosen restrictions on the abortion policy during next year鈥檚 legislative session. She wants to slow the loss of needed providers across the state.

鈥淧eople don鈥檛 feel safe,鈥 Larson said.

The U.S. Supreme Court ruled on June 27 that Idaho must for now continue to allow abortions in medical emergencies. The ruling came in a lawsuit filed by the Biden administration, which argued that the federal Emergency Medical Treatment and Labor Act requires such care.

But the ruling does not provide a permanent solution. It kicks the case back to lower courts. Confusion remains over a doctor鈥檚 ability to perform abortions even in emergency settings, and the Idaho Medical Association said it will continue to work toward a clear health-of-the-mother exception within state law during next year鈥檚 legislative session.

鈥淲e still need more clarity for our state鈥檚 doctors,鈥 OB-GYN Megan Kasper said in a medical association press release.