A hospital in a rural area outside of Idaho’s capital city of Boise closed its labor and delivery and neonatal intensive care units April 1, citing declining birth rates and staffing issues.

West Valley Medical Center is the third facility to close its maternity services in Idaho since the state enacted a near-total abortion ban in August 2022. The county where the medical center is located had more than 3,300 births in 2022, and West Valley sees about 45,000 outpatient visitors in a year. The entire medical center has 112 beds.

The law subjects physicians to two to five years in prison, fines and the loss of their medical license for providing an abortion, even in emergency situations, at least until the U.S. Supreme Court makes a definitive ruling on the federal Emergency Medical Treatment and Labor Act’s application in Idaho. Oral arguments in that case will take place April 24.

A February report by a coalition of Idaho physicians found the state lost 22% of practicing OB-GYNs since the ban took effect, and 55% of maternal-fetal medicine specialists. The first closure happened in Sandpoint, at Bonner General Hospital in March 2023. The hospital cited the political climate along with staffing issues in its announcement as the reason for closure.

West Valley did not specifically call out the abortion ban or other politics as a reason for closure, but Dr. Ted Colwell, who worked there full time for many years and as a retiree until the April 1 closure, told States Newsroom he thinks it was a factor. Colwell describes himself as “pro-life,” but he is concerned about the state of medical care in Idaho.

His responses to questions have been edited for clarity and conciseness.

States Newsroom: What’s your experience with West Valley Medical Center in Caldwell?

Dr. Ted Colwell: I moved here from a residency training and started practicing in 1982 at what was then called the Caldwell Women’s Clinic, which started in 1969. I was the fourth physician in the group, and I’ve been basically in that practice for 36 years, though it has gone through different names and changes of staff. West Valley was always owned by HCA Healthcare, and we had a general OB practice. Someone asked me how many deliveries I’ve done over the years, and it’s around 7,000.

SN: When did you retire?

Colwell: I retired in 2016. Because our group is accredited by the American Institute of Ultrasound Medicine, they needed someone to take on the role of reading ultrasounds for the clinic, so I’ve been doing that since I retired but that’s mostly from home.

SN: What was it like when you were told about the closure?

Colwell: I knew we were struggling, but when the announcement came, I was shocked. Caldwell is kind of a funny hospital in a sense that it’s kind of rural, but we had excellent maternity services and neonatal intensive care there. The hospital serves not only Caldwell, but a lot of the surrounding areas, so it’s not a small rural hospital, it’s a small regional hospital. St. Lukes and Saint Alphonsus (the two major hospital systems in the state) have spread their hospitals west at the same time, so in a way West Valley became surrounded, but that being said, we still have a very loyal patient population. I’m just sorry that something couldn’t be done to keep the services going at West Valley. I think they tried everything they could.

SN: What do you know about the staffing issues that led in part to the closure?

Colwell: I’ve been sort of involved with some of the recruitment efforts and interviewing of some of the potential candidates. Last year, we had five potential candidates, and due to various situations, all five decided to go elsewhere. Idaho used to be a state that attracted OBs for the outdoors, for the family values, the recreation — it’s a good place to live. But I think the overturn of Roe v. Wade had an impact, even though Idaho wasn’t known for large numbers of abortions. I know abortions happened here, and some physicians provided them, but the vast majority of the physicians I knew over the years did not do elective terminations. It didn’t really become an issue for me until this whole issue with the hospital came to a head.

What I heard from others was that those who were interviewed in the last year expressed concerns regarding the legal climate and concerns of prosecution, which led them to not take our offer of employment. These concerns were from those that were relatively fresh out of training. I, on the other hand, wouldn’t care about that, and would do the right thing for the patient regardless. I guess that comes with 40-plus years of experience.

SN: Why do you think closing the labor and delivery unit is cause for concern?

Colwell: I feel that women and mothers bring families to the hospital, children and husbands, and when you lose that, there’s a risk of losing a lot of services at the hospital. People will be starting to drift off to other facilities further away to get their care. And when you come to the emergency room, if you’ve got a condition where it’s gynecological and there’s no one in the hospital who can take care of it, to me it puts the hospital in a bad situation. If a patient halfway through their pregnancy is told, “You’re going to have to find somebody else,” first of all, can they find somebody else? And two, can the other clinics who are still active absorb these patients? It’s going to put stress on the whole system.

SN: You described yourself as “pro-life.” Tell me what the difference is for you when it comes to this kind of medical care.

Colwell: There comes a time when you have to make a medical decision for the life of the mother. It’s taking care of patients. People are going to suffer under this law, and it makes me mad that politicians get in the way of evidence-based medicine. I think they should not make it a criminal offense to take good care of women who need medical care and treatment.

SN: What else do you want to add about the current landscape of maternity care in Idaho?

Colwell: I wish the legislators that push these laws through would think about the consequences of their actions. I think they kind of shoot from the hip, is my feeling, and they’re trying to make a statement, and I have not seen a real push (from organizations) to educate the legislators as to what the heck they’re doing. Why don’t you consult with the people that are involved? I mean, my gosh.

I hope West Valley can survive this. And it probably will. But it’s going to affect a lot of people in the meantime.