I
think that that's what's hard for folks
that don't have a medical background to understand
is that that is the area we always deal in this gray area and,
and we're constantly weighing our decisions of, of these are the probabilities.
What decision do you want to make as the patient?
Uh It's almost never a clear cut answer on most of medicine.
That is Doctor Lauren Coulson,
a family physician who provides obstetrics and
reproductive care to the Treasure Valley.
That interview was done the day
the US Supreme Court overturned Roe V Wade on June 24th, 2022
and that Dobbs decision triggered Idaho's abortion ban putting doctors in a
position to be prosecuted for performing or helping a woman to have
an abortion. He was talking about the muddled mess that put doctors in
would that bill or that law go into effect?
And that day he was explaining his concern,
not really knowing what situations would warrant an abortion when it comes
to saving the life of a mother because that was the definition
because nothing is ever 100% certain. As he told us,
one thing,
Doctor Coulson was sure of he didn't expect two years later or nearly
that he would be talking publicly about what happened to his wife.
That Idaho's abortion laws would lead to issues on how to handle a miscarriage
of which there are three ways you could have a surgical procedure
known as AD and C which is taken care of that day.
You could take some medicine which takes a couple of days, but
it's convenient, safer option for a lot of women
or you could rely on what is called expectant management
where the body expels the pregnancy itself. But that could take weeks or months.
It is unpredictable.
Here's what happened when Kristen Coulson was offered those options.
Um
Doctor Lauren Coulson. Yeah, it's been
about 3, 3.5 years and his wife Kristen have been trying for a while to have a baby.
Then several weeks ago, it was not this last Friday, but the previous Friday,
Kristen found out she was pregnant
again.
This time, we went in for our ultrasound and we had what's called an an
embryonic pregnancy
where a gestational sac will grow in the uterus, but there isn't
an embryo that's growing with it or the embryo grew and was reabsorbed.
I mean, it's a very clear non viable pregnancy.
Kristen is familiar with the non viable pregnancy,
having miscarried multiple times,
which means she's also familiar with her options.
It's called expectant management where your body
um,
resolves the miscarriage on its own and then there's
also um a procedure called AD and C.
So it's a surgical procedure.
There's also medication that you can take and it's prescribed by your physician.
You chose the.
Yes, I chose the medication based on my past history.
Um And my experiences with the other options,
I felt that the medication was the best option for me with this pregnancy.
The medication she was prescribed was miSOPROStol which causes the
uterus to contract to expel a non viable pregnancy.
It's also one of the drugs used in an abortion.
So
your doctor gave you a prescription
and you took it to the pharmacy.
Yes, it, it was immediately sent to my pharmacy after my doctor's visit.
Then what happened?
Um Typically I get a text message when my prescriptions are ready from
my local pharmacy and I didn't receive a text message that day.
So finally,
Kristen called and asked the pharmacist and they shared with
me that they were not going to fill the prescription.
They did not feel comfortable filling the prescription at that dosage.
Um Due to the Idaho laws, Idaho laws as they pertain to abortion
would make anyone helping to perform that procedure
liable to time in prison a
fine
and a loss of their medical license.
What did you say?
I was shocked and confused frankly.
Did they give any other explanation besides that?
No,
they recommended that I call my doctor's office
and have the prescription sent to another pharmacy.
What was that like for you?
It was hard. I mean, anyone that's gone through a miscarriage, it's a very
emotional and,
um,
sad time to begin with and,
you know, thinking that I can just go to my Pharma pharmacy,
get this prescription filled and,
you know, we can resolve this.
It,
it was
frustrating.
Yeah. I think that there's a lot of concern, um,
around medications like miSOPROStol that are also part of a
regimen if you were having an abortion as well.
Um,
and for the pharmacists, I think just like as a physician sometimes,
if there's a lot of
ambiguity with the laws where people aren't quite sure,
don't understand exactly what they can and can't do.
And
so where does my liability?
We
wanted to get a pharmacist perspective.
What boxes do I have to check
in order to make sure this is a
legal prescription.
Do you think pharmacists are wary of,
kind of fulfilling some of these prescriptions based on Idaho's abortion laws?
I do. Well, I mean, you think it's, it's much easier
to just
not fill a prescription. Um, that's the kind of the easy way out, the safe way.
It's the safe way out.
And I think it's out of abundance of caution, you know,
no one wants to violate a law but if the education isn't
coming down from the state or if the law isn't clear,
then it's really hard to make those distinctions,
pregnancy
complications that lack of clarity is why Doctor
Coulson wanted to take his wife's story public
posting on social media because of idol laws. So that's cool.
The day it happened when uh
Lauren wanted to kind of take it out in the public. Were you ok with that?
Absolutely.
I think that it's important for people to
hear these stories and get a better understanding
of the impact that the laws are having on the community.
Do you think that
raising awareness and, and like bringing attention to this
will change anything?
I hope so,
miscarriages are incredibly common.
And so while this happened to Kristen and this happened to us and,
and we're being public about this, this is happening to
tons of people throughout the state all the time.
And
I think for
our legislators and others to realize how common it is, people need to talk about it.
And that's a big reason why we decided to talk about it.
Kristen told us she's fortunate to be married
to a physician who specializes in reproductive care.
So she knew what was allowed and what wasn't?
She knew this pharmacist was likely misinterpreting the law.
They live in Boise and she was able
to get her prescription filled at another pharmacy.
But
she said she was also worried about those women who
live in smaller towns across Idaho with fewer options.
Doctor Colson pointed out miscarriages.
Yes, they are common according to the National Library of Medicine.
As many as 26% of all pregnancies end in miscarriage.
So likely there are going to be women who run into this problem at some point,
which is why at his clinic,
they just keep medications like this, this miSOPROStol on hand.
So patients can avoid
any hassle of a pharmacist refusal.
Both he and the pharmacist would like to see some directive.
That'd be Matt Murray from Custom Medica that we spoke with today.
Both he and Coulson would like to see some directive and
education from the state to clear up any confusion when it comes
to miscarriage medications and treatment.