Idaho voters have rejected a ballot measure that would have restored legal abortion access, leaving in place one of the strictest bans in the United States in a state where a peer‑reviewed study found 43 per cent of obstetricians left or stopped practising obstetrics in just over two years.

Proposition 1, the Reproductive Freedom and Privacy Act, failed on Tuesday with 56.32 per cent against and 43.68 per cent in favour, according to unofficial results.

The Associated Press called the race for opponents early on Wednesday, with 286,909 votes recorded in favour. Results will not be official until they are certified by the Idaho State Board of Canvassers, which meets this month.

The defeat means the state's near‑total ban, in force since the Supreme Court overturned Roe v Wade in 2022, remains law.

Idaho's near-total abortion ban generally permits abortions to prevent the death of the pregnant woman or, during the first trimester, in documented cases of rape or incest. However, a federal judge has also blocked the state from prosecuting doctors who provide abortions to protect a pregnant patient's health or prevent self-harm.

Idaho's attorney general has said he plans to appeal. Doctors who violate the ban can face felony charges and professional licensing penalties, while a separate state law allows certain family members to sue providers for at least $20,000 (£14,828) in statutory damages.

Had it passed, the measure would have repealed the ban and allowed abortion until foetal viability, generally around 23 to 25 weeks, and later only in medical emergencies. It would also have enshrined rights to contraception, fertility treatment, miscarriage care and pregnancy‑related care.

Obstetrician Numbers at the Centre of the Idaho Abortion Rights Row

The study, published in JAMA Network Open, found 114 obstetricians left Idaho or stopped practising obstetrics between August 2022 and December 2024. That equals 43 per cent of the 268 doctors practising obstetrics in the state. Twenty new obstetricians arrived over the same period, a net loss of 94.

Not all of those left Idaho. Of the 55 OB-GYNs who stopped practising obstetrics in 2024, 23 moved out of state, 12 retired, nine switched to gynaecology-only practice, seven moved from rural to urban practice sites and four moved elsewhere within Idaho.

The cause is disputed. Scott Tucker, practice administrator at Women's Health Associates in Boise, has said departures from his practice were mostly due to other factors, including population growth and a national shortage of obstetricians and primary care providers.

Melanie Folwell, executive director of Idahoans United for Women and Families, which led the campaign, called the result 'a tremendous, frankly gutting, loss, especially for the women, families, and physicians of Idaho'. Mary Strow, communications director for the opposing Stop Prop 1 campaign, said: 'The people of Idaho have spoken.'

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Idaho Abortion Rights Campaign Drew Millions From Both Sides

Idahoans United gathered more than 110,000 signatures to qualify the measure, against a minimum of 70,725, including support from at least 6 per cent of registered voters in 18 of Idaho's 35 legislative districts.

Opponents included the Idaho Republican Party, the Church of Jesus Christ of Latter‑day Saints, which gave $1 million (€930,000 and £795,000) to the opposing Too Extreme for Idaho committee, and the Roman Catholic Diocese of Boise, which gave $300,000 (€279,000 and £238,000).

Governor Brad Little, a Republican, said before the vote that Proposition 1 'simply goes too far', arguing that it would allow under‑18s to obtain abortions without parental consent. Supporters have said the measure was not intended to override such laws.

The Idahoans United committee raised more than $5.8 million (€5.4 million and £4.6 million) and spent more than $2 million (€1.9 million and £1.6 million), according to state campaign finance records. Too Extreme for Idaho had raised more than $4 million (€3.7 million and £3.2 million) by mid‑October.

Since the Dobbs ruling, voters in 17 states have considered abortion‑related ballot measures, according to the health policy research group KFF. Idaho joins Florida, Nebraska and South Dakota, where voters rejected measures to expand access in 2024.

Campaigners said they would urge lawmakers to add exceptions to the ban in the coming legislative session.

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