Idaho abortion trial ends after emotional testimony and controversial defense witnesses

BOISE (Idaho Statesman) – The Boise trial in a lawsuit challenging Idaho’s near-total abortion ban ended Thursday after six days of tense proceedings and emotional testimony from women who said they were forced to leave the state for medical procedures .

The lawsuit, which sought clarity about health exemptions for abortions, drew tearful testimony from Idaho doctors and the four women who sued the state. And during the defense, plaintiffs’ lawyers clashed with prosecutors over evidence they called anti-abortion “propaganda” and targeted state witnesses. Idaho’s defense included an executive at an anti-abortion think tank and a doctor who said under cross-examination that he was considering an abortion using hormonal contraception.

Plaintiffs’ attorneys said they wanted to clarify whether the exceptions apply to pregnant patients with medical conditions or complications that threaten their health, including future fertility; pre-existing or underlying medical conditions that cannot be effectively treated during pregnancy; and patients with a fatal fetal diagnosis.

The state argued that if the plaintiffs had their way, Idaho would have to add exceptions that would open the door to any condition being considered justification for an abortion, even stepping on a rusty nail. Lawyer James Craig said any risk of infection could be presented as a health-threatening condition and used to justify abortion.

Throughout the case, prosecutors have said the Idaho doctors and women who sought abortions outside the state had no standing to sue in the case, which they said was based on hypothetical situations rather than existing problems.

Fourth District Judge Jason Scott, who presides in Ada County, won’t make a decision in the case until early next year. State prosecutors rested their case late Thursday morning and both parties agreed to take six weeks to review trial transcripts before submitting their final findings and conclusions.

Just before court ended Thursday, Craig said the state planned to file another motion to dismiss the case.

The first days of the trial featured emotional accounts from women who said Idaho’s abortion ban forced them to leave the state to terminate desired pregnancies after they were diagnosed with fatal fetal conditions.

The women named in the lawsuit told their own stories of failed pregnancies that forced them to undergo abortion procedures out of state: Jennifer Adkins was at risk of developing life-threatening complications if she continued her pregnancy with a baby that would not survive. Jillaine St. Michel’s baby had severe abnormalities affecting several different organs. Kayla Smith’s baby had numerous heart defects. And Rebecca Vincen-Brown’s baby had a rare genetic condition that typically causes miscarriage and death shortly after birth.

The courtroom quickly became tense as the state objected to most of the women’s testimony. Craig said in his opening argument that the state recognized that the women had “tragic pregnancies” but argued that they would not seek compensation for those pregnancies because they were no longer pregnant.

Idaho doctors said they were confused about the law and what constitutes an abortion that is “necessary to prevent the death of a patient.” Doctors said they delayed treating patients with complications and sent them out of the state.

Dr. Julie Lyons, a Blaine County family doctor and one of the plaintiffs in the case, said a pregnant patient who came to the emergency room bleeding multiple times after her placenta separated from the uterine wall was “like a hot potato.” Lyons said doctors passed the patient around, hoping to find a clear path forward before mentioning abortion as an option.

Two doctors at St. Luke’s Health System spoke about how the laws prevent them from meeting national standards of medical care and the likelihood that their medical decisions will be questioned. Two foreign experts said the laws were unclear and confusing and did not allow doctors to help pregnant patients facing significant health problems, whether from fetal or maternal complications.

Idaho’s ban allows abortions if a doctor determines, based on “good medical judgment,” that doing so will save a mother’s life.

“Who will decide that I did not exercise sound judgment?” said Dr. Katharine Wenstrom, director of fetal medicine at a Rhode Island hospital and professor at Brown University’s Warren Alpert Medical School. “Will it be someone without medical training?”

She said she would never practice medicine in a state with an abortion ban like Idaho’s because the threat of criminal charges, loss of her medical license or lawsuits from family members of a fetus could affect her decision-making. Those consequences “would essentially end my career and ruin my life,” she said in court.

Liz Woodruff, executive director of the Idaho Academy of Family Physicians, which is also a plaintiff in the case, described “severe confusion” among the group’s 800 members across the state about how abortion bans would follow Roe v. Wade interpreted what guaranteed the constitutional right to abortion was repealed in 2022.

She said the concerns have led to “urgent” calls for lawmakers to change the laws to add a health exception and make them more consistent with medical terminology. Lawmakers have so far refused to make changes to the law, and state health and justice officials have failed to provide doctors with guidance on how to manage pregnancy complications.

When asked why her organization sued the state, Woodruff began to cry.

“We had done everything possible to address our members’ concerns and were otherwise unable to do so,” she said.

After days of testimony and cross-examination of the plaintiffs’ witnesses, the state called its witnesses to the stand. Dr. Dustan Hughes, a gynecologist and founder of the Lifestages medical practice in Nampa, and Rod Story, a family doctor from Pullman, Washington, who has a family practice in Moscow.

Plaintiffs’ attorneys declined to include statements from Hughes and Story, who were only introduced as witnesses earlier in the week. Craig said the state had difficulty finding doctors who could testify because of concerns about “professional repercussions.”

Hughes and Story said in their testimony that they do not find the law confusing in their practice – although plaintiffs’ attorneys pointed out that Story does not provide regular gynecology care for his pregnant patients.

Hughes, who has privileges at Saint Alphonsus Regional Medical Center in Nampa, said he tries to advise other doctors when they raise concerns about the legality of an abortion.

“I was able to provide routine care, so my ability to treat these ladies was not affected at all,” Hughes said.

Hughes said under cross-examination that the state learned about him through his work with Lifeline Pregnancy Care Center, which provides pregnancy tests, ultrasounds and other pregnancy resources. Plaintiffs’ lawyers criticized the nonprofit as a “crisis pregnancy center,” an anti-abortion facility that tries to persuade pregnant women not to have abortions.

Story also faced pushback from plaintiffs’ lawyers, who questioned his general stance on abortion. During cross-examination, Story said he considered an abortion to be any procedure that results in the interruption of a fertilized egg – including hormonal contraception. Story said that while current exemptions for medical abortions for molar and ectopic pregnancies are consistent with his morals, he opposes Idaho’s exemptions for cases of rape and incest.

The state’s final witness was Dr. Ingrid Skop, a Texas gynecologist and vice president of medical affairs at the Charlotte Lozier Institute, a prominent anti-abortion think tank. Skop has made controversial statements on abortion in other states and was called “the first call for anyone seeking a gynecologist to defend abortion restrictions” by the Texas Tribune after she served on the state’s Maternal Mortality Review Committee earlier this year State was appointed.

Skop, who is not licensed to practice medicine in Idaho, said in his testimony that Idaho’s ban is clear and allows doctors to provide patients with necessary care. Skop said abortions are often not medically necessary and can be physically and mentally harmful to women. She also described the abortion as “feticide” and explained a “dilation and evacuation” abortion procedure using illustrations that the plaintiffs’ legal team described as “prejudicial and inflammatory.”

“The best word I can think of is propaganda,” said attorney Leah Godesky.

During cross-examination, Godesky attacked Skop’s credibility and pointed to flawed research that Skop had published on abortion. Godesky asked Skop if she had spoken to Idaho doctors, pregnant Idaho residents, hospital administrators or district attorneys before expressing her opinion about practicing medicine under Idaho’s abortion bans.

Skop said that was not the case.