OPINION: A private and personal decision

Proposition 1, the Reproductive Freedom and Privacy Act, will appear on Idaho's Nov. 3, 2026, general-election ballot. If approved, this initiative will re-establish for women their right to keep the government out of private and personal medical decisions.

Prop 1 includes abortion before fetal viability and in certain medical emergencies after viability. Today, Idaho Code 18-622 makes performing an abortion a felony punishable by two to five years in prison.

Reproductive-health decisions are extremely personal. They should only be made by patients in consultation with their healthcare providers and not be dictated by the government.

I am not a woman of course, but I can speak to this issue from two points of view.

As a practicing Certified Registered Nurse Anesthetist. I’ve spent the last 40 years working in hospitals where pregnancy related complications were treated almost daily. And for a while I provided anesthesia coverage at a Planned Parenthood facility.

In those settings, I cared for many women undergoing pregnancy terminations. 

None of these procedures was an easy experience. Not for the physicians and nurses, and certainly not for the patients. There were days when we left the operating room close to tears — not because of a political position about abortion, but because of the difficult circumstances surrounding the patients and their families.

One lesson that stayed with me was how little the reality of abortion resembled the political rhetoric surrounding it. In the hundreds of patients I encountered, I never saw someone treat abortion casually or as a substitute for contraception. Every patient had a distressed personal story and circumstances that led her to that decision.

As a young adult, I dated a woman who became pregnant. We were college students. Neither of us wanted to remain together, and neither of us was in a position to provide a child with the stability and support we believed a child deserved.

Had that pregnancy continued, the child would be 47 years old today.

The entire experience was fraught. But I don’t regret that relationship, nor do I regret the decision we made together. If anything, I believe more men should face up to their roles and responsibilities related to unplanned pregnancy.

Years later, I married and raised two beautiful children. 

These experiences reinforced for me that reproductive decisions are deeply personal and that circumstances differ enormously from one pregnancy to another.

That is why I believe if we discuss Proposition 1 openly and honestly, we will pass it in November.

The measure restores reproductive freedom and protects the ability of patients and their health care providers to make private medical decisions without fear of governmental intrusion. 

Opponents mischaracterize the measure. They argue that it would significantly expand abortion rights. I think that is untrue. Prop 1 merely returns a right that Idaho’s women had before Roe v. Wade was reversed.

Disagreements over Prop 1 deserve to be addressed on the basis of what the initiative actually says rather than through slogans or exaggerated claims.

The medical-emergency provisions are particularly important. Idaho physicians have continued to raise concerns about uncertainty surrounding the state's existing abortion law and its medical-emergency exception. The Idaho Medical Association reported in 2026 that questions about the exception remained unresolved following the legislative session.

Reasonable people can disagree profoundly about abortion. Some disagreements are rooted in religious convictions; others are based on philosophical, moral or medical beliefs. Those differences are real and deserve respect.

Not everyone’s circumstances are the same as our own. That goes for all of us.

Pregnancy can involve difficult diagnoses, medical emergencies, rape, infertility, miscarriage, financial hardship, personal relationships and deeply painful choices. The people facing those circumstances are not abstractions. They are patients, loved ones and physicians.

For me, the central question is who should make these intense personal medical decisions.

I believe those decisions are best made by patients in consultation with medical professionals who truly understand their individual circumstances.

Whatever one's position on Proposition 1, the conversation should be grounded in facts, compassion and respect.

Reproductive decisions are private and personal. Our disagreements should not prevent us from treating the issue honestly and treating one another with dignity.

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Evan Koch is chairman of the Kootenai County Democrats.