It’s a scene out of an American dream: a stretch of city beach buzzes with young families playing and laughing under the hot afternoon summer sun, moms chasing after children, splashing in the shallow ripples of Lake Pend Oreille. We are on the outskirts of Sandpoint, Idaho, a quiet, charming lakeside town in the mountain west. From the idyllic scenery and bustling beach, you wouldn’t know this is a place recently overwhelmed with anxiety, grief and fear born of state politics.
Lauren Sanders relaxes among the beachgoers in a sea-green bikini that reveals her pregnant belly, keeping an eye under her sun hat on her young daughter, Gwen, who’s angling to get back in the water.
Sanders will give birth to her second child at home later this year with the assistance of a midwife. Her pregnancy has so far been healthy and she wants to have a home birth. But if anything goes wrong – a last-minute emergency, a scare, an unpredicted turn - and she needs hospital maternity care, she’ll be put into an ambulance and driven over the two-lane highway to a larger city half an hour away.
She is a bit worried. But she’s also angry that the options of pregnant people who live in Idaho were snatched away by politicians who appear willing to risk lives like hers in their haphazard quest to ban abortion.
Across Idaho, doctors are leaving, looking for states where politics don’t dictate how they practice medicine. The consequences of Idaho’s anti-choice laws hit Sandpoint fast and hard, hollowing out medical care for women within months. For years, the town had a maternity ward that delivered as many as 350 babies every year – now it has nothing. The OB-GYN ward shut down this spring and doctors have been fleeing the state in a steady stream, seeking shelter in places where their work doesn’t put them at risk of criminal charges or big lawsuits.
“Basically, I’m lucky because I have a healthy pregnancy,” says Sanders. “But there are all these other people out there who are going to give birth who aren’t healthy. I don’t think people even think about the little things that can happen that a midwife can’t handle.”
Photograph: Natalie Behring/The Guardian
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It’s become a gamble, getting pregnant and giving birth in a place that no longer has a maternity unit or any obstetricians. Sandpoint is small, fewer than 10,000 people, but it’s been a medical hub for a rural region of 50,000 in north Idaho, Montana and Washington.
For people like Sanders, pregnancy care in town is no longer an option. This is what happens when a state government that’s been itching to ban abortion enacts some of the most restrictive laws in the country and ensnares all of reproductive health and a good share of routine medical care in its dragnet. But the women of Sandpoint are clear about one thing they want others to know: this can happen anywhere in the post-Roe United States. Nowhere is as safe as you might believe and the battle won’t stop at state borders.
Idaho is one of several states that had trigger laws: immediate abortion restrictions that went into effect when Roe v Wade fell a year ago. In August of 2022, the state enacted a near-total ban on abortion with exceptions only if the mother’s life is in danger, or in the case of rape and incest. Those instances require a police report to be filed. The state also adopted what it called an “abortion trafficking” ban, which bars taking minors to other states for abortion care. Family members can sue doctors for thousands of dollars if they perform an abortion, and doctors may face criminal fines and even prison time.
Idaho also became the only state in the country to stop tracking maternal mortality rates. Activists say it’s like they don’t want anyone to know how deadly their decisions might be.
The abrupt shift has created a climate of fear and anxiety, especially for women and families. Krista Haller, a therapist who specializes in working with pregnant people and new parents, says many have lost trust in their medical system.
“You saw so much about abortion, like it was such a hot word, but it’s not even about that,” she says. “It’s about the medical rights that women have – that’s really what comes up. Women are feeling very scared about the care they’re going to get. They’re unsure about their medical care and whether they can trust the medical system.”
The fear beset doctors and is pushing them out.
Dr Amelia Huntsberger moved to Sandpoint 11 years ago with her husband, planning to put down roots, build a medical practice and stay through retirement. She’s an OB-GYN, her husband an emergency room doctor. They both grew up in smaller cities in the north-western United States, so Sandpoint was a natural fit.
This July, the Huntsbergers’ home on a winding road on the edge of town was filled with moving boxes.
By the end of summer, they will be gone, starting over in Oregon, starting over with new jobs and new schools for their three kids, practicing medicine in a state that doesn’t leave them vulnerable to arrest or lawsuits for saving their patients’ lives. This is not what they wanted or planned, but as Huntsberger explains through intermittent tears across her patio table, leaving Idaho became their only way forward.
“Yeah, this is a conservative state. We knew that when we moved here. But it’s become very extreme. We now have some of the most extreme examples of government interference in healthcare that exists across the country,” says Huntsberger. “And there’s that irony – we are a liberty state: ‘You do you. I’ll do what I do.’ Except if you have a uterus and it’s something related to healthcare, then the government suddenly has a lot to say, without bothering to understand what they’re legislating. There’s some real willful ignorance here.”
It has seemed, she says, like a willful act on the part of lawmakers to fail to understand the repercussions of the laws they have enacted. That impact falls most heavily on women and families, and particularly on those who don’t have a lot of money or power.
Like many women in Sandpoint, Huntsberger is by turns angry, exhausted and forlorn about what’s happening. This is a small town fueled by women, a hub for young families, a thriving resort and tourist destination that, yes, votes majority Republican but where many of the downtown businesses are owned and run by women. Many were shocked by how abruptly the new laws devastated their healthcare.
Jen Jackson Quintano, who owns an arborist business in town but has become a full-time organizer focused on abortion rights, is fighting back. Like many small towns, Sandpoint is trying to lure young families to move here but the disappearance of critical healthcare won’t help.
As a first step, she saw the need for women to tell their stories because abortion is taboo. When she solicited abortion experiences from around the community, they poured in. The flood of personal narratives surprised even Quintano, who worked to turn them into a local theater production. Breaking the stigma around abortion, she says, is a critical first step in getting the community to talk about the basic healthcare and human rights it has lost. The stage play touched a nerve.
“People were crying, just openly weeping in the audience, listening to these stories. It was so powerful. And then the aftermath of that, I started having people approach me in the community,” she says. “At the grocery store in the frozen food aisle, a man comes up to me, and he said, ‘I went to your stage production. And I want you to know, I got a woman pregnant when I was in Vietnam. And I’ve never told my kids this, but I want to tell you my story.’ And after he tells it to me, he says, ‘I think it’s time for me to share this with my kids.’”
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In March, Bonner General Health, the local hospital, announced that it would no longer provide any obstetrical care, leaving pregnant patients and others to go elsewhere for their healthcare. In its announcement, the hospital cited Idaho’s new laws.
“Highly respected, talented physicians are leaving. Recruiting replacements will be extraordinarily difficult,” the hospital noted. “In addition, the Idaho legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as standard of care.”
The threats translate into real life for doctors. Huntsberger describes changing into her scrubs to perform emergency surgery on a pregnant patient who was bleeding internally. In that moment, she felt a wave of anxiety not about the actual surgery, but about the laws and whether her decision and actions in the operating room would get her into legal trouble. It happened more than once.
“I know that this is a high-stakes case, I know I need to move quickly. I need to get in there. I need to do my job. That stress, I know what to do with that. I can handle that,” she recalls thinking. What was less manageable was the potential threat of prosecution or a lawsuit for the procedure she needed to perform to save her patient’s life.
In the middle of the emergency, she found herself wondering: “What would a prosecutor choose to do, or the family [choose to do], because we have both civil penalty and criminal penalty laws?”
The raft of extreme abortion laws left doctors like Huntsberger unsure if they could continue to practice any kind of family medicine in Idaho, where untrained political figures now have greater say over medical decisions than physicians. Across Idaho, doctors are leaving, looking to practice in safer states. After months of weighing their options, including many sleepless nights, the Huntsbergers finally decided the risks and anxiety were too much. It was time to leave.
As she talks about the decision to leave, Huntsberger tears up again. They are not a family that hops from place to place; they found home here. She knows their ability to flee the state is also a privilege. Like much of the mountain west, Idaho is a place of growing economic inequality, and many residents simply can’t afford the cost of uprooting their lives to relocate to a safer state. As she talks about it, Huntsberger mentions having two pregnant patients within the last year who lived in their cars – women who live at the mercy of extreme politics.
“We can look across the country, at the abortion laws, and who bears the burden and the brunt of these abortion restrictions. And it is on people in lower socioeconomic classes, it is people of color, it is Indigenous people,” she says. “It’s this doubling down on vulnerable communities.”
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Idaho has long been conservative in its politics, yet like most places it is more complex than one-dimensional national political conversations might have you believe. It was also one of the first states to allow women to vote. Like much of the Rocky Mountain west, its politics have been shaped by elected officials who espouse values of personal liberty and freedom, but pass increasingly intrusive legislation that creeps into the personal lives and private spaces of their constituents.
In recent years, seemingly liberated by the unhinged rhetoric and bizarre posturing of Donald Trump and the US supreme court’s decision on abortion, the state has veered off a cliff into political extremism. Trumpism has gone local, infiltrating state legislatures and local governments. But the women of Sandpoint warn this concerted attack on human rights won’t stop at their state’s borders. Idaho’s far-right undercurrent is now a norm in American politics.
Along with its ramping up of abortion restrictions this year, the legislature enacted a law banning gender-affirming care for minors and the governor signed a strict “bathroom bill” mandating that restrooms and changing rooms be segregated by the gender a person is assigned at birth. A bill to prohibit sex education in schools before the fifth grade finally died after weeks of debate, while a measure to provide free menstrual products in schools also died.
“It does seem to be decades of organizing that are paying off and it seems to be spiraling. The misogyny was always there, and the racism was always there,” says Amanda Hendrix-Komoto, a historian at Montana State University who grew up in southern Idaho and has researched Mormon histories of the place. The Church of Latter-Day Saints has a heavy presence in Idaho, but its attitudes about abortion and related healthcare are not so extreme as those of the evangelical Christians who now wield the heaviest political power in the state. Rather, generations of viewing women as not quite equal may have helped create an atmosphere that made it easier to erase the rights of marginalized people.
Huntsberger has become an unlikely activist, a doctor who decided she had no choice but to speak out when the state interfered with her ability to treat her patients. When I ask if she’ll really leave that behind in Oregon, she laughs, a quick respite from our deadly serious conversation about consequences for families in Idaho and what losing medical care will mean. It’s hard to imagine she’ll stop speaking out about the consequences of anti–abortion legislation.
“Nobody knows if their pregnancy is going to be uncomplicated or complicated. Nobody sets out to have a complicated pregnancy. Things happen, some of which can be predicted, and some of which cannot. So you have a little bit of a component of Russian roulette,” she says. “Being pregnant is always more dangerous than not being pregnant.”
