are stepping into their roles during a critical moment for reproductive health care: Laws are changing rapidly and access to abortion across the country is diminishing rapidly, placing a greater strain on access to abortion in states like Oregon, where it remains legal. And even before Dobbs v. Jackson Women’s Health Organization — the June 2022 decision that overturned Roe v. Wade — reproductive health advocates faced challenges, like spiraling rates of sexually transmitted infections in certain populations as well as internal movement tensions that haven’t gone away. Almost immediately in the wake of Ginsburg’s death, state legislatures began drafting and passing “trigger laws” — abortion bans that would kick in as soon as Roe was overturned. Idaho was one of 22 states that had passed trigger laws in anticipation of that moment. Its law, which took effect in August 2022 after the Dobbs decision was formally announced, says doctors who perform abortions in the state can be punished with up to two years in prison. While the law as written includes some exceptions for cases where the person seeking an abortion can prove the pregnancy was the product of rape or incest — or that their life is in danger — the ban has driven doctors out of the state. The Idaho Coalition for Safe Healthcare, which has advocated for a rollback of the state’s abortion ban, says the number of gynecologists practicing in the state dropped by 22% in the 15 months after the ban kicked in. Two hospitals have stopped performing labor and delivery services altogether. Idaho is not alone in seeing an exodus of gynecologists; those who’ve left states with bans have told outlets like KFF Health News they worry about facing criminal charges if they provide care for common pregnancy complications. While the state’s Supreme Court has since ruled that the law does not apply in situations where a patient presents with an ectopic or molar pregnancy, doctors say they need to be able to act quickly in emergencies, like when a patient is miscarrying but the fetus still has a heartbeat. [In June, SCOTUS dismissed two cases related to Idaho’s ban, effectively allowing emergency abortions in the state for the time being.] Conservative legislatures acted quickly in anticipation of Roe’s repeal, and so did their counterparts — and health providers in states where abortion remained legal. By the time Dobbs was officially announced, Planned Parenthood had already leased clinic space in Ontario, which is situated on the Oregon side of the Oregon-Idaho border and about an hour from Boise, where Planned Parenthood had a clinic until 2022. The town, which had 11,645 people at the time of the 2020 Census, already draws significant traffic from Idaho due to a lack of sales tax and, more recently, legal cannabis. The Ontario clinic “soft opened” in March 2023 and opened fully later that spring. “One of the things that inspired me to join PPCW is because this affiliate, upon Dobbs, within 12 months had identified a location, totally refurbished the spot, hired the staff and did everything that we need to do to open that clinic with a focus of taking care of Eastern Oregonians,” Kennedy says. Kennedy notes that there is a “horrible dearth of health care options for folks in general” in Eastern Oregon. According to its website, the Ontario clinic provides abortion services, STD testing and treatment, and gender-affirming care — much like other Planned Parenthood clinics. But according to Kennedy, 80% of the visits to the clinic are abortion-related. “The rest of Planned Parenthood centers in Oregon, most of what we do is family planning-related,” Kennedy says. “That includes cervical cancer screening, chest and breast cancer screening, STI care, contraception, well-person care, gender-affirming care. We offer this comprehensive sexual reproductive health care across the state of Oregon and Southwest Washington. And in Ontario, the demand for abortion is very significant because of this horrific ban in Idaho.” Kennedy says the number of patients coming from Idaho to Oregon seeking abortions has increased between 1,200% and 1,300%. A Guttmacher Institute report released this spring says the number of people traveling for abortions doubled between 2022 and 2023; 400 patients traveled from Idaho to Oregon during the first year after Roe. PHOTOS BY JASON E. KAPLAN Amy Handler in a recent meeting at Planned Parenthood Columbia Willamette’s Northeast Portland headquarters Dr. Sara Kennedy speaks in a recent meeting. 37
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