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How bad is the situation for OB-GYNs in Idaho due to anti-abortion Republicans? Even a conservative Mormon doctor is now trying to sound the alarm before it’s too late.
Here’s the situation, as I’ve explained before: Republican-dominated Idaho passed a near-total abortion ban in 2022, and that led to an exodus of OB-GYNs from the state. Some retired early, some stopped providing certain kinds of care (a move that hit rural areas especially hard), and others just moved to states that value their medical expertise.
The result was that, in the 37 least populated Idaho counties, home to a quarter of the state’s residents, there were only 23 OB-GYNs. (For comparison, the seven most populated counties had 151 OB-GYNs.) They felt like they had no choice; providing care could have led to imprisonment or the loss of their medical licenses.
The bottom line is that women who need abortions or have riskier pregnancies in those communities are in danger, all because conservative Christians don’t give a shit about their health. Under the guise of protecting the unborn, Idaho Republicans have made life miserable for the living. The state is unsafe if you’re a pregnant woman, especially one who doesn’t want to be pregnant, and it’s unsafe if you’re a practicing OB-GYN.
A recent New York Times piece highlighted that half of the state’s 44 counties “no longer have a practicing obstetrician.” The remaining doctors are so overbooked right now that the wait time for a “hysterectomy can be six months. It can take nine months to secure an appointment for an annual exam.”
Things can’t get worse. Right?
Well, next week, Idaho voters will have the chance to restore some of the reproductive rights that have been taken from them. A ballot initiative could restore the ability to get an abortion until fetal viability—roughly 22-24 weeks into pregnancy—which is what they had under Roe v. Wade. The “YES” side only needs to pass by a simple majority for that to happen. If that side wins, and Republicans don’t pass another law to undo the decision, it might bring doctors back to the state.
But the Mormon Church, just as they supported the anti-gay Prop 8 in California in 2008, is now injecting itself into this campaign. Earlier this month, they donated $1 million to fight the initiative.
"While The Church of Jesus Christ of Latter-day Saints remains neutral toward political candidates, it actively addresses ballot initiatives it believes carry significant moral consequences," the LDS Church wrote in a statement.
The Mormon Church wants to make life even more hellish for doctors and their patients. As if they haven’t done enough damage. It’s also wild for the Church to say it cares because this issue has “moral consequences.” The majority of Mormons vote for Republicans, and that means they’ve already failed a very simple moral test.
But now one conservative doctor is opening up about how the LDS Church’s position doesn’t align with her own expertise and has her “torn” about what to do.
Dr. Heather Pugmire is an OB-GYN in Idaho, and she never performed elective abortions even when she could because it violated her religious beliefs. But the 2022 law affected her field in profound ways. She saw doctors driven out of the state. She thought about her own workload increase. She understood that patients were not being properly cared for.
Practice-wise, it’s made it impossible to recruit other OB-GYNs to the area. And so my ability to keep practicing at my current pace has been really hard. I’ve been on the verge of having to quit because I don’t have the support I need. I can’t be on 24/7. I’ve tried. It doesn’t work.
A lot of people will say just offer job candidates more money, but we can’t even get to where we can offer them more money. The law has made it feel like Idaho doesn’t trust doctors, that we’re trying to get away with something. And that’s been very clear to other physicians across the nation.
And truly, if laws don’t change, I’m not going to be able to keep doing this. So then I leave and that shuts down OB services in my area. That puts strain on the surrounding areas. And they’re not getting doctors either.
Pugmire fully believes in the Church’s leaders, yet she also knows what Idaho’s law is doing to her patients and her practice. She knows she can’t ignore what she’s seen. Idaho’s laws are making it harder for doctors to do their jobs and get patients the care they need. And now the Church has put her in a bind.
She thought about how, despite her anti-abortion views, she’s personally had trouble caring for mothers whose lives were in danger. As an example, she talked about a patient whose water broke when she was merely 14 weeks pregnant. The pregnancy couldn’t continue—a baby would never be born—and Pugmire said the proper treatment is to prevent infection and hemorrhaging by eliminating the fetus. But that’s an abortion. So before performing that procedure, she “had to spend almost two hours calling my lawyer, calling my CEO, calling three other doctors to be able to put statements in the medical record that I’m not the only one who thinks this is the right way to go.”
In other words, instead of focusing on caring for the patient, which she wanted to do, she had to work around a Republican law to protect her own ass.
She’s spent years asking state representatives to change the law (to no avail). Now Prop 1 may be her best bet. But the Church’s opposition to it is forcing her to choose between her expertise and her faith. She’s “torn,” she says, about what to do.
That’s why she’s not explicitly telling voters to vote YES, but rather saying the status quo isn’t working—and that Prop 1 would make it easier for doctors like her to provide compassionate care for their patients in a way that doesn’t violate their faith.
I know it’s ridiculous that she’s letting a handful of nonagenarians have any say over how she should do her job, but I hope other Mormons listen. Voting YES wouldn’t require them to support abortion in opposition to their religious beliefs. It would give doctors and patients more wiggle room to make tough decisions. Hell, even treating miscarriages is difficult now, much less riskier pregnancies. By speaking out, Pugmire is hoping to let people know about the downstream consequences of Idaho’s laws.
So that’s the pitch: Yes, Prop 1 is a vote on abortion access, but Pugmire’s experience shows it’s also a vote about whether doctors can make difficult medical decisions without fearing legal punishment.
(Pro-choice activists, of course, have been saying all this forever. I know. I know.)
She explained her thinking to The Salt Lake Tribune on their “Mormon Land” podcast:
… I know that I can follow the church’s policy and the teachings—and I am comfortable with those teachings—and that I can be a competent and compassionate physician under Prop 1 easier than the status quo.
Now, truly, if they would change the law, that could be easy, too. I don’t think they would even have to change it very far. If they added protections for the health of the mother and cases in which severe defects mean the baby won’t survive, I don’t think we’d have an issue.
But something needs to change.
…
I was a 100% yes for it until the church made its statement. Now I’m quite torn. I absolutely believe in prophets. I do believe they receive revelation. I do believe that they speak out on important things.
I don’t know if they understand the nuances, especially with them issuing a similar statement in Nevada. But really, for me, Prop 1 is a wake-up call to the Legislature that says we need to do something. This isn’t sustainable.
I realize there will be a lot of eye rolls over this. Did she just now realize the Church’s position has always been this bad? Why would she reconsider supporting the initiative just because the Church weighed in? Why can’t she just do the right thing instead of letting religion lead her astray?
At the same time, though, remember that people like Pugmire are exactly the sort of people who might be able to reach the otherwise unreachable. She’s a devout Mormon. She’s anti-abortion. She’s a respected doctor. If right-wing voters won’t listen to people like me, they might listen to people like her.
We need to not penalize doctors for helping people make hard decisions. But we absolutely can have a culture of not doing elective abortions in our state. That was there when I came. I came in 2012. It was very clear. That’s part of why I came. I didn’t want to be asked to do them. And we didn’t. No one in southeast Idaho did.
…
Our goals are the same. We want healthy moms and babies. And if we can work together to do that and agree on that, then I think it makes it much easier to get rid of that fear.
You know what? Fine. More of this, please.
She’s not talking to liberals who already understand this. She’s talking to conservatives who don’t.
She’s trying to tell them this can improve health care in her broken state without violating their religious beliefs. She’s basically reassuring them that they’re not bad Mormons by ignoring the Church’s wishes in this particular case. As things stand, though, Idaho’s laws make it harder for good doctors—even devout Mormon ones—to do their jobs.
I wish she trusted what she’s seen in her own practice more than the Church’s position. She shouldn’t be “torn” when there’s an obvious right answer. But if her testimony helps other Mormons question that position, more power to her. And who knows. Maybe if people realize the Church is wrong on this issue, they’ll realize the Church is wrong on a whole bunch of other ones, too.
The inability to anticipate consequences seems to be one of the defining characteristics of conservatism. As for the pro-life crowd, they're really only pro-life on one issue and that's more about controlling women than any concern they have for the unborn. More often than not, they quit caring about mother and child the minute the child is born. They're opposed to universal healthcare, pro death penalty, opposed to sensible gun laws and never met a war they didn't love.
My cousin is part of the Wilson cult in Idaho. I keep waiting to hear that one of her kids -- or grandkids -- has died due these laws.