Support for this American life comes from Squarespace. Squarespace is the all in one website platform for entrepreneurs to stand out and succeed online. Whether you're just starting out or managing a growing brand, squarespace makes it easy to create a beautiful website, engage with your audience, and sell anything from products to content to time, all in one place, all on your terms. Head to Squarespace.com for a free trial, and when you're ready to launch, go to squarespace.com american to save 10% off your first purchase of a website or domain. That's squarespace.com american. Hey there, podcast listeners. It's Tyra with a quick message before the episode. I've been using this space now and then to tell you about other podcasts you might like, and today I want to talk about Heavyweight, Jonathan Goldstein's show. I just listened to the opening episode of their new season, and it is one of the most beautifully made stories I've heard anybody make in a while. He says it with such perfect kind of masterful efficiency. It's about a childhood friend of his and about getting older and about the people we lose. And there are these old recordings of him and this friend when they were kids.

And when Jonathan goes back to them today, they seem to contain so much more than they did at the time I cried, which I almost never do at a podcast. So that's my recommendation. This week, heavyweight, season three, episode one. It's titled Lenny. If you don't know Heavyweight, it's reliably one of the weirdest, funniest, most accomplished shows out there. Jonathan invented a way to host a podcast and a thing to do in a podcast that's different from anybody else. And you used to have to get the show on the spotify app, but now it is available wherever you get your podcasts. So Heavyweight try a bunch of them. And now, here's our show for the week. A quick warning there are curse words that are unbeeped in today's episode of the show. If you prefer a beeped version, you can find that at our website. Thisamericanlife.org it was Jeff's first time working for his big brother. His brother needed somebody last minute because the guy bailed on him. Jeff also had somebody bail on him. He moved back home for the summer for this girl he liked, and it.

Became really apparent right away that that wasn't going to work out, so he.

Had some time on his hands. His brother was doing a research study on black bears. His brother's a wildlife biologist and offered him this job as a field tech.

And a summer working with black bears.

Was a dream that wouldn't be a dream for everybody. Why was that a dream for you?

Oh, I just think bears are the coolest animals. They're so cool. Black bears are so cool. How fast they can climb a tree, like their ears. I love their bears ears. I just love everything about bears.

So Jeff loves bears. His brother Wes studies bears. Jeff is the younger brother. Wes is the older brother. Wes's research was to track where bears were in Bryce Canyon National Park in Utah. Here he is.

There was a bear that had broken into a tent, swatted a woman while she was sleeping really scared her. And so the idea was to call her some bears, track them, see where they were going, how they're spending their time.

If they could figure that out, the park could relocate campsites away from those areas and post signs. So Wes and Jeff spent the summer putting collars with GPS devices onto a bunch of wild bears. And then in the winter, they had to go back and check on the bears, do a quick exam, make sure their collars weren't too tight. Once the bears fattened up for winter, swap out any old collars that needed new batteries. It turns out the easiest way to do that is to visit the bears when they're hibernating in their dens. In most bear dens, that job isn't actually too difficult or scary. The dens are small, like a cavity in some rock or under a tree, Wes says.

And they're generally shallow enough that I have a pole that has a syringe on the end of it. I can just extend that pole and sedate the bear from outside of the den. I don't even generally even have to go inside, generally.

But then you get a couple of dens where it's like you're the only thing between the bear and the exit. And that's when it gets kind of sketchy.

And that's what happened in this case.

Oh, this one was like on another level, though. This one was crazy.

This one happened on a wintery day. The two of them headed out to see bear number 95. From their study, they saw a signal in the GPS climb maybe a thousand feet up a steep hillside to get to him in the snow. It was hard and cold. And then they struggled to find any opening at all in the rock that could be a den because it's just a blanket of snow everywhere. The search for maybe half an hour.

And then Wes is, like, standing on this tiny little opening. And then I see these branches right by his feet. And a lot of times bears will bring branches into their den. So I'm like, Wes like, I think you're standing on top of the den. And he's just like, no way.

They clear away the snow and it's an opening the size of a manhole cover going into the side of a sandstone cliff.

And then we crouched down and looked. You could only see like 20ft in and it's just black. So honestly, this den, it would be terrifying to go in it if you didn't know anything was in there. And you know that there's a bear in there. So that just intensifies it so much more. But it's like, even if there wasn't a bear, I'd be like, this is scary.

Wes and Jeff discuss whether they're going to go into this hole. Black bears aren't like grizzlies. They almost never attack people. But going into this very unusual den where the bear might feel trapped or threatened and have no way out except through them, there's a choice. Jeff does talk back to Wes way more than any normal field tech would because he's his brother. But Wes is the boss and he's like, we came this far and we really do need to change that bear's collar.

And I start crawling in looking for the back of the den, looking for the bear, and it's just not there. And this hole just plunges into darkness. My headlamp only goes so far and I just keep going. And immediately I realize, like, shit, this is a really long dent. This is much longer than anything I've ever seen or even heard of.

How long?

This thing extends 80ft back and at the end of it, it's just pitch black. You really do have to suppress a lot of primal stuff that's telling you this is a place where you are not supposed to be. This is not a place for humans.

Wes is in front big brother scientist, jeff's behind little brother assistant. And they're army crawling because the tunnel is too low to stand up in. It's pretty crammed. And you know that feeling where you're in your belly in a tunnel inching towards a bear? No, of course not. You don't know that feeling. Who has done that? But you have been in this situation of moving towards something scary or dreadful ahead, and now you have gotten yourself in it. You can't turn back. You have to keep moving. You just have to deal. And that is what today's show is about. We have this story and then we have another one in the second half of the show. And yes, it's this American life from WBEZ, Chicago IRA Glass. Anyway, so they're edging towards this bear, right? The tunnel is gently slipping downward. And the smell, you may be wondering about the smell. It's like wet earth musty.

The bear brings in a nest of like, pine tree boughs and other sticks and stuff. So it does kind of smell cedary.

And nice, too, like it's musty. But it's honestly not as bad as what you would think, because when a bear goes into a hibernation, west will give you a lot more scientific name on this, but they create, like, a butt plug of poop so that they won't poop the entire time they're in their den. So there's like no feces or like urine in there. So it honestly isn't terrible.

They're maybe 1520 25ft into the tunnel and Wes's headlamp points at the far end.

And I just see these two green eyes at the very end of this tunnel staring back at me. And the thing about these hibernating bears is bears don't hibernate very deeply, so if a bear hears you approaching its den, it can come out of that hibernation, and generally within five to ten minutes, they can be mobile. And so this bear was awake, and they have the topedum lucidum, which is the thing you see in cat's eyes or dr eyes or whatever that reflects light back at you, and they reflect a really kind of green glow. And so it's just, again, the stuff of nightmare is like, you're crawling down a deep, dark hole in the mountains and there's two green eyes shining back at you.

The light starts to catch these two eyeballs at the very end of the den that are just, like, gleaming back at us. So at that point, I'm, like, terrified, and I start kind of freaking out. I start saying, like, Wes, this is crazy. This is crazy. I don't know about this.

And Jeff just started saying, we shouldn't be here. We shouldn't be here, we shouldn't be here. It was like a mantra that he.

Was and like, I keep saying that.

And it was starting to really freak me out. I was trying to summon all this courage and draw in all my experience, and then I have him behind me telling me that we just should not be in there. And so I turned around and then.

Wes just goes, Jeff, shut up. Then my immediate response was, like, you're so brave.

And then he just started repeating, you're the bravest person I've ever met. You're the bravest person I've ever met. And that helped, actually. That made me feel a lot better.

It's funny how he needs to keep saying something to have someplace to put his fear.

Yeah. I think for him, he needed to vocalize that. And for me, I was really going inward and just trying to focus on the bear, and I was looking for any cues that that bear was going to be aggressive. And at that point, you'll leave.

What are you watching for?

They make a really distinctive sound when they're really upset, and then they make this really interesting jaw popping noise too. It literally, like, clacks its jaws. It pops its jaws. It's kind of like a sound. And then from there, it proceeds to swatting the ground with its paws. And then if it is still upset, it'll bluff charge you. And a bluff charge is just where the bear comes at you and then stops short.

Are you terrified?

Oh, yeah. I was absolutely terrified. I have a video that I took when I got close to the bear. I took a quick video from my phone, and at the very end of it, you just hear me say, this is so scary.

Okay. Oh, this is so fucking scary. This is so scary.

Because it really was. It was terrifying.

Oh, my gosh.

All of my body, a lot of my psyche was saying, you absolutely need to get out of this den. It's this feeling of being a soft, pink human being in a place where we don't belong.

Of course, Wes being in the tunnel with this bear, he's a bear expert and he's thought some about what this experience must have been like for the bear.

Where these black bears live, they're top dog. There's nothing bigger or more dangerous than them, so they don't have stuff that crawls into their dens and gets closer and closer to them. So it must be a very unique experience for them as well. I'm obviously a bear. Like, what the hell is this thing doing in here?

When the bear sees you, it knows it can kick your ass, right? Like, it can just look at you and it doesn't even without even thinking or doing any math in its head or something, it just sees your size and it just knows, like, well, you're not a threat. But then is it scared?

Yeah. I think the thing that we have to realize with wild animals is that for them, a fight means much more than can I win or will I lose? It's like, am I going to be injured in this? Because for any animal, bears included, if they sustain a big injury in any kind of scuffle or fight or whatever, that could be a death sentence for them because then they no longer have the ability to feed or escape or even move. And so they tend to be very risk averse.

So Wes and Jeff keep army crawling forward with a syringe full of sedative on the end of a seven foot pole. And finally Wes gets close enough to jab it into the bear. Mission accomplished, right?

But we jab it. The bear doesn't react at all, doesn't.

Flinch, and most important, does not fall asleep. Partly because it gotten so big since they'd last seen it, like 350 pounds, which would require way more sedative than Wes gave it. So the two of them head back out of the cave to prepare another dose of sedative, which they definitely are going to need. That job goes to Jeff, a little brother.

And it was something I was fully capable of doing, but I think I was still just dialed up all the way to eleven with all my emotions and my thoughts weren't clear, so I was like, doing a terrible job.

Like, your hands aren't totally steady.

Yeah, I'm just like making a mess. I'm, like, fumbling around. And eventually the bear makes its way all the way through the 80ft of den and starts coming out.

This is not the plan. It would be very bad for a tranked out bear to leave its den at all. It could easily wander off and get lost in the snow in the middle of winter. And Wes and Jeff remember they're bear guys, they do anything they can think of. So the bear's in this research don't get hurt by it and experience the minimum amount of discomfort or stress. They have another field tech with them who's been waiting outside the tunnel, and Wes orders that guy now keep the bear in the den. And the guy starts swatting at the bear with a plastic shovel to keep it from emerging.

And it just does not care. It's not even registering that he's there and just keeps walking past him.

Wow.

Yeah. So at that point, I ran, and the thing that I really didn't want to have happen was the drug take hold while this bear was trying to get away and have it tumble down the hillside or down a cliffside or something like that. I just wasn't willing to let that happen. So I ran and actually grabbed the bear by its back legs and pulled them out from under it. And then I straddled the bear and pushed its head down into the snow. In the meantime, I had said, Wait.

What are you talking about? You're able to do that because the bear is kind of like is the bear walking like a sort of cartoon drunk bear kind of thing? Like it's staggering along?

Yeah, that's honestly exactly how it was walking. That's a perfect representation.

So he's on top of this bear, straddling it, holding its collar and head down in the snow. He's actually gotten a second dose of sedative into him by then, but the bear is still awake. And Russ then looks over at Jeff, who is so panicked that he has dropped the entire case of drugs. Jeff is supposed to be preparing a third dose.

And I just yell at Jeff. I say, Jeff, come grab this bear. I'll do the drugs.

Kind of an unusual set of sentences to say to anybody. They switch places. Jeff is now the one straddling the bear, hands on its collar, and the bear gets up and starts to move again.

It's almost like, you know that movie The Replacements where Keanu Reeves is a quarterback? Or like any of the football movies where the big hefty lineman catches the ball and then they're just, like, slowly moving towards the end zone, and the whole defense jumps on them and they're just kind of, like, falling off of them and trucking.

And he's still going towards the goal line.

Yeah, he's going in, like a straight line with all these people hanging on him. It's kind of like that. We're just, like, hanging on this black bear, and it's just like slowly going in a straight line, just holding it.

By the collar, getting dragged along, slowing it down a little bit, but that's all I can do. And this thing with this bear where none of the normal rules apply, totally.

Off the map, like, I was like, this is what I have to do, but I can't believe I'm doing it. It was, like, surreal. It's like I was in a dream. It starts making its way to more of a downward slope, too. So now it's, like, really hard for me to stop it, and I'm just kind of like, on the back of it. And it walks straight into a pine tree and literally couldn't figure out what was going on and just tried to keep walking forwards into a tree.

Wes remembers it more like a juniper bush, but in any case, it does its job. The bear stops, finally, passes out on the ground. They do their business, change the collar, examine the bear. And then, so the bear doesn't get lost and confused in the snow, when it wakes up, they grab its limbs and drag it 15 yards or so back up the slope to the opening of the tunnel, which is exactly as completely exhausting as you would imagine. It takes maybe half an hour. The temperature's dropping. Wes is worried that the bear might get cold, so he leaves a blanket on top of him before they go looking back. What Wes and Jeff both talk about is the terror that they felt in that tunnel. Wes says it was a whole new level of fear he didn't know existed, like the kind of primal fear not long ago, humans must have had all the time facing off with animals that wanted to kill them and eat them.

And it's something that we've forgotten, but I think it's something that still sits deep inside of us that when you do have these experiences with large animals, that it bubbles to the surface. And in a way, it was really intoxicating. I'll tell you, that night I didn't sleep a wink because my adrenaline was just coursing through my body. It just made me feel honestly, made me feel very alive. And even when I think back on that, I can still remember the feelings I had that night as I went back to the cabin and everything, just how bright the stars seemed and how crisp the air felt. And it really just reminded me how good it is to be alive.

In the bear. The bear was fine. The drugs that gave it probably doesn't remember the details of what happened, Wes said. And over a year later, wes went back to that tunnel when the bear wasn't in it and found the blanket inside. The bear must have liked it a little. It smelled like bear fur all over it. Wes took it back, kept it as a souvenir. He says it still smells faintly like bear. After the break, we have another story of people thrown into a dangerous and utterly foreseeable situation and how they handle it in this episode that we're calling the bear at the end of the tunnel. Wes and Jeff, by the way, have a podcast where they tell stories of animal attacks. It's called tooth and claw. If you enjoyed the story that you just heard, you should know that by their standards, this story was not so special. The ones on their show. Way more eventful. More in a minute from Chicago Public radio when our program continues. This is American life from our Glass Today's program. Again, the bear at the end of the tunnel. Stories of people who find themselves trapped in some dangerous situation, and now they just have to deal.

We have arrived at act two of our show. Act two the devil's in the details. And there are so many details. So a few months ago, we brought you this story from one of our producers, Mickey Meek, about an OBGYN in rural Idaho who was deciding whether or not to leave the state after Roe versus Wade was overturned and abortion was outlawed there.

I don't want to leave here. I mean, I don't want to leave, but I don't know if I can stay.

This OBGYN, Amelia Huntsberger, was facing in Idaho a set of abortion laws that kicked in after Roe was overturned that are some of the most restrictive in the country. And can I just say, I think when most of us think of these laws, we think of their effect on abortion clinics and abortion care providers. That wasn't this story. Amelia was a general OBGYN at a hospital. In other words, doing PAP, smears, birth control, delivering babies. And her hospital did not terminate pregnancies unless it was a medical complication, which, by the way, is like most hospitals in the United States. But when river was overturned and these new laws in Idaho took effect, they defined abortion in the broadest possible terms. It was effectively a complete ban. Even pregnancies that weren't going to be viable could not be terminated. And any doctor who performed an abortion breaking those rules faced severe consequences. They could lose their medical license. They could go to prison for two to five years, and they could get sued. Family members could sue. If a rape resulted in a pregnancy and the victim decided to get an abortion, the rapist's family could sue the doctor for performing the abortion.

And the problem for Amelia, this OBGYN said she ran into all kinds of situations where, in the course of administering normal health care for her patients, she could run afoul of the law. For instance, if a patient showed up at her hospital miscarrying and bleeding, uncontrollably in the past, amelia could terminate the pregnancy to stop the bleeding. But now she could be charged with a felony if she did that, if she did anything to terminate a pregnancy, if it still had a, quote, fetal heartbeat. That's a phrase in the law, though in the early stages, it's not a heartbeat. It's just electrical activity and some tissue that could eventually become a heart. So now when Amelia faced pregnancies with serious complications, situations where the longer she waited to act, the more danger the patient was in, she can no longer just think about what was best for the patient who was in front of her.

When you do surgery like that, or somebody's having ongoing active bleeding that's already high stress and that sort of high stress, like, I trained for that. I know what to do with that. I can handle that. Then you add in this other weird layer of like, is her brother going to not understand that this was a not viable pregnancy and that her life was at risk? And what about her mom? What about her partner? What about her sister? Do these people understand how serious this condition is? Or do they only understand that I removed a pregnancy that had a heartbeat? I don't know. How am I supposed to know?

So she worried about getting sued. She worried about getting prosecuted. This came up all the time.

At.

The end of our story. Back in March, amelia was still hanging on in Idaho, still deciding. Since then, so much has happened. Just a few weeks after we aired that story, amelia decided she was going to move away because of Idaho's abortion laws. She was one of the first OB GYNs in the state to announce she was going. About a week after that, something that she feared might happen someday happened a lot quicker than she'd imagined. The hospital where she practiced, Bonner General Health, announced that it was shutting down its entire labor and delivery department. The hospital cited the new laws as one reason they said recruiting new doctors would be, quote, extremely difficult. Finances was the other reason. Since then, all three of the other OBGYNs who shared a practice with Amelia have left the state. What Amelia dreaded most in moving away was what was going to happen to her patients. How would all this affect everyone in Idaho trying to have a baby? We thought about that for today's show because what would happen to them. This was, in a sense, the bear in the tunnel. The difficulties and possible danger that all those patients face because of the new laws and what has unfolded since has been pretty dramatic.

Our producer Mickey Meek went back to talk to patients and to the lawmakers who put them into the situation that they're in in the state. Here's Mickey.

I talked to half a dozen pregnant women who'd been planning to deliver at Bonner General and suddenly found themselves contorting their lives around logistical problems they had never imagined facing for something as every day as trying to have a baby in the state of Idaho. Brooke McCumber is 25 years old and was days away from giving birth when I reached her. Amelia had been her doctor, and Brooke's plan had been to do her prenatal appointments at Bonner General and deliver there, too. But now the closest Idaho hospital with a labor and delivery department was almost 2 hours away in a small city called Coeur d'alene. She had to take her three little kids with her in the car on a four hour round trip for every prenatal appointment. Blood pressure, fetal heartbeat, 4 hours for a 15 minutes check.

In the days that we would have to go out to Coeur d'alene, it was like from 930 to 06:00 at night, I would have my sister, who she lives in Spokane, so she's about 35 minutes from Coeur d'alene, but she would hang out with the kids so I could go to my appointment. And then we would have to go out for lunch or do a picnic and then go to a park because I'm like, they can't just sit in their car for 4 hours back to back.

The distance to the hospital also worried her. She was freaked out about not getting to the hospital in time and giving birth on the side of the road. Her labors have always been pretty fast. Would she have time to make it to the hospital when Brooke got three weeks away from her due date? She couldn't take being on high alert all the time, so she moved in with her mom, who lived 2 hours away, close to Brooke's new hospital. Brooke took the kids with her. Her husband couldn't join them because of work, and her mom was working every day. So Brooke was caring for three little kids basically on her own. At eight months pregnant, it was hard to leave her husband. But splitting up their family temporarily was the only solution they could come up with.

Me and my husband have never really been apart before, and so being in a bed alone has been strange. And then our two boys, they've had some trouble sleeping, so they'll wake up in the middle of the night. So then both the boys will crawl into bed with me, and then I wind up, like, on the couch because I'm like, I need to try to at least get one more hour of rest.

Bonner General had been the only labor and delivery unit in its region of northern Idaho. When it shut down, it became a statistic and a whole separate long standing crisis the closure of labor and delivery services in rural hospitals all over the country. Nearly half of rural community hospitals no longer offer obstetrics care. The chaos created by Bonner General's closure for the women I spoke with involved the most basic important stuff childcare money. Some women told me they would lose a day's worth of pay every time they had to drive to an appointment. They talked about having to budget hundreds or even thousands of extra dollars for travel or housing in a place closer to a labor and delivery department or switching to a midwife not covered by insurance. Or if they went to another state to get care. Insurance might not cover that either. I talked to one woman who told me she bought helicopter insurance for a medical evacuation flight in case she started hemorrhaging or had some other kind of emergency complication. Turns out it's cheaper than you'd think. $75. And she wasn't. The only one helicopter insurance for normal pregnancies. This woman's name is Jesse Grossman.

She's 32 years old, and this was her first kid. And in Idaho, she worried the abortion laws tied doctors hands in too many cases.

So I decided what I put in my birth plan was that if we do have to transfer to the hospital, I want to be taken in Washington. I can be less worried about dying, basically. But then, of course, I'm just spiraling about like, well, what if the worst case scenario happens? And what if I have justice? Is the helicopter going to be able to get us to Spokane in time? And just this, like, am I going to die? Is my baby going to die? Like fear. There's no guarantees.

For anyone pregnant person doctor anyone who might want to look at the maternal mortality statistics in Idaho since the new laws passed. The state used to have a committee that tracked maternal deaths and their causes, but it doesn't anymore. The legislature decided not to renew it in its last session. Idaho is now the only state in the country without a committee like this. So that's the situation for these women who just needed general OBGYN care during their pregnancies. But then there are the high risk patients, which includes, by the way, anyone who's expecting twins, anyone with high blood pressure or diabetes, anyone over 35, and anyone whose pregnancies include rare complications. These people are in a much more dire situation in Idaho now because they may need what's called a maternal fetal medicine doctor. These are highly skilled OB GYNs specialists at keeping both the fetus and the patient alive and healthy through these pregnancies. And these doctors have been leaving the state. Kayla Smith had a maternal fetal medicine doctor. Her first pregnancy had complications, but things were going smoothly with this one. It was a boy. She and her husband had picked out a name, brooks.

And then when she was 19 weeks, she went in for her anatomy scan.

And I just remember the sonograph. I know they can't say anything, but she just kept going over his heart quite a bit. And so, of course, I'm talking myself down. Like, it's know, it's just different. This like each person has a different way of doing things. And then it was just really quiet, and then she left. And so Dr. Cooper walked into the room.

Dr. Kylie Cooper, her maternal fetal medicine specialist.

I just remember she had a diagram, and I just remember her being like, I've never seen a heart defect this severe before. They couldn't really see the baby's aorta at all. His, I guess, aortic arch wasn't really formed.

The only thing Kayla wanted to know was, could Brooks survive past birth? She and her husband had already decided they could care for a child with special needs. So Dr. Cooper referred her to a pediatric cardiologist, but he told her no Brooks's chances of survival were very unlikely. He'd called some of the best pediatric hospitals in the country, and none of them could offer her a surgical option to fix his heart. She remembers sitting in an ultrasound room with her doctor.

She's like, if you decide to continue this pregnancy, I'm here for you, and we will figure out what that means and where we need to go from here. She's like, but if you do decide that you did not want to continue this pregnancy, she's like, I'm just really sorry. There's I personally can do for you.

And you understood at that point this is because of the laws?

Yeah, I mean, her hands were tied. I knew she was protecting herself, but also, I would never ask her to be in that position. Yeah, we just all kind of looked at each other like, what the hell do we do now?

Most patients, like Kayla, whose pregnancies have what are called lethal and life limiting fetal anomalies, choose termination because continuing their pregnancies will result in miscarriage stillbirth or death shortly after delivery. But Kayla's doctor could not offer her a termination. Just a week or so before this, terminating a pregnancy like Brooks would not have been considered an illegal abortion in Idaho. But now, under Idaho's new laws, it was. So Kayla started asking her doctor about what if she did continue her pregnancy and delivered Brooks? What would it be like for him? Would he feel any pain during the birth? Would he suffer from air hunger? Feel breathlessness as he gasped for air? But of course, her doctor couldn't guarantee that he wouldn't feel anything, even with palliative care and morphine.

So then it just also felt like there was only one option, and it wasn't one that we wanted to make. But I don't want my son to suffer. I'm not going to put myself through that and also risk my own life because Dr. Cooper kept reiterating to me, she's like, you have a 40% chance of getting preeclampsia again.

Preeclampsia is one of the leading causes of maternal mortality. It usually involves a surge in blood pressure that can seriously harm or kill a pregnant patient. It's unpredictable and hard to know when it'll happen and how severe it will be. Which brings us to the main thing doctors find so frustrating about Idaho's new abortion laws. There's language in the law that says they can't terminate a pregnancy unless it's quote, to prevent the death of the pregnant woman. Dr. Cooper said she doesn't know what that means. Does it mean she'd have to wait for Kayla to be near death's door from preeclampsia before she could intervene? Her whole training, all doctors'training, is to stop problems before death ever becomes imminent. The only other situation where Dr. Cooper could terminate a pregnancy is if the fetal heartbeat stopped, if the fetus was dead. Kayla described her options in Idaho as a, quote, shit buffet.

So do I risk going to term. Knowing that I'm not even going to have a son to take home and risk my life and not be there for my daughter, I mean, I want to make it very clear that I was, at that point, 20 weeks pregnant. I could feel him move. He was very active. And what that does to someone's mental health, it's just devastating, because I just felt trapped. There are some really dark thoughts that I never thought I would have thought. Things like, you know, is there a chance that his heart will stop? Because I knew where I'm currently at in Idaho, that would be a reason for them to help me.

I heard this from other pregnant women in Idaho with lethal fetal anomalies. They found themselves wishing for the heartbeats to stop. Hearing that Brooks could suffer if he made it to term, kayla decided to leave the state in order to end her pregnancy. She got an appointment at a hospital in Seattle. Because she was so far along 21 weeks, second trimester, and because it wasn't clear if her insurance was going to cover it, she had to pay almost $15,000 up front. She and her husband took out a loan and then drove seven and a half hours with her two year old daughter. Kayla had a choice of how to end her pregnancy with a surgical procedure or by inducing labor early. Kayla knew she wanted to induce. She delivered Brooks. After 12 hours of labor, he was stillborn, she says there was this weird, eerie silence in the delivery room, and then everyone left so she and her husband could hold Brooks.

There were things that came up after that were kind of like someone know, people saying congratulations, like just walking in.

The room, because they didn't.

Right? Right.

Brooks was cremated two weeks later. Kayla made the seven and a half hour drive back to Seattle to pick up his ashes.

My parents would have, without a doubt, driven up to Seattle to get him if I needed them to know, brought him to us when they were able to come over here. But I just remember talking with my husband and being like, it doesn't make me feel good. I feel like I just need to go. And he was like, then you just need to go. And so I drove over to Seattle with my daughter. It was one of those things that I was like, I just need to be in charge of this so I know what's happening.

Kayla was the first case like this that her doctor, Dr. Cooper, handled after Idaho's abortion laws changed. Her first case where she couldn't do anything to help. Then there were more patients like Kayla. She couldn't help. And in April of this year, she was the first maternal fetal medicine doctor to leave Idaho because of its abortion laws. There was already a shortage of these specialists in Idaho before the laws went into effect. Only nine in the entire state. Now there are just five, and one of those will retire before the end of the year. That fear that every pregnant woman I talked to in Idaho had, that they'd be left totally on their own in a medical emergency, it happened to Becca, the last patient Dr. Cooper had to tell, I'm sorry, I can't help you. Before she moved out of Idaho. Becca is 31. She lives in the Boise area and used to oversee a fitness club. She went to college on a pole vaulting scholarship. When she was about 16 weeks pregnant, she learned that her fetus had a genetic anomaly. Multiple organs were developing abnormally, including its heart and kidneys. If she continued the pregnancy, she'd likely miscarry and was at risk for preeclampsia or severe hemorrhaging.

You know when you see in movies and people get like fatal diagnosis and they just kind of go numb and all you hear is a Blabbering doctor in the background. And I don't actually remember a whole lot of that conversation. I just remember sitting there and trying not to ball my eyes out because we'd wanted this one, we wanted to grow our family. We tried for almost a whole year for this one. And we told people, we're like, yeah, we're pregnant. It's going to be know, we think it's going to be a little girl, or know.

She decided to make the same choice Kayla made leave the state. Becca drove to Portland, Oregon to terminate her pregnancy at a clinic. But that's not what she and her husband told their family and friends.

We were not comfortable being outright and telling them exactly why we were going to Portland. So we told family and friends that we were going for genetic testing just because it is so controversial right now in our state and we didn't want to risk losing good relationships.

If it came down to it, Becca's story is different from Kayla's because she wasn't able to get the full procedure. The night before her appointment for a surgical termination, she started miscaring. It was around midnight. She was at a hotel with her husband and two year old daughter who were sleeping.

And I was just laying in bed and I started counting and counting and contractions were happening every 30 seconds. And so the only thing that I kept thinking to myself was like, oh, no, it's happening. And so the only thing I could think of was to lay on my side, to breathe through it and relax and just think to myself, like, I have to keep this thing in. I've got less than 8 hours. Gotta keep it in, gotta keep it in.

The clinic didn't open until the morning, so Becca woke her husband, who phoned the clinic's on call doctor. Becca says the doctor told them she'd be fine. She was just cramping. Her contractions continued to get more intense, surging and then backing off. Her husband kept going out to the hotel hallway to call the doctor again. They thought about getting an ambulance, but knew their insurance wouldn't cover it. Becca says she forced herself to not make a sound. No crying or groaning. Her daughter was sleeping in a pack and play near her, and she didn't want to wake her up and scare her. And what happens next gets graphic.

And then right around 04:00 is when all of a sudden it was just a consistent, intense just like curdling you want to scream and grit your teeth contraction. And it lasted what seemed like forever. And then the pressure was completely gone. And then all of a sudden, I started leaking amniotic fluid everywhere. So I ran to the toilet, and all of a sudden my body once again had one another one of those contractions and just squeezing like you're going to squeeze all your organs out of you. And out came the baby. And I looked down at the toilet bowl, and there it was. And I just kind of sat there and just stared at it.

Becca got into the hotel shower and again says she didn't make a sound, even when her husband was trying to get her uterus to contract. So she'd stopped bleeding, which meant kneading his fist into her lower abdomen the way the doctor instructed him over the phone. She says it was incredibly painful.

And so laying in the shower and is just streams of blood going into the drain. And the whole time you're just like, why is this happening? This should not be happening.

If Becca had been able to get a termination in Idaho, it probably wouldn't have. Her doctor, Kylie Cooper could have done the procedure as soon as she decided. Becca would have been in and out in a day, not in a hotel room far from home. In the morning, when the clinic opened up, a couple of employees showed up to collect the fetus. Becca then hobbled over to the clinic for an exam. It was next to her hotel, and she had to walk past a line of anti abortion protesters. Her husband had to stay behind to watch their daughter. When she came back, they drove home to Idaho. 7 hours. They sat silently almost the whole way before talking to Kayla and Becca. One part of the post row experience I'd never heard about was that people who had to travel out of state to terminate safely had all these complications figuring out what to do with the remains. Because of rules about traveling across state lines with human remains, becca had wanted to donate the body for medical research to give her pregnancy loss more meaning. But for logistical reasons at the clinic, she didn't get that option.

Becca and her husband decided to cremate, but they had no idea when the clinic would send the remains.

A couple of weeks later, we're home, and postal worker comes up to our door and was like, hey, I'm here. You need to sign for a package. And I was like, oh, okay. There is this white box that says remains labeled on every single side of the box.

For some reason, the box was addressed to baby and not the parents, and.

The postal worker doesn't actually realize it until I was signing for it. And she saw the name on the top, and her face just fell. And she was like, okay, bye. And immediately just left. And I was just like so I just grabbed the box and shut the door and just sat down.

As a terrible coda to a terrible experience back home. Becca worried that people who'd helped them go out of state might get in trouble if she talked about it. It wasn't clear who a prosecutor might go after. So in the earliest, hardest days, she had a secret instead of just a loss.

I didn't feel like I could openly talk about it, because a lot of the grieving process, at least for me, is being able to talk about it, write about it, even just sympathize or empathize with other people who've gone through similar situations. You know, people, they just don't. It made it a muted and quiet, very lonely grieving process.

Becca and Kayla met recently. They're part of a group of people with other patients and doctors who are trying to sue the state, hoping to expand the exceptions in the abortion laws to include lethal fetal anomalies like the ones they had in their pregnancies. And most important, they want the law to allow doctors to provide abortions to preserve a person's health, not just to prevent their death, which is the language in the law right now. Their case was filed by the center for reproductive rights, who filed similar legal actions in other states with restrictive laws. They represented the abortion clinic in the supreme court case that overturned Roe. I contacted the two Idaho lawmakers in the house and senate who sponsored the law that criminalizes abortion. I wanted to find out how they think it's working. Were they hearing about the kinds of experiences I was? Did they know about the doctors leaving the state? Do they think they need to make any changes? One of the law's sponsors declined an interview, and the other didn't respond to multiple requests. So I reached out to republican lawmakers who voted for the law back in 2020 before Roe fell.

Doctors leave the state.

Senator Jim Guthrie represents a district in southern Idaho and identifies as pro life. I was surprised he walked into the interview with a notebook with stats about the number of doctors who'd left the state and started citing them. So far, it's at least 19 doctors that worried him.

I'm pro life, but I think there's got to be some consideration for the docs as they practice that they're not going to find themselves in court. The second is the health of the mom. Because when you talk about pro life, the life of a mother is if you're trying to protect that, that's pro life too, to me.

When you first voted for the abortion laws, did you think that Roe would actually fall or did it feel more like a symbolic act at that time?

It's a good question, and I think to answer that honestly, probably didn't think it would happen because what had gone on for what, 50 years, something like that.

He's the chair of a committee in the Senate that abortion bills go through before they go to the rest of the legislature for a vote. He says the language in the abortion ban was always more aggressive than his own personal beliefs. At that time when you voted for them, were you looking that closely at the language of the laws?

Maybe there was some things overlooked as far as what the consequences would be because they weren't truly consequences yet in your subconscious, you're thinking it's not going to be overturned, so this is one way you can make a statement. You kind of get into that deal where if you're pro life, even though the bill has some things that are problematic, you are going to come down on the side of erroring, on the side of protecting the unborn.

Like the other lawmakers I talked to, he says he believed the intent of the laws when he voted for them was to shut down abortions happening in clinics in the state, not to help shut down a rural labor and delivery unit or force patients to travel out of state because of severe fetal abnormalities. Those were consequences he didn't foresee. Now, seeing how things have played out, do you regret voting for those laws or would you have done something different if you could go back in time.

In the context of being pro life and recognizing the importance of the unborn? I feel like that vote at that time with what was in place, as far as trying to push back against an embedded law, I think that was an appropriate vote at the time, even though once the Roe versus Wade was overturned is when the reality, I think, sunk in for all of us.

I talked to three Republican legislators and they were all in the same situation, trying to grapple with the consequences of what had just been theoretical policy when they first voted for them. But now was real law affecting real situations in people's lives? Where Republican lawmakers used to be pretty much on the same side, now they have different ideas about how to apply pro life to Idaho's new laws. The next lawmaker I talked to was Representative Brent Crane. For nearly 20 years, he's represented a district outside of Boise and makes his living running a fire alarm and security business. He believes in life at conception and says he's proudly sponsored or co sponsored more than a dozen pieces of anti abortion legislation. He and Senator Guthrie are on the same page as far as seeing the need to broaden exceptions in the abortion laws. But they also have to work alongside lawmakers who think there shouldn't be any exceptions, for instance, for rape and incest victims. Representative Crane describes them as still stuck in what he calls a pre Roe mindset, where everything is still black and white. He says he used to view abortion that way, too, until Roe finally fell.

I remember sitting by the fireplace with my wife. That's usually where we sit and download in the evening or early morning. And I said, I've got to get my head around this issue because we are not prepared to deal with this as a state.

What did you mean by that?

A post row environment is totally different. In pre row, all legislation was crafted to try to set questions up before the court. Well, now you're in a post row environment where you have to govern. That means you have to have legislation that is going to work. And for a pro life lawmaker, most pro life lawmakers will take a very conservative and very rigid stance on the issue of life. Like, no, I'm not going to give any ground at all for any more exemptions. That's it. Whatever. For me, personally, I think that there are some instances where the families need to make those decisions.

Again, this is a place where lawmakers who used to all be on the same side of abortion are now in conflict. And there was a draft of a bill in the last legislative session that got to the main problem with the current law. The way OBGYN see it, the bill would have allowed abortions for some serious health complications before they became life threatening. In other words, letting doctors make decisions based on the health of the pregnant person, not just their potential death. Representative Crane chairs the house committee that abortion legislation goes through, and he scheduled a hearing for the bill that he had to cancel at the last minute because he didn't have the votes to get it out of committee. For some of his members, considering the health of the pregnant person opened a.

Can of worms behind closed doors. That was part of the debate. And then if we're opening health of the mother, where does that stop? Is it mental health? Is it just tied to physical health? Is it financial? Is how are you defining health? The mother?

Representative Julianne Young is a Republican from southeastern Idaho. She's vice chair of that committee and opposed that new language about health complications.

What I don't want to do is put language in that's so vague that it has the effect of opening the door to abortion in situations where you could protect both lives. And so if we're talking about high blood pressure, if we're talking about conditions that are common to pregnancy, then we don't want that lumped into anything that could be a life threatening condition for the mother. Because the reality is that as women, we put our lives on the line by choosing to have children. There are always risks with every pregnancy, and you can never eliminate every risk.

Yeah. What's your medical knowledge of pregnancy?

Oh, well, I'm not going to claim to be an OBGYN, but I've learned a lot over the years, and I guess I speak to the issue not as a medical professional, but as a mother. That's really where my expertise is.

She has ten children. She switches off bringing her youngest two to the capitol with her, and they sit down on committee meetings and hearings. Also, random fact. Turns out my uncle was her orthodontist when she was a kid. Representative Young is wary of letting doctors consider the health of the pregnant person, of giving doctors in Idaho hospitals the kind of control they had before Roe fell. For Representative Young, the sweep of the new laws is not some overreach. It is the point.

The concern, I think, with the health exception is that we have some in the medical community who have practiced in an environment for a lot of years where the life of the child was not valued equally.

Are you talking about in Idaho hospitals.

Specifically or like around the know? Because that was the way it was. It was a fetus, it was a clump of cells, and there wasn't the protection in the courts for the life of the child.

Unlike Senator Guthrie, who is worried about doctors leaving Idaho, representative Young thinks that some Idaho OB GYNs are exaggerating their fears about prosecution under the law. She says others are scaring themselves by overthinking the phrase to prevent death. She points to language in the law that says they can use their, quote, good faith medical judgment. Representative Crane, who talked about the pre row and post row mindsets of Republicans, also agrees with her on this. On this topic, he doesn't see as much gray.

If you're not performing elective abortions, you have nothing to worry about. It's just like if you're not going over the speed limit, you don't have to worry about a cop pulling you over for speeding.

Elective abortions is a phrase antiabortion lawmakers and activists use, but it's not a medical distinction. In medicine, any termination of a pregnancy for any reason is an abortion. Whether it's to prevent death or to help rape an incest victims or just not wanting to be pregnant. They're all just called abortions. Disconnects like this in terminology are another frustration doctors in Idaho have about the new laws OBG mans who have left and ones that are trying to figure out if they can stay but aren't sure if they can stay, is they're? Like the law is still vague to me.

What's the vagueness in the law?

The vagueness for them, there's an exception for life of the pregnant patient. But what does that need to be. How does that define? Is that 15% close to death? 50%? 45? And also there are these things that come up. This person has preclampsia. It is going to develop. I can't say when they're like, I can't operate in that area because there isn't that health language.

Honestly, do you think that if a doctor says, hey, look, I'm going to have to take your child goes the have to if I don't take the child, the mom's going to die. What do you want me to do? Take the child? He does that and you get a wildly aggressive prosecutor that says, I'm going to take you to court for violating the trigger law in the state of Idaho. You think a reasonable court of people that are made up of just honest citizens like you and I are going to say, yeah, we're going to throw you in jail for that, we're going.

To prosecute you for that?

They're not going to how long has the law been in effect? Right, been in effect a little over a year. Have any doctors been prosecuted? Have any cases come forward?

No.

I think what the doctors are saying is they're like, I know lawmakers are telling us that, but there is no guarantee that shooter isn't going to come after me. There is no guarantee that a family member isn't going to sue me, and I don't want to have to go to court. And I've also got kids and I've got a livelihood. We have an AG that's really aggressive. And so they're like the lawmaker's assurance of no one's going to come after you, you're not going to lose in court isn't assurance for me.

I understand. I mean, I spent more than almost 90 days listening to these exact same arguments. Look, life of the mother is life of the mother. It's not this highly technical, highly nuanced argument that I think that some of these folks are scared about. I don't know. I mean, you're a reporter, I'm an alarm guy. For me, it's pretty simple. Life of the mother. Hey, the mother's life. Yeah. Okay, then I have the ability to operate in this space.

I mean, I think that's where OBGYNs get mad. We have legislators who are not doctors.

That's true.

But on the flip side, you have doctors that are trying to tell legislators how to do their job. And we have constituents that are asking us, hey, this is what we want you to enact. And that's where the tension exists.

I ran by him and Representative Young some of the specific experiences I'd heard from pregnant women and OB GYNs, the actual people who've been stock shouldering the emotional and logistical burdens of the new abortion laws and how disconnected they said they felt from this new era in Idaho that's supposed to be pro life and pro family. Here's how Representative Young sees this moment.

So what I hear you describing a lot seems like adjusting. To a new situation. And undoubtedly there's a little pain with every change. So we just don't live in a world where everything works out perfectly all the time. And so that just because there's some inconvenience associated with making the policy change to protect life doesn't mean that it's not the right thing to do. Because there's always two sides to the story, and there are a lot of babies who are going to live in this state that might not have lived, and that's valuable, that's worth protecting, that's worth paying a price for, even if it means that there has to be some growing pains associated with that.

OBGYNs in the state have been telling me that access to good maternal health care in Idaho has deteriorated so rapidly over the last year that the state is now in crisis. Does that feel accurate to you? Is crisis the word that you would.

You know, I guess I haven't seen that yet. But what I keep coming back to as a legislator, if you're a physician that doesn't want to adhere to a standard of protecting both the life of the mother and the life of the child, then that may be frustrating for you. I think there's going to be some sorting out maybe as the standard of practice adjusts to what the statute mean.

I guess the concern is if people in adjustment is yeah, what I'm saying.

Mickey, is I don't think that we have to desert this value of protecting life in order to have a thriving OB community. We should be able to make these two things work together. And it might take a minute to have the conversation and figure it out, but I do believe that it's possible.

In the year after Idaho's new laws went into effect, representative Young and other lawmakers did end up making a few changes to the law. Some of the most notable, abortions are now legal for certain kinds of pregnancies that are never going to be viable. Like ectopic. Pregnancies and abortions are now legal for rape and incest victims if those victims do it in the first 13 weeks and file a police report. Since most sexual assault victims never report, this is still a steep barrier. But the thing OBGYNs wanted most new wording that would allow them to consider the health of their pregnant patients. Legislators didn't give them that. The lawmakers say they're still working on it. But after that legislative session ended, that's when most of the OBGYNs who left the state or decided to retire early got out. We're living in this moment where there's a political and ideological sorting happening in many parts of the country. There are people who are picking up and specifically moving to red or blue states to escape the laws their state legislatures have passed. It just seems easier than trying to change the politics of the place where you live.

But the big question for the patients I talk to in Idaho is how many OBGYNs will still be left standing to care for them after the sorting out period Representative Young brought up is finally done. In a recent survey, 50% of OBGYNs in the state said they were definitely leaving or still considering leaving. 50%.

Is one of the producers of our show. Two of the women in her story with high risk pregnancies, Becca and Kayla, are pregnant again, both with girls. Kayla recently moved out of state because of the abortion laws. Food speed ahead. You heard what I just said and don't look back it's time to get away and don't waste your time because that would be a crime you've got a plan don't wait another day well, today's program was produced by aviator Kornfeld and Nancy Updyke. The people who put together our show today include Jane Ackerman, James Bennett II, susan Burton, Jendai Bonds, sean Cole, Michael Comete, bethel Hapty stone Nelson, Catherine Raymondo nadi raymond elise Spiegel, lily Sullivan, francis swanson, christopher Sotala, matt Tierney, julie Whitaker and Diane Wu. Our managing editor sara abduroman our senior editor david kestenbaum. Our Executive Editor is Emmanuel Berry. Special thanks today to Emily Corrigan, Stacey Syed, Katie Bradish, Lauren Sanders, Leandra Wright, Jacqueline Kettler, Paige Belfry, Jen Jackson, Pintano, Becky Yurango, Liz Woodruff and Allie Block from the podcast The Nocturnists. Our website. Thisamericanlife.org, where you can stream our archive of over 800 episodes for absolutely free. Thisamericanlife.org this American Life is delivered to public radio stations by PRX, the Public Radio Exchange.

Thanks as always. Joe Brookham's, co Founder Mr. Tory Malatea. I don't know how he snuck into the Republican caucus this week as they've been fighting over who the new House Speaker should be. He said he totally figured out how to tell when any Republican was going to vote against Jim Jordan.

They make a really distinctive sound when they're really, really upset.

I'm Eric Glass. Back next week with more stories of this American life. Yeah, you knew all along this thing would turn out wrong. So goodbye and go full speed ahead. Speed ahead. Close. This is IRA Glass. Remember on the TV show Buffy the Vampire Slayer, how annoyed and offended the vampires on the show would get every Halloween, seeing people dress up in vampire costumes, they were like, Seriously? That's how you see us? That's what you think we are. Next week on the podcast of this American Live, we take that logic further. All that that supposedly spooky stuff at Halloween, we say, forget that. Let's talk about the everyday stuff that's truly scary. That's next week on the podcast or on your local public radio station.