BOISE (Capital Sun of Idaho) Dr. Harmony Schroeder had discussed with lawmakers and others how to feel comfortable working in a state that had a near-total abortion ban, complete with criminal and civil penalties for breaking the law, before she left her OB-GYN clinic in Idaho for Washington last year.
Schroeder desired to remain. With over 3,000 patients and a team of doctors she adored, she had been a practicing physician in Idaho for almost 30 years. She believed that things would get better once elected leaders realized that a ban would result in worse medical care and more unfavorable effects.
As women were transported out of state during a time when they were not protected by federal law from receiving emergency abortion care, things actually grew worse.
Schroeder believed that by putting herself in danger of going to jail, she was either compromising care for women or compromising herself.
If found guilty of violating the statute, providers risk a minimum of $20,000 in civil penalties, a medical license revocation, and up to five years in prison.
“Oh,” she remarked, “they said, “we would never truly throw you in jail.” The Legislature seemed to be giving us a pinky swear at times.
Between August 2022 and December 2024, 114 OB-GYNs departed Idaho or ceased practicing obstetrics, including Schroeder, according to data from a peer-reviewed study published in JAMA Open Network, a section of the Journal of the American Medical Association. This ratio is greater than what was previously reported and accounts for 43% of the 268 obstetricians in the state.
According to the report, there was a net loss of 94 doctors during that time while 20 new OB-GYNs relocated to Idaho.
Although it is not the only state with a prohibition, it is one of the most severe in terms of changes in the number of obstetricians. While the numbers may not always be statistically significant, doctors in Texas, Tennessee, Oklahoma, and other ban states have told researchers and the media that they are retiring from their professions or leaving the state due to bans. These departures are frequently in states where there is already a shortage of maternal health care.
According to the March of Dimes, North Dakota, South Dakota, Oklahoma, Missouri, Nebraska, and Arkansas had the greatest percentage of maternity care deserts in 2024. Every state on that list has a nearly complete abortion restriction, with the exception of North Dakota and Nebraska.
Of the 55 OB-GYN doctors that Idaho lost in 2024 alone, 16 either switched from a rural to an urban practice site, 23 relocated outside the state, and 12 retired. The others relocated within the state. Everyone who left relocated to a state without limits on abortion like Idaho’s.
According to a survey from the U.S. Department of Health and Human Services, Idaho needed 20 additional OB-GYNs to satisfy demand as of 2018, four years before the Dobbs v. Jackson Women’s Health Organization ruling by the U.S. Supreme Court terminated federally protected access to abortion.
Although Schroeder enjoys her new profession in Washington, she nevertheless laments the circumstances that compelled her to relocate.
She remarked, “I wish it didn’t have to be this way.”
Study proves what we feared was happening
The Idaho Medical Association’s CEO, Susie Keller, said the losses are more severe because, despite the state’s recent population boom, Idaho has historically had the lowest physician-to-patient ratios in the country.
Idaho was ranked 50th by the conservative Cicero Institute in 2024 and lowest by the Centers for Disease Control and Prevention in 2019 for overall patient-to-doctor ratios. Between August 2022 and November 2023, the number of patients to obstetricians rose from one every 6,668 Idahoans to one per 8,510 Idahoans, according to a report by the Idaho Coalition for Safe Healthcare.
Keller said the medical group has made a concerted effort to find ways to keep doctors on board, including unsuccessful attempts to amend the abortion law to include a health exception during the last two years.
We heard about people leaving every time there was an incident that either maintained or exacerbated this challenging situation, Keller said.
Dr. J. Edward McEachern led the study, which demonstrates clearly what Keller claimed the medical association already knew anecdotally. “It’s also evidence for the elected officials who have accused them of exaggerating the situation and fabricating data or stories,” she said. Ra l Labrador, the attorney general of Idaho, stated in June 2024 that doctors in Idaho who departed were doing so because conducting abortions accounted for the great majority of their income, although he offered no supporting data. In April 2024, Republican Representative Brent Crane, the chairman of the committee that would discuss legislation pertaining to abortion, claimed that hospital legal counsel was misleading providers about the law’s ambiguity because they intended to weaken and eventually repeal it.
According to Keller, “this type of focused research truly paints a very clear picture of what we had feared was happening.”
There is disagreement among clinics regarding the issues. According to Scott Tucker, practice administrator at Women’s Health Associates in Boise, other causes have primarily been responsible for the loss of doctors throughout the last three years. According to him, there is a national scarcity of OB-GYNs and primary care physicians, and population expansion is causing clinic wait times to increase throughout the valley.
According to Tucker, the abortion restriction in Idaho hasn’t had a significant effect on us other from the fact that we receive a lot of inquiries and requests for contraception counseling.
He continued by saying that although hiring new doctors is never simple and the restriction has made things more difficult, they have onboarded a new doctor every nine months for the previous four years and have two applicants scheduled to begin in 2026. He claimed that candidates from the Midwest and the East are the ones who show the most interest and that a large portion of what they hear is exaggerated.
I don t know if it s fair to the public for them to never feel like this is a problem
For 14 years, Dr. Becky Uranga worked with Schroeder at OGA, a Boise-area physician-owned OB-GYN clinic. She saw Schroeder go, as well as another OGA physician who retired and another who entered a different medical specialty.
Another longtime OB-GYN made his leaving known in June. After 26 years of practice in the area, Dr. Scott Armstrong wrote to his patients to inform them that he would be leaving OGA on October 17 to return to the Midwest to assist in caring for my elderly parents and start a new chapter in my life.
By October, there will be eight OB-GYNs working at the practice, down from twelve a few years ago, according to Uranga. Additionally, clinics like OGA are dealing with more work as a result of the closure of other labor and delivery facilities in the region, which is the most populated in the state. For women of all ages, Uranga’s clinic offers the complete range of obstetrics and gynecological care, including labor and delivery and surgery.
According to Uranga, all of those individuals (from the closed clinics) subsequently came to us.
In a 24-hour shift, the average number of deliveries has increased from two or four to five or six.
“It doesn’t feel like that anymore, and it’s a really special moment that you want to be all in, present, and available for whatever could happen,” she said.
According to Uranga, there is a void left when a doctor departs, particularly one who has been in practice for a long time. Schroeder was a specialist in menopause care, and many of her 3,000 patients were undergoing treatment for this condition. To close that gap, Uranga pursued additional study to earn her board certification in menopause care.
OGA briefly restricted new patients for specific services, including some Medicaid patients, as they managed the shift with fewer doctors. Additionally, Uranga no longer travels to a remote part of Idaho to do surgery, as she and Schroeder once did.
She assists in organizing and raising money for the reproductive rights ballot measure that would restore access to abortion in Idaho when she isn’t traveling to clinics, calling patients, doing procedures, or giving births. She is also setting up recruiting calls with possible doctors in between all of that.
After learning about the medical environment, she spent too much time talking to candidates who gave a firm no, so she recently had to inform a recruitment coordinator that they must be open and honest about Idaho’s abortion regulations.
According to my nurse, I am constantly scheduling people before, during, and after (hours), which is unfair to my family, my nurse, and I’m not sure if it’s fair to the general public for them to never feel like this is an issue, Uranga said.
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