4 Women Testify That Idaho’s Abortion Ban Made Them ‘Medical Refugees’

This week, four Idaho women took the stand to testify against the state’s total abortion ban, specifically challenging the ban’s ambiguous and ineffective medical emergency exception, and recounting the severe mental health struggles it has inflicted on them. The women—Jennifer Adkins, Jillaine St.Michel, Kayla Smith, and Rebecca Vincen-Brown— were each denied emergency abortion care and had to travel out-of-state, making them “medical refugees,” which is how one of their attorneys put it to Jezebel.

In the trial’s opening arguments on Tuesday, attorneys for the women, who are represented by the Center for Reproductive Rights, raised that the ban’s emergency exception rule doesn’t recognize suicide as a medical emergency. “Pregnancy can have significant impacts on mental health and trigger the onset of severe depression, psychotic episodes, severe anxiety,” Nicolas Kabat, a staff attorney at CRR who’s working on the case, told Jezebel. “For some women, there’s no medication that’s going to make that better, and they need to end their pregnancy to make sure they don’t end their life or suffer other psychiatric symptoms.”

At the end of 2022, researchers at the University of Pennsylvania published a study that showed women and pregnant-capable people of reproductive age are at greater risk of suicide in states that severely restrict abortion. The study drew on 40 years of data that preceded the Dobbs v. Jackson Women’s Health ruling that’s allowed almost two dozen states to ban abortion. Kabat said their lawsuit asks the court to clarify under what circumstances Idaho doctors can provide abortions, specifically asking the court to recognize that doctors can offer abortion services when pregnancy complications create a serious risk of infection or bleeding, for fetal conditions, and also, crucially, for severe mental health conditions, which “don’t get enough attention.”

The plaintiffs who testified were explicit about the severe impact their experiences had on their mental health. Adkins, the lead plaintiff and a mother to a young son, took the stand first. Within 12 weeks of her pregnancy in April, Adkins learned her fetus had Turner syndrome and had a 1% chance of survival. “No parent wants to wish that when they look at an ultrasound, they don’t see their baby’s heartbeat,” Adkins said. “Yet, here I was hoping that I wouldn’t, just because I wanted the decision to be made for us.” Instead, all her doctor could do was “hand me a piece of paper, face down, with a list of [abortion] providers that I could attempt to call on my own outside of Idaho,” as well as bereavement resources.

Jennifer Adkins’ pregnancy was going well until her 12-week scan revealed devastating fetal anomalies endangering her health. Because of Idaho’s extreme abortion ban, she had to leave the state for care. Now we’re suing Idaho for the harm it caused Jennifer and other patients. pic.twitter.com/26dLlSDa1I

— Center for Reproductive Rights (@ReproRights) September 22, 2023

St. Michel, who gave birth to her second child in January, testified next. In 2023, 20 weeks into her second pregnancy, she learned her fetus suffered from multiple severe developmental conditions and was unlikely to survive. Instead of being able to receive an emergency abortion, which would also mitigate the risk of life-threatening infection, she had to fight to get on weeks-long waiting lists for abortion clinics in 20 different cities out-of-state. A last-minute cancelation opened up an appointment at a Seattle clinic, but she had to go to the appointment by herself while her husband watched their toddler son. “Each day was worse than the last,” St. Michel said through tears. “During those days, my mental health got progressively worse and worse.” When she became pregnant again later in 2023, she and her husband “were guarded and couldn’t be blissfully unaware of the consequences of potential complications that may arise.” With their previous experience in mind, they sought genetic screenings as early as possible and moved to Minnesota, where she gave birth. St. Michel testified that she and her husband “love Idaho,” but have no plans of moving back until laws the change, because she wants to live in a state where her daughter “can feel safe.”

Next, Smith testified that 19 weeks into her pregnancy in 2023, she learned her fetus had a congenital heart condition and was unlikely to survive. Through tears, she recounted how her family was forced to seek a loan to access the procedure for $20,000 without insurance coverage out-of-state, in addition to a range of associated costs. Smith says she was “petrified” when she learned she was pregnant for a third time last year, and she and her husband moved to Washington shortly after. About 21 weeks into her third pregnancy, she developed preeclampsia, which can lead to fatal complications, and received an emergency c-section.

Vincen-Brown learned 16 weeks into her second pregnancy that the fetus suffered from several fatal fetal conditions. Still, she, her husband, and their two-year-old daughter had to drive seven hours out of state for an emergency abortion. The procedure would take two days to complete. But when she returned to her hotel at the end of the first day, she passed her pregnancy in the hotel bathroom, experiencing severe bleeding and pain while her daughter slept in the other room. Vincen-Brown, who had one more child after this experience, recounted that navigating Idaho’s abortion ban “impacted my emotional well-being, my overall mental health, my financial situation.” She further testified, “I worry for my two daughters, once they become of reproductive age.”

Speaking to Jezebel shortly after testifying, St. Michel took particular issue with the state of Idaho’s dismissive arguments trying to discredit the women’s lawsuit. On Tuesday, an attorney for Idaho said in his opening arguments that the women are “relying on hypotheticals,” and compared their horrific pregnancy complications to “stepping on a rusty nail.”

The state accuses the plaintiffs of trying to “distract” the judge with their testimony, and says they are arguing for a ruling that would allow abortions for “any potential health issue that any pregnant woman could face, no matter how minor.”

— Alice Miranda Ollstein (@AliceOllstein) November 12, 2024

“One of the most upsetting parts was that there are four of us plaintiffs right in front of them disclosing our very personal lived experiences, and they dismissed us as being hypothetical,” St. Michel said. Kabat told Jezebel that this has become anti-abortion states’ entire strategy in response to lawsuits across the country: “It’s the same response everywhere—they want to act like these women don’t exist, pretend these stories aren’t happening, their bans don’t have these impacts. So they fight tooth and nail to not give them a platform to talk about this.”

Earlier this year, attorneys for Idaho attempted to have the Biden administration’s lawsuit against their abortion ban thrown out by the Supreme Court. They argued that the lawsuit called for women suffering from mental health conditions to be able to get abortions under the medical emergency exception. Attorneys for the Biden administration, who sued the state under EMTALA (the Emergency Medical Treatment and Active Labor Act), said this wasn’t true. But, Kabat told Jezebel, CRR’s lawsuit does want the state court “to allow women experiencing psychiatric emergencies to have options” including abortion. “After discussing with a psychiatrist and seeing what alternative treatments there are, we want them to be able to access abortion if a psychiatrist determines that’s the best solution,” he said. Their lawsuit is “seeking broader relief in Idaho” than the federal case at the Supreme Court, which the justices ultimately punted and sent back to a lower court.

Two years after the Supreme Court killed Roe v. Wade, CRR has continued to represent women denied emergency abortions in lawsuits across the country—almost all of them are seeking clarity in medical emergency exceptions. “The biggest throughline is that these exceptions don’t work,” Kabat said. “The people who pass these laws were told from the start that they were going to wreak havoc, tie doctors’ hands, and force patients to wait til they’re on their deathbed for care or become medical refugees. And that’s what’s happening.”