A first-in-the-nation ruling affirms that Dobbs did not give states license to force pregnant women to endure serious harm, and that the Constitution still protects the right to medically necessary abortion care.
Earlier this month, in the case of Seyb v. Members of the Idaho Board of Medicine, a federal district court issued the first post-Dobbs decision recognizing the U.S. Constitution still protects the right to abortion in specific circumstances. And while legal opinions rarely move me to tears—as even the most progressive outcomes are typically cloaked in legal jargon that does not communicate the often urgent or tragic human experience underlying the case—Judge B. Lynn Winmill’s deeply attentive opinion in Seyb did just that.
Idaho has one of the nation’s strictest abortion regimes: Abortion is generally criminalized at every stage of pregnancy, with narrow exceptions. As Winmill writes, as a direct consequence of this ban, “a woman’s body itself is conscripted into service and forced to bear permanent damage in service of the potential life she carries.”
In a stunning defeat for those who believe that pregnancy creates an exception to the “basic principle of bodily integrity,” Winmill makes clear the state may not elevate its interest in protecting potential life by stripping pregnant women of the “right to self-protection that is essential to the American tradition of justice.”
The plaintiff Dr. Stacy T. Seyb, who is represented by a legal team from The Lawyering Project and Legal Voice, is a fetal-maternal specialist at St. Luke’s Health System. Prior to Idaho’s abortion ban—a trigger law designed to take effect if and when the Supreme Court returned authority over abortion regulation to the states—he provided abortion care to about 10 to 20 patients a year with serious health complications.
Since then, fearing “performing some medically necessary abortions would put him at risk of imprisonment, fines and cumbersome legal proceedings,” he instead refers these patients out of state for needed abortion care.
Underscoring the punitive harshness of this reality: Since the ban went into effect in 2022, 35 percent of practicing OB-GYNs have left the state, according to a JAMA article cited by Winmill.
This unforgiving access landscape compelled Seyb to file the lawsuit, in an effort to establish a “constitutional right to medically indicated abortion care.”
As he explained in a press release on the day the lawsuit was filed,
“Idaho’s abortion bans not only threaten healthcare providers like me with criminal prosecution, but they jeopardize the health and lives of pregnant people throughout the state. Because of these cruel laws, my patients have been forced to travel outside Idaho to obtain potentially life-saving healthcare, sometimes on an emergency basis by helicopter, further endangering their health in an already dire situation.”
On the eve of trial, Idaho Attorney General Raúl Labrador suggested the legal challenge mounted by Dr. Seyb’s legal team was little more than a foolhardy attempt to relitigate Dobbs.
As he insisted to the Idaho Capital Sun, in overturning Roe v. Wade, the Supreme Court “made clear that there is no right to abortion in the U.S. Constitution, and that states have the right to determine abortion policy [and] this applies to … abortions that are done for a medical reason.”
As Wendy Heipt, senior attorney at Legal Voice, puts it: The decision in Dobbs “didn’t take away or even speak to the right of self-preservation and self-defense, which are different.”
Accordingly, the case presented the court with a novel legal question: Are Idaho’s abortion ban exceptions “so narrow that it crosses a … constitutional line that forces pregnant people to accept death or serious permanent harm”?
In a direct response to the legal team’s framing of the case—and firmly rejecting Labrador’s baseless relitigating Dobbs claim—Winmill identified the lawsuit was about:
- a pregnant woman’s ability to seek necessary obstetric care under the most difficult and tragic of circumstances;
- whether the state may pick and choose which life-threatening conditions can justify an abortion; and
- self-preservation and the limit of the state’s power to make a woman suffer for the sake of an unborn child.
Grounded in these principles, Winmill held that Idaho’s abortion ban was unconstitutional on two independent grounds:
- It violated the 14th Amendment’s Due Process Clause by denying pregnant patients a fundamental right to medically indicated abortion care.
- By excluding self-harming behavior from the law’s life-saving exception, it denied patients with mental-health conditions equal protection under the 14th Amendment.
The Constitution Protects Medically Necessary Abortion Care
Drawing upon the historical evidence presented by Seyb’s legal team, Winmill concluded the right to a medically indicated abortion is “deeply rooted in our nation’s history and tradition.”
In this regard, the record established, “State legislatures and state courts have consistently shielded health-preserving abortions from prosecution for the past two centuries” through a liberal “interpretation of the life-of-the mother exceptions in early abortion prohibitions,” often by treating “life and health as synonymous.”
Making clear, as argued by the legal team, that Dobbs did not eviscerate the right to a health-preserving abortion, Winmill explained, the right “reflects the underlying principle of self-protection, which is undeniably implicit in our scheme of ordered liberty. These longstanding protections for health-preserving abortions exist within a deeper right to self-protection that is essential to the American tradition of justice.”
And yet, as he pointed out, Idaho’s abortion ban “contradicts this long tradition and the underlying right to defend oneself from harm,” by extending it to “every population except pregnant women, who must endure every harm short of death to serve the state’s interest in forcing their bodies to bear a child.”
Repudiating Idaho’s claim that Dobbs gave states license to conscript women’s bodies against their will in service of pronatalist aims, Judge Winmill’s first-in-the-nation ruling affirmed that federal constitutional limits still constrain how far states may go in compelling women into reproductive service—even in the post-Dobbs landscape.
Unfortunately, however, Winmill also ruled that, absent a medical risk to the pregnant person herself, there is not a protected right to abortion in cases of a fetus with a life-limiting anomaly or a multifetal pregnancy where “the abortion of at least one fetus increases the chance that the others will live.”
Accordingly, since these situations fall outside the boundaries of the protected constitutional zone, Idaho was left free to elevate its interest in “protecting potential life and affirming the dignity of children with profound disabilities” over the bodily integrity of the pregnant person, declaring that “the denial of such care is ‘incompatible with the concept of human dignity and has no place in a civilized society.’”
Mental Health Emergencies Are Medical Emergencies
… pregnant people with serious mental health conditions should be treated no differently than those with physical health conditions.
Paige Suelzle, The Lawyering Project
Winmill further ruled Idaho’s exclusion from the life-threatening exception to the ban of self-harming behavior that may result in death violates the equal protection clause. As he explained, although “mental health disorders manifest behaviorally, they are medical conditions with origins in the physical body.”
Accordingly, Idaho may not single out abortion seekers at risk of death from self-harming behavior, for disfavored treatment.
Paige Suelzle, litigation counsel at The Lawyering Project, stressed to Ms. the importance of the court’s recognition “that pregnant people with serious mental health conditions should be treated no differently than those with physical health conditions”—especially since “mental health conditions were the most common cause of pregnancy-related death in Idaho from 2014 through 2024.”
Walking Through the Constitutional Door Left Open by Dobbs
In a major abortion rights victory, Seyb’s legal team prevailed in its effort to establish that the right to health and life-saving abortions are “housed in a constitutional lane that is wholly distinct from the protective [right to privacy] lane for abortion that was established in Roe and eviscerated by Dobbs. [This accordingly] will enable pregnant Idaho residents with medical indications to obtain abortion care in their home state without incurring the financial, logistical and emotional burdens of interstate travel or being exposed to further health risks because of such travel.”
However as Winmill acknowledges: This is not the end of the road. The decision leaves “pregnant women faced with a devastating fetal diagnosis [to] either [still] bear the challenges of pregnancy while waiting to watch their child die, or flee the state to receive appropriate medical care.”
Winmill finds it troubling that Idaho has made a policy decision to treat women in this situation “more as incubators for a fetus who will not survive than as human beings with the capacity to make an extraordinarily difficult decision about their bodies and their families.” Due to constitutional limits, the solution to this access inequity “lies at the ballot box rather than the courthouse.”
In their initial complaint, Dr. Seyb and his legal team similarly emphasized that the requested relief “will address only a fraction of the harm that Idaho’s Abortion Bans are causing.” While meaningful, they wrote, such relief alone cannot secure justice for all Idaho residents; that would require repeal of the abortion bans through legislation or direct democracy—or the Supreme Court’s reversal of Dobbs.
Voters may soon have an opportunity to pursue that broader relief: In the upcoming midterms, Idahoans can cast a vote in favor of the Idaho Reproductive Freedom and Privacy Act, a ballot initiative to restore abortion access in the state.
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A note from Ms. editors: We want to hear from you for The Majority, a new campaign collecting stories about how reproductive freedom has enabled readers to build the lives they want and need. Poll after poll shows a majority of Americans support reproductive healthcare access. Yet public debate overlooks the lives shaped by abortion access, contraception, IVF, miscarriage care, maternal healthcare or comprehensive sex education—countless women who chose to pursue an education, have children, not have children, protect their health and chart their own future. Add your voice and complete the sentence: “Access to reproductive choices gave me the freedom to….” Together, these stories will help show not only why reproductive freedom remains a majority value, but also what it makes possible.
Look to these trusted groups if you or a loved one needs to know more about reliable abortion care:
- A one-stop-shop for abortion seekers: I Need An A
- Other websites to explore all your options for abortion care: Plan C Pills, Abortion Finder
- Safe websites to buy abortion medication: Aid Access, Massachusetts Medication Abortion Access Project, Hey Jane
- If you need help affording abortion care, tell your telemedicine provider or contact an abortion fund near you.
- To protect your digital privacy when planning your abortion, click here.
- For free legal help as a patient or doctor, call If/When/How’s Repro Helpline—844-868-2812—or contact Pregnancy Justice.
- For medical advice, contact the Miscarriage & Abortion Hotline: 833-246-2632.
- If you need to know the abortion law in your state, look to the Center for Reproductive Rights. or Guttmacher Institute.
