Extending its work on behalf of patients denied or delayed in receiving medically necessary abortion care despite severe and dangerous pregnancy complications, on September 12, 2023 the Center filed complaints in three states—Idaho, Tennessee and Oklahoma. With these actions, the Center seeks to ensure that pregnant people in such dire situations can access abortion care in these states, and that doctors are given clarity on what situations qualify under the “medical emergency” exceptions in their states’ abortion bans.
Plaintiffs also include an Idaho medical association and physicians who argue they are unable to provide care to patients even in dire situations because the bans threaten them with harsh criminal, financial and professional penalties.
The stories of these patients and physicians exemplify the dangers that state abortion bans pose to pregnant people’s health, lives and future fertility and make clear that many Americans in obstetrical emergencies are not getting the care they need.
Adkins v. State of Idaho
Lead plaintiff in the case Jennifer Adkins, of Caldwell, was pregnant with her second child when her 12-week ultrasound revealed her baby had skin edema and cystic hygroma, both of which carry a high mortality rate. During the same appointment, a geneticist told Jennifer that her daughter was also likely to have Turner syndrome, a rare chromosomal condition that affects female fetuses and results when one of the X chromosomes is missing. Doctors told Jen her pregnancy was likely not viable, as Turner syndrome almost always results in miscarriage. They also said that if she did not miscarry, Jen was likely to develop mirror syndrome—a condition leading to the development of edema and preeclampsia which, if left untreated, could be fatal.
Though Jennifer was devastated by the news, it was clear to her that continuing the pregnancy would endanger her health. Aware of Idaho’s abortion ban, she questioned her doctors, who admitted that if the state’s laws were different, they would have referred her to an in-state abortion clinic. But because of Idaho’s abortion laws, she would instead have to travel outside Idaho to get the care she needed. After calling several clinics in neighboring states, Jen was able to travel with her husband to Portland, Oregon, to obtain abortion care—but only after receiving financial assistance from two abortion funds. Later, Jen was able to get her fetal tissue tested, and the diagnosis of Turner syndrome was confirmed.
While Jen hopes to become pregnant again, she is anxious about being pregnant in Idaho. She worries that because her hospital has recently lost its obstetric genetics counselor and will soon lose its only remaining maternal fetal medicine (MFM) specialist, she will be left with little to no in-state options for genetic counseling and high-risk pregnancy care should she need it in future pregnancies.
“No one deserves this heartache. It makes me angry to know that this is happening to countless Idahoans and others across the country.”
— Jennifer Adkins, lead plaintiff, Adkins v. State of Idaho
Jillaine St.Michel, of Meridian, was excited to be pregnant with her second child when her 20-week ultrasound revealed that her baby had multiple severe developmental conditions affecting multiple organ systems and was unlikely to survive.
Jillaine and her husband knew that an abortion would be the best option for their baby, but Jillaine’s doctors explained that because of Idaho’s laws, they could not provide her with that care. Jillaine and her husband began reaching out to out-of-state abortion clinics, although Jillaine found it emotionally and financially difficult to be suddenly forced out of state to receive essential health care. Jillaine was beyond gestational limits for some clinics, and was on the wait list at several others. She was only able to obtain care when she did due to a cancellation at a clinic in Seattle.
Jillaine is pregnant again and expects to give birth in January. As a health care provider herself, she believes that decisions about pregnancy and childbirth should be kept between the patient and their doctor, without government interference.
Kayla Smith, formerly of Nampa, pregnant with her second child, was shocked to learn at her 19-week ultrasound scan that her baby had a serious and inoperable congenital heart condition. After consulting with a maternal fetal medicine (MFM) specialist and a pediatric cardiologist, she and her husband learned that their baby was not likely to survive past birth and there were no viable medical interventions available. Kayla’s doctors also explained that because Kayla had previously developed preeclampsia during her first pregnancy (her daughter is now three), she had a heightened risk of developing preeclampsia again if she carried her pregnancy to term.
Devastated by the news but determined to spare their baby from suffering and ensure Kayla’s safety and health, Kayla and her husband decided that what Kayla needed was abortion care. But because of Idaho’s abortion bans, her doctors could not provide that care for her. Kayla and her family traveled to Washington to obtain abortion care—a trip that cost thousands of dollars and required them to take out a personal loan, as well as receive assistance from friends and family. Worse than the financial toll, Kayla was upset that she had been forced through such an ordeal just to obtain necessary medical care.
Kayla is pregnant again, with a girl—but she and her husband were so concerned about raising two daughters in a state like Idaho, where their bodily autonomy rights are not guaranteed or protected, that they have since moved to Washington.
Rebecca Vincen-Brown, of Ada County, was thrilled to be pregnant with her second child when she began experiencing vaginal bleeding approximately 12 weeks into her pregnancy. She had several ultrasounds and appointments with her obstetrician-gynecologist (OB-GYN) and MFM because her baby was measuring small and low in her uterus. After she underwent two rounds of non-invasive prenatal testing—which were inconclusive but showed a likelihood of severe chromosomal conditions—she went in for an early anatomy scan at 16 weeks and learned her baby had a number of fatal fetal conditions including dangling choroid plexus, micrognathia, significant cardiac issues and horseshoe kidney. Doctors told her the baby was unlikely to survive to birth, and if Rebecca were to continue her pregnancy, she risked developing preeclampsia or severe hemorrhaging.
Rebecca wanted to prevent her baby from suffering and remain healthy and present for her two-year-old daughter, but her doctors were not able to provide her the care she needed due to the abortion bans. So she, her husband and their daughter drove for seven hours to Oregon so that she could obtain abortion care. After Rebecca had gone to the abortion clinic for the first day of her abortion procedure, she passed her pregnancy in the hotel bathroom in the early hours of the next morning. Her husband had to perform multiple rounds of fundal massage on her stomach to help stop the bleeding. They both had to be careful not to make any noise while their daughter slept.
Rebecca is pregnant again and recently learned she is carrying a baby girl. While happy to be pregnant, she is anxious about her health while pregnant in Idaho and is concerned about her daughters’ rights and safety.
“Over the last year, Idaho’s laws have caused confusion among our members and doctors in the state. This is unsustainable in an already strained health care system that’s experiencing a significant exodus of doctors. We urgently need clarity on these laws in order to protect both pregnant Idahoans and our doctors, and to prevent further irreversible harm.”
—Dr. John Williams, Board President, Idaho Academy of Family Physicians
Dr. Emily Corrigan
Dr. Emily Corrigan is a board-certified, hospital-based OB-GYN in Boise, Idaho, who works with a team to provide 24/7 care to patients with pregnancy complications. Dr. Corrigan has been a practicing OB-GYN for over 16 years, during which she has cared for thousands of pregnant people and delivered thousands of healthy babies. But since Idaho’s abortion bans went into effect, her team has experienced challenges navigating the confusing medical exceptions to Idaho’s abortion bans and providing timely and appropriate basic medical care to their patients. Dr. Corrigan has seen firsthand how many providers in Idaho are afraid to care for patients with dangerous pregnancy complications because of the bans’ vague and narrow medical exceptions and severe penalties. When those physicians turn such patients away, they often arrive at Dr. Corrigan’s hospital needing urgent care.
Dr. Corrigan has also watched as many physicians have been forced to leave Idaho altogether to practice medicine elsewhere, causing statewide staffing shortages and putting Idaho’s health care system on the brink of collapse. Since the bans have gone into effect, Dr. Corrigan’s hospital has lost its obstetrics genetic counselor and two thirds of its maternal fetal medicine (MFM) specialists. Their sole remaining MFM is scheduled to retire in November, leaving Dr. Corrigan and her colleagues without an MFM on staff to consult for patients with high-risk pregnancies. Because of the abortion bans, Dr. Corrigan’s hospital has also had trouble hiring and retaining physicians. As a result, Dr. Corrigan’s team has faced challenges filling shifts, avoiding burnout and providing quality care to all of their patients. She fears that as long as the bans remain in effect, her department will never become resourced enough to meet the needs of incoming patients.
Dr. Julie Lyons
Dr. Julie Lyons is a board-certified full-spectrum family physician in Hailey, Idaho, and has been a practicing physician for over 17 years. She is a member of the Idaho Academy of Family Physicians and a preceptor for medical students to receive hands-on clinical training. Dr. Lyons provides prenatal and obstetrical care to a heavily rural community in Blaine County and surrounding areas, which includes a large and growing immigrant, refugee and Indigenous population. Dr. Lyons’ patients tend to have higher rates of prenatal complications and are more likely to develop high-risk pregnancies due to systemic barriers to health care access in rural areas.
Since Idaho’s abortion bans went into effect, Dr. Lyons’ practice has had significant problems navigating and ensuring compliance with the laws and, as a result, her patients have been denied or delayed in accessing abortion care for emergent medical conditions. Dr. Lyons’ practice has also been heavily impacted by the departure of half the state’s maternal-fetal medicine (MFM) specialists since the bans went into effect. Many of Dr. Lyons’ patients have low incomes, cannot easily take time off from work or and lack reliable access to transportation and childcare. For some patients with complex or high-risk pregnancies, the drive to Boise to see an MFM specialist is challenging enough; out-of-state travel to get an abortion because their pregnancy poses a risk to their health is insurmountable. Read more about why Dr. Lyons joined the case.
The Idaho Academy of Family Physicians (IAFP)
The Idaho Academy of Family Physicians (IAFP) is a professional membership organization consisting of physicians, residents and medical students who practice medicine throughout the state of Idaho. About 28 percent of its 656 members practice medicine in rural areas, and about 30 percent provide obstetric care as part of their family medicine physician services.
IAFP members have been harmed by Idaho’s abortion bans in myriad ways. Its member physicians have been unable to care for their patients according to their medical training, education and expertise. IAFP members are also confused about what medical care they are allowed to provide to their patients under the bans’ confusing medical exceptions.
In the past year, the IAFP has advocated for Idaho’s abortion bans to be amended to permit abortion in cases where the pregnant patient’s health is at risk, including when a patient’s pregnancy is not viable due to a likely lethal fetal diagnosis. By joining this case, the IAFP is raising the alarm about how the bans are driving physicians out of Idaho and bringing the state’s medical system to the brink of collapse.
Blackmon v. State of Tennessee
“I was condemned to endure both physical and emotional torture, knowing that I was going to deliver a stillborn. How can Tennessee politicians stand by while this happens to people like me? I want some good to come out of my ordeal, so I am joining this case.”
—Nicole Blackmon, lead plaintiff, Blackmon v. State of Tennessee
Lead plaintiff in the case Nicole Blackmon, of Nashville, was thrilled to learn she was pregnant in the summer of 2022—just months after the murder of her teenage son in February 2022. But during the second trimester of her pregnancy, her baby was diagnosed with a lethal condition called limb-body-wall complex in which the organs develop outside of the body, and Nicole was devastated. In addition to hypertension and a pseudotumor cerebri (false brain tumor) that caused headaches and blurred vision and required medication she could not continue while pregnant, Nicole was suffering from depression and anxiety due to the recent loss of her son. Moreover, because of her serious, chronic health conditions, she was at high risk of having a stroke during labor and delivery of a baby that had no chance of survival.
But without resources to escape Tennessee for an abortion, Nicole was forced to continue her pregnancy despite the grave risks it posed to her physical and mental health. She began to show signs of preeclampsia, a potentially fatal condition. At 31 weeks, she gave birth to a stillborn baby after more than 32 hours of labor. She is now grieving the loss of two children within a year, and she continues to have ongoing problems with her vision as a result of her ordeal.
Allie Phillips, of Clarksville, was 18 weeks pregnant and eagerly looking forward to the birth of her second daughter when she received devastating news: the baby had multiple fetal diagnoses that were incompatible with life, including an inability to produce amniotic fluid; several organs that had not properly developed; and semi-lobar holoprosencephaly, a congenital condition where the brain does not develop two hemispheres. Though there was no available treatment for her daughter’s conditions—and the continuation of the pregnancy posed risks to Allie’s own health, since a previous gastric sleeve surgery compromised her ability to maintain proper hydration and nourishment—Allie’s doctor refused to offer her any advice on how to obtain an abortion due to Tennessee’s restrictive laws.
Allie was eventually able to raise the funds to travel to New York City, where she learned her baby had already died in utero, leaving her at a high risk of infection and blood clots. Allie was able to receive the abortion she needed in New York, but she was forced to grieve her loss far from her own home and family. Read more about why Allie joined the case.
Katy Dulong, of Chapel Hill, had undergone fertility treatment and was early in the second trimester of her pregnancy with her first child when she was diagnosed with cervical insufficiency and told that she would inevitably lose the pregnancy. Though Katy asked to be given abortion medication to expel the pregnancy promptly without further risk to her own health, she was instead sent home by doctors who told her their hands were tied by Tennessee’s laws. Katy did not receive the abortion care she wanted and needed until ten days after the diagnosis, by which time her cervix was fully dilated, all amniotic fluid had drained and almost all of the fetus’ body was in her vaginal canal.
After the abortion, a hospital doctor told Katy she was extremely lucky to have survived; without abortion medication, she could have died within days. A pathological examination later determined that the placenta exhibited signs of acute inflammation and hemorrhaging. Katy was also lucky to have retained her reproductive capacity and is now pregnant again, due in November.
Dr. Heather Maune
Dr. Heather Maune is a board-certified OB-GYN in private practice in Nashville, Tennessee. Since the state’s ban went into effect, Dr. Maune has been forced to delay or refrain from performing abortions in situations where she would previously have been at liberty to perform them, and she believes that the ban impedes her ability to offer her patients the nationally recognized standard of care in obstetric emergencies. Dr. Maune was prepared to testify about the harm that would be caused by Tennessee’s restrictive new law when it was under consideration, but the legislature chose to approve it without hearing any testimony from physicians.
Dr. Laura Andreson
Dr. Laura Andreson is a board-certified OB-GYN in private practice in Franklin, Tennessee. Like Dr. Maune, Dr. Andreson has been forced to delay or refrain from performing abortions that she would have been at liberty to perform before Tennessee’s ban went into effect, and she believes that the ban impedes her ability to offer her patients the nationally recognized standard of care in obstetric emergencies.
“No one ever thinks they need an abortion, but I am living proof that abortion is health care. It’s not safe to be pregnant in Oklahoma. With this complaint, I want to make sure that no one else has to suffer the way I did.”
—Jaci Statton, complainant, Oklahoma
Complaint Against Oklahoma Children’s Hospital for Violating the Emergency Medical Treatment and Active Labor Act (EMTALA)
Jaci Statton, of central Oklahoma, learned that she was pregnant in early 2023. Unfortunately, by late February, Jaci was experiencing lower abdominal pain, nausea and dizziness. Her OB-GYN delivered a devastating diagnosis: Jaci had a partial molar pregnancy—a dangerous condition where a nonviable embryo develops with a tumor that may become cancerous, which can lead to severe bleeding, high blood pressure, preeclampsia and death. Her doctor advised that Jaci needed an abortion.
Jaci was later transferred to the University of Oklahoma Medical Center, where she hoped to receive the emergency abortion that she needed to protect her life. But that hospital refused to perform an abortion because there was still fetal cardiac activity, even though the pregnancy was nonviable and Jaci’s health was in danger. That hospital then transferred her to Oklahoma Children’s Hospital, which similarly refused to provide an emergency abortion despite confirming that Jaci faced a threat to her life without treatment. Hospital staff told Jaci to wait in the parking lot until she was on the verge of death. Jaci’s husband tried to access an ethics board but was denied a chance to speak with hospital administration.
Two days later, despite the risk of hemorrhaging, Jaci and her family made the three-hour drive to Wichita, Kansas, where she was able to obtain an abortion. Because of the trauma Jaci experienced, she has since had two more procedures—including a tubal ligation to prevent future pregnancies. She feared that if this situation recurred, she could die and leave her two children and stepchild, for whom she is a full-time parent.
Denied abortion care?
The Center for Reproductive Rights is dedicated to helping all people access abortion in their communities, including people who are denied care while facing pregnancy complications. If you have been denied care and want to speak to a lawyer about your options, please reach out to [email protected].