I’ve spent more than five years sitting with women through some of the most vulnerable times in their lives: trying to conceive, pregnancy, birth, loss, and the tough, beautiful, overwhelming months after a baby arrives. I hold a perinatal mental health certification (PMH-C) because I believe this job deserves specialized, compassionate care.
So I want to talk with you as your neighbor, as a Catholic, as a proud Idahoan of more than 20 years, and as a Licensed Clinical Professional Counselor about Proposition 1 on our November 3 ballot, and why I believe a YES vote matters so much for the mental health of Idaho mothers and families.
I know this is a personal topic, and people in our community hold deeply felt beliefs on every side. My door at Hart Counseling is open to every client, whatever their views or their vote. What I’m sharing here comes from what I see in my work.
What Prop 1 actually does
Prop 1 is the Reproductive Freedom and Privacy Act, a citizen-led initiative that needs a simple majority to pass.
In plain language, a YES vote would:
Create a right to abortion before fetal viability, and after viability when a medical emergency threatens the pregnant person’s life or health.
Put into law the right to make decisions about contraception, fertility treatment (including IVF), and prenatal and postpartum care.
Protect doctors, nurses, and other providers from criminal penalties and professional discipline for providing that care.
Still allow the state to regulate abortion after viability, and keep existing conscience protections for providers.
A NO vote keeps Idaho’s current law: a near-total ban, with exceptions only to prevent the mother’s death and for reported rape or incest early in pregnancy. Under current law, performing an abortion is a felony carrying two to five years in prison.
That felony piece matters more than most people realize, and here’s why.
Fear doesn’t have a place in the exam room
When lawmakers, not medical professionals, decide what counts as the “wrong call,” evidence-based care becomes a criminal liability. Idaho families have shared stories of being sent home with dangerous complications and told to come back when they’re “sick enough.” Some have had to be flown or driven out of state for emergency care.
From a mental health perspective, that uncertainty is its own kind of harm. Many of these are wanted, longed-for pregnancies. Imagine receiving devastating news about your baby, and then learning your own doctor isn’t sure what they’re legally allowed to do for you. Then you’re sent home to figure it out alone: leave the state, or wait until you become “sick enough”. That combination of grief, fear, and helplessness is exactly the kind of experience that can lead to medical trauma, birth-related PTSD, and perinatal depression and anxiety.
I have too many clients coming into my office carrying this unnecessary secondary trauma. Pregnancy loss is already heartbreaking. I know that personally from my own loss in 2020, which some of you have read about here on my blog. But now, instead of only processing grief, we are processing two things at once: the complex grief of the loss, and the trauma of how it was handled. I’ve sat with women who were told their baby would not survive, with no brain development but a heartbeat, and that their doctors’ hands were tied. I’ve sat with a women who hemorrhaged after her misscarriage and nearly died because an OB/GYN wasn’t readily available.
That last story leads me to the next thing I want to talk about.
Our maternal care workforce is shrinking
Idaho lost more than a third of its practicing OB/GYNs between 2022-2024. Across our 37 most rural counties, home to nearly a quarter of Idahoans, only 23 OB/GYNs remain. Labor and delivery units have closed in Sandpoint, Emmett, and at West Valley Medical Center in Caldwell, right here in the Treasure Valley.
Today, about half of Idaho’s counties don’t have an OB/GYN. With so few trained professionals, women who face complications during birth may not have someone nearby who can help them in time.
This affects every pregnant Idahoan, not just someone facing a hard decision. Fewer providers means longer waits, longer drives, overloaded clinics, and less continuity of care. Have you tried to schedule your annual exam in the last couple of years?The OB-GYNs we do have are often booked many months out. When I scheduled my annual exam two months ago, the first opening was March 2027! (So consider this your friendly reminder to vote YES and schedule that annual exam.)
Mental health is the leading cause of maternal death in Idaho
This is the part I most want people to hear. Idaho’s own Maternal Mortality Review Committee found that the most common underlying cause of maternal death in our state is mental health conditions, including suicide and overdose, and that nearly all maternal deaths were preventable.
Prevention depends on the care we can provide: OBs, midwives, nurses, trained counselors, and psychiatric providers who can screen, refer, and treat. When we lose physicians and labor and delivery units, we lose the touchpoints where a struggling mom might be seen, screened, and supported. Most of my referrals now come from pediatricians, who are doing double duty, caring for the baby while also keeping an ear out for how mom is doing, because we just don’t have enough providers for moms.
Why I’m voting YES
I’m voting YES on Prop 1 because I want Idaho to be a place where:
Women can be honest with their doctors without fear.
Doctors can follow their training and act quickly in an emergency.
Families facing a heartbreaking diagnosis have options and time to grieve.
OB-GYNs want to come, stay, and build their careers here in beautiful Idaho.
Prenatal and postpartum care, fertility treatment, and contraception are protected as personal health decisions.
At its heart, perinatal mental health care is about trust: trusting women to know their own lives, and trusting the providers who care for them. Prop 1 is a step toward rebuilding that trust.
*If you’re struggling right now
If you’re pregnant or postpartum and feeling anxious, low, overwhelmed, or not like yourself, you are not alone, and it is not your fault. Help is available:
Postpartum Support International HelpLine: call or text 1-800-944-4773
988 Suicide & Crisis Lifeline: call or text 988
Caitlin Goicoechea-Hart, LCPC, NCC, PMH-C
Sources
Idaho Capital Sun, 2026 voter guide on Proposition 1
Idaho Capital Sun, “Doctors left Idaho after abortion ban, study confirms” (July 31, 2025), reporting on the JAMA Network Open study of Idaho’s OB-GYN workforce: https://idahocapitalsun.com/2025/07/31/doctors-left-idaho-after-abortion-ban-study-confirms/
Idaho Capital Sun, reporting on labor and delivery closures
The New York Times Magazine, on Idaho’s abortion ban and OB-GYNs (October 20, 2026): https://www.nytimes.com/2026/10/20/magazine/idaho-abortion-ban-ob-gyns.html
The New York Times, “Abortion rights activists in Idaho find their pitch: Bring back the doctors” (October 2026), via The Salt Lake Tribune: https://www.sltrib.com/news/health/2026/10/04/idaho-pop-1-supporters-hope-voters/
Idaho Maternal Mortality Review Committee reports: https://dopl.idaho.gov/mmr/