BOISE, Idaho — A federal judge says Idaho can’t prosecute doctors who perform abortions to protect a pregnant person’s health or prevent self-harm.

U.S. District Judge B. Lynn Winmill made the ruling Thursday, writing that Idaho’s “Defense of Life Act” and “Fetal Heartbeat Act” — which together create a near-total ban on abortion — violate the due process and equal protection clauses of the 14th Amendment. Physicians who violate the laws can lose their license and face up to five years in prison.

Both laws include narrow exceptions, including abortions done to prevent the death of a pregnant woman or in some cases of rape or incest where the pregnant person has filed a police report.

The case isn’t about bodily autonomy or reproductive choice, Winmill wrote in the 81-page decision, but rather the “limit of the state’s power to make a woman suffer for the sake of an unborn child.”

The state can’t pick and choose which life-threatening conditions justify abortion, he wrote.

“A pregnant woman’s health is not a state resource to be allocated at the legislature’s whim,” Winmill wrote.

Idaho’s attorney general plans to appeal

Dr. Stacy Seyb, a Boise maternal-fetal medicine specialist who sued over the law in 2024, said the ruling will allow him to practice medicine without fear of prosecution, and to offer patients with serious medical conditions the option of ending a pregnancy without having to leave the state.

Idaho Attorney General Raul Labrador said he would appeal, and is “confident this decision will be overturned.”

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“The Supreme Court made clear that abortion policy belongs to the people and their elected representatives, not a single federal judge,” Labrador wrote in a statement.

A doctor says the ban forced patients out of state

In the lawsuit, Seyb said he wanted to provide abortions to patients facing serious health risks, including those at high risk of self-harm from mental illnesses. He also said he should be able to provide abortions when the fetus has been diagnosed with a fatal or grave condition, when a miscarriage is inevitable, or in multi-fetal pregnancies where reducing the number of fetuses would increase the likelihood that the others would survive.

Attorneys for county prosecutors and the Idaho Attorney General argued that Seyb misunderstood the state’s abortion ban, and that the ban already allows most health-preserving abortions. But Winmill said there is a gap between life-saving abortions and abortions performed to prevent non-lethal harm, and noted that Seyb said he has to refer patients in that gap to other states for care — including several with grave pregnancy complications who had to be flown to Utah for treatment.

Judge: Idaho can’t force women to bear permanent damage for a fetus

Winmill said just like the state can’t force a mother to donate a kidney to her toddler, it can’t force a pregnant woman to suffer serious harm for a fetus.

The judge also said there is no reason to treat mental illness differently than other health conditions. Barring a pregnant woman from life-saving care for mental illness threats is “an affront to human dignity,” Winmill wrote.

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Seyb noted suicide and overdose are among the leading causes of death for pregnant and post-partum people in the U.S., and that between 2018 and 2021 mental health conditions were the most common underlying cause of maternal death in Idaho according to the state’s Maternal Mortality Review Committee.

In cases where there is no elevated health risk for the mother — including situations where the fetus will die shortly after birth or in multi-gestation pregnancies where aborting one fetus will help the others survive — there is no fundamental right at stake, Winmill found.

That’s because in these cases, the law is rationally related to the state’s interest in preventing abortions based on mistaken fetal diagnoses and affirming the dignity of people with profound disabilities, Winmill wrote.

And physicians could still face civil penalties for performing abortions under another state law, which allows extended family members of an aborted fetus to sue the provider for at least $20,000.

Abortion is on the ballot this fall in Idaho and other states

Idaho voters will decide this fall whether to roll back the state’s abortion ban. If approved, the voter-led initiative would allow abortion until fetal viability, which is generally considered to be after 21 weeks.

Voters in Virginia and Nevada, where abortion is legal through at least 24 weeks, will consider state constitutional amendments creating a right to abortion. In Missouri, voters are being asked to override a constitutional amendment passed in 2024 in order to bring back an abortion ban.