Doctors Warn Abortion Bill Would Restrict Montana Obstetric Care

A bill introduced by Kalispell Rep. Matt Regier that would ban dilation and evacuation procedures is currently being considered in the Montana Senate

By Denali Sagner
The state capitol building in Helena. Beacon file photo

Bills seeking to limit abortion are taking center stage as the 68th Montana Legislature moves into its penultimate month, prompting medical providers to warn of an ominous future for labor and delivery care across the state.

During a contentious hearing on Tuesday, the Montana Senate Judiciary Committee heard testimony on House Bill 721, a proposal by Speaker of the Montana House Rep. Matt Regier, R-Kalispell, that would ban dilation and evacuation (D&E) procedures in Montana, a form of abortion and miscarriage treatment.

Though Regier emphasized in an address to the committee that House Bill 721 is not about “the abortion debate,” participant testimony, as well as questions from the committee, delved into issues of abortion access, religious freedom and privacy rights, echoing debates that have embroiled Montana since the overturning of Roe v. Wade last June. Despite exemptions in the bill that would allow physicians to perform D&E procedures in emergency cases, medical professionals speaking about House Bill 721 forecast grim consequences for labor and delivery care in Montana should the legislation pass, as it would threaten doctors with severe criminal and financial penalties.

Formally titled “An Act Creating the Dismemberment Abortion Prohibition Act,” House Bill 721 would outlaw D&E, a procedure performed by physicians in the case of miscarriage, pregnancy complications and elective abortion. During D&E, a physician dilates the cervix of the patient and removes fetal tissue through vacuum aspiration. The bill text states that D&E, which it calls “dismemberment abortion,” is “a barbaric practice, is dangerous for the pregnant woman, and is demeaning to the medical profession,” characterizations that were refuted repeatedly by healthcare providers.

“There is no established medical procedure that uses the disrespectful language as stated in the title of this bill,” Nicole Smith, the executive director of Blue Mountain Clinic in Missoula, one of the state’s few abortion providers, said.

Tim Mitchell, a Missoula-based maternal-fetal medicine specialist, told the Beacon on Wednesday that D&E is “a relatively uncommon procedure” in abortion clinics in Montana, and that rather, the procedure is most commonly used for women experiencing miscarriage or pregnancy loss in the second trimester. Mitchell said that D&E is a “critical procedure in the setting of medical emergencies,” such as abdominal trauma from vehicle accidents or cases of domestic violence.

While the bill includes exceptions for the removal of ectopic pregnancies and for medical emergencies, Mitchell said that in many cases, such exemptions are rendered irrelevant in the face of hefty criminal penalties for doctors, and that effective labor and delivery care would likely still be impacted in Montana should the bill pass.

Under House Bill 721, healthcare providers who perform a D&E are guilty of a felony and can face a fine of up to $50,000 and/or five to 10 years in prison, in addition to a loss of their medical license. Physicians and physician assistants who fail to report a D&E can also face fines.

“Physicians should be able to provide care without the fear of such excessive penalties,” Jean Branscum, CEO of the Montana Medical Association, said during the Tuesday hearing. “The practice of medicine is complex. Medical standards of care and the given medical situation should drive care, not the fear of going to prison.”

“My major concern is how it will impact the ability to perform this procedure in an urgent fashion in a life-threatening situation,” Mitchell said, outlining situations where doctors are afraid to perform a D&E, even to save the life of a patient, for fear of legal retribution, a pattern that has taken shape in other states that have passed abortion bans.

Earlier this month, Bonner General Health in Sandpoint, Idaho, announced that it would no longer deliver babies or provide obstetrical services, due in large part to laws passed by the Idaho Legislature that have restricted obstetric care and imposed heavy penalties on physicians. Many such laws, the hospital said, have driven providers out of the state entirely.

“Highly respected, talented physicians are leaving [Idaho]. Recruiting replacements will be extraordinarily difficult,” a March 17 press release from the hospital stated. “In addition, the Idaho Legislature continues to introduce and pass bills that criminalize physicians for medical care nationally recognized as the standard of care. Consequences for Idaho Physicians providing the standard of care may include civil litigation and criminal prosecution, leading to jail time or fines.”

Pregnant women in Sandpoint will now have to drive 46 miles for labor and delivery care moving forward, according to reporting from the Idaho Capital Sun.

The Senate Judiciary Committee will vote on House Bill 721 in the coming days. The bill passed the House of Representatives on March 3 on a party line vote.

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